tinnitus A Little Help Here

[samclemmons]

While in service I jumped a fence and landed on a pitchfork driving it through my foot. Two months later I had surgery to remove cellulitis/plantar fibromatosis. I spent 30 years with an altered gait but it wasn't till the last 5 or so years that it got bad. I was service connected this year for post tibial paralysis. In the last 6 months I've developed ankle and knee problems my podiatrist calls neuritis, plantar fasciitis both feet, pes planus with calcaneal(sp) and interdigital neuroma left foot all of which my civy doctor says are directly related to my altered gait. I've also got tinnitus and hearing loss which my ear nose and throat guy says is attributable to a 13 month hitch in the hangar in GTMO bay.

so,

1. service connected - post tibial paralysis

2. secondary issues - bi fasciitis, bi pes planus, Mortons neuroma, neuritis ankles and R knee, attributable to altered gait.

3. Request service connected - Tinnitus/hearing loss - jets/aircraft engines

Figuring out these rating numbers is confusing. Does sombody have a handle on these?

A. Should I file an informal claim with this?

B. Is there an example of a 21-4138 that has been filled out and filed that I can view? (I'm a better mimic than I am a freestyler.)

C. I've got the diagnosis and nexus letters for the secondary issues as well as the Tinnitus/hearing loss. What else do I need?

thanks for your help

[Berta]

You presented exactly what the 21-4138 should contain right here in your post-

what you want SC for, and why you should get it.

If I were you I would attach copies of any statements from your civilian doctor and the 'ear,nose, and throat guy' that support your claim to the 21-4138 and tell VA they are attached in the 4138 statement.

WOuld they be willing to provide a more detailed Independent Medical Opinion fopr you- there is topic under search feature here as to how this IMO should be prepared.

I think the first doc has covered how these conditions are related to your inservice problem as to causing the altered gait-

I think the Ear,Nose doctor will need your SMRS and also an explanation of your MOS in order to prepare a good IMO.

Does the altered gait ( which I feel the civ doc made sense in that it is related to and caused by the inservice accident) affect both legs or just one?

Do you have to favor one leg due to this?

Has this caused a bilateral affect to your ability to stand and walk?

Possibly not but if you get an IMO, the doc might as well cover any potential secondarys to the other foot and/or leg.

[samclemmons]

Thanks Berta.

Yeah. I'll be seeing my podiatrist next week and will talk to him about an IMO. Is it necessary to include the rating numbers for each disability on the 21-4138? There are a couple that don't seem to have a rating number... the interdigital neuroma and neuritis- ankles and knee for instance. Also, if two of the problems fall under the same rating number is that a problem?

After several visits to my VA PCP and the VA Podiatrist I've noticed that these people are loathe to name a condition or disability that is not SC'd even in the face of progress notes from my civ Podiatrist that clearly states the diagnosis and attributes the problems to my SC'd condition. The VA Pod did make a diagnosis of the Mortons Neuroma in my left foot which is the foot that has been SC'd so that was a modest victory. However, he did not even mention the problems with my right foot or knee, the fasciitis or the neuritis. It is pretty obvious that I favor my left leg with a pronounced limp and she did mention the altered gait in her notes.

Now, even though they won't name the other problems, they certainly treat them. I've had two sets of orthotics (shoe inserts) and several Rx drugs scripted for these problems. I can't help but wonder if there is a "code of silence" among these practitioners.

[Berta]

The VA will decide on the ratings based on the Schedule of Ratings here at hadit.

You could try to search at the BVA web site for similiar claims and see how they were rated.

Your claim might well depend on getting those independent medical opinions.

Did you have a complete audio exam from the private doctor?

If you search under Hearing loss claims-you will see how the VA rates them due to Hertz and decibel levels etc-

and it looks to me that you certainly were exposed to acoustical trauma in service.

If you were not issued protective hearing gear this is a good point to make to the VA and to the IMO doc too.

[samclemmons]

Yes. I've had a complete hearing exam from a civilian audiologist who works with my ear, nose and throat guy. I won't have the paper work from them until February 3. I've also had a complete exam through the VA which shows Tinnitus and hearing loss and follows closely with the private practice exam. The VA exam lists acoustical trauma to the United States Navy with nothing specific. I see my civ Podiatrist on the 4th and will request an IMO and will file after that, with or without an IMO since I already have a nexus letter from him drawing the connection.

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