I Am So Confused

[Herkemeyer]

Hello All,

I have been lurking around the site for a couple of months, but finally decided to jump in. I am confused at the wording on the schedule. I had wrist surgery approx. one year ago, prior to my ETS. This is what the schedule says:

5214 Wrist, ankylosis of:

Unfavorable, in any degree of palmar flexion, or with

ulnar or radial deviation.................................................................... 50......... 40

Any other position, except favorable.................................................. 40......... 30

Favorable in 20º to 30º dorsiflexion.................................................... 30......... 20

Note: Extremely unfavorable ankylosis will be rated as loss of use of hands under diagnostic code 5125.

At my C&P, the examiner noted my range of motion at 45degrees palmer flexion and 30 degrees dorsal flexion. So if I have pain when my wrist flexes forward than I have ankylosis in any degree. Am I right here? I have not received my rating yet, I just want to be prepared for all situations and have a plan. Any advice I can get would be greatly appreciated.

[Herkemeyer]

Purple,

I have only been seeing the surgeon to evaluate my progress and Physical Therapy. But my last surgeon APPT. was in OCT. 08 just prior to my C&P. The only concern he has is the stabilty of his work, not any collateral effects ie. pain, ROM, functionality. And Physical Therapy ended in Jul. 08 after they stated I had plateaued and further treatment would not be beneficial.

This has been an ongoing issue for going on ten years. It was only in late 2007 that I received a definitive diagnosis of a torn ligament and received the recommendation for surgery. So going and seeing my primary doc has tapered off greatly over the past ten years since they were no help.

[Berta]

Check out some similiar claims as yours at the BVA web site- you might need an IMO as Mike R said-

and the VA must consider the Deluca factor:

this appears in many claims at the BVA on Remand:

"Specifically, the VA examiner did not provide

an opinion with regard to the DeLuca factors, i.e., any

additional functional limitations due to pain, weakness,

fatigability, and lack of endurance. DeLuca v. Brown, 8 Vet.

App. 202 (1995)."

[luvHIM]

Herkemeyer, welcome to hadit.

I have read your posts, as well as all the other posts. First of all, "ankylosis" means stiffening of the joints or "fixed" position.

I have ankylosing spondylitis. So, in essence the bones have fused together and there is no flexion or mobility. So, the answer to your question is NO, you do not meet the criteria for ankylosis.

However, I agree that "chronic wrist sprain" is more like a syndrome than even coming close to being a disease or diagnosis. Although, in VA dialogue it is ratable because of the word "chronic" and because the doc indicated that it was due to your surgery, which is service connected. I don't think there is any arguement there. But to get the rating you are looking to get, especially with the exam stating there are no abnormalities...you will need another docs opinion in your favor. Otherwise, I hate to say it...but I agree that it would probably end up being a low ball rating...10% at best with pain on motion.

Edited March 3, 2009 by luvHIM

[LarryJ]

I have another of my "silly-assed-questions":

HOW can there be "no abnormalities" AND "chronic wrist sprain"?

Wouldn't "chronic wrist sprain" (whatever the hell that is) rise to the level of being an "abnormality"? I mean, it ain't NORMAL to have "chronic/constant wrist sprain"...........is it?

Hope to heck I don't ever have it! (whatever it is).

Ya know what I'D have to do (this is what I'd have to do, NOT what YOU should do, okay?).

I'd have to show up at the VA Medical Center and start walking down the halls, clutching my wrist (with the opposing hand, of course), moaning, muttering, MOANING, CRYING, heck, I'd even collapse and flop around on the floor and start screaming:

OMG, IT'S MY CHRONIC WRIST SPRAIN, AGAIN! WON'T SOMEONE PLEASE HELP ME?

That's what I'd do.............but, then, of course, my 100% I didn't get by being NORMAL <_< !

[luvHIM]

Larry, I know what you're saying. But I think the doc is indicating that there are no "bone" abnormalities, which can be the case in a sprain/strain.

BTW...I know it was a rhetorical question...I just didn't have anything to do and I was online...so, hey...

[Herkemeyer]

Hello all,

I have received my rating and it has my wrist rated at 10% for a chronic wrist strain/sprain. I spoke with my primary doctor and he called shenanigans on the whole chronic sprain diagnosis. However, he wants to send me back to the same surgeon who did my surgery and his only concern is the stability of his work NOT my pain or lack of ROM. I am about to switch health insurance so maybe I can get another opinion from a new orthopedic surgeon. Anyone have any suggestions on moving forward.

I know that ROM ratings are pretty stringent but I just don't understand how I have the same rating as my wife and she has no loss of ROM and no daily pain.