Forget It

[Jayg]

Forget it. B)

Edited June 8, 2009 by Jayg (see edit history)

[Pete53]

After my initial intake into the VAMC in Dallas and waiting and waiting I decided I was at War with the VA. I knew that to them I was just another number to deal with. No one read my C File but me unless they were trying to deny me and they also made a lot of chit up to suit their purposes. I was really surprised about the lies that they wrote in my file about what I refused to do. I bet over the years I refused a prostate exam I never heard of over a dozen times.The fact is seeing thousands of Veterans a month does not allow time for a proper examination.

[rentalguy1]

RELAX.....

There is nothing in that C&P to get bent out of shape over. There is no malicious intent anywhere in that document. There is nothing harmful to your claim in there, with one exception. I take it that you actually have been prescribed orthopedic shoes and/or inserts. If this is the case, write a 21-4138 explaining this to the rater, and attach copies of the medical records that prove this fact. It is hard to get more than a 10%-30% rating for foot problems (from what I have seen) and it looks like that is about where you fall with this C&P.

It looks to me like the examiner tried their best to be thorough and cover their butt, but they missed as much in your medical records and they found. Again, though, nothing harmful to you in there. If I were you, I would not go to your congress person as that would slow things down considerably. Just write a statement, send in the supporting records, and go back into waiting mode for a few months.

Good luck

[john999]

If you really want to fight this you are going to have to get a podiatrist or orthopod to do an IMO for you. I am surprised the VA did not say that all your problems are due to your weight. Since everything to do with this kind of disability is based on ROM you need help.

[rentalguy1]

Flat feet ratings have nothing to do with ROM. They ave everything to do with structural deformities and subjective complaints of pain:

5276 Flatfoot, acquired:

Pronounced; marked pronation, extreme tenderness of plantar

surfaces of the feet, marked inward displacement and severe spasm

of the tendo achillis on manipulation, not improved by orthopedic

shoes or appliances:

Bilateral 50 ,.,, ,,,,.,,,,,,,,.,,,,,.,,, , ,,,,,,,,,,,,,,,,,,,,, 50

Unilateral 30

Severe; objective evidence of marked deformity (pronation,

abduction, etc.), pain on manipulation and use accentuated,

indication of swelling on use, characteristic callosities:

Bilateral 30

Unilateral 20 , ,, ,,,,,,,,,,, 20

Moderate; weight-bearing line over or medial to great toe, inward

bowing of the tendo achillis, pain on manipulation and use of

the feet, bilateral or unilateral 10

Mild: symptoms relieved by built-up shoe or arch support 0

I am almost positive that you will fall under either the moderate (most likely) or severe, bilateral category, based upon statements the examiner made in the physical examination portion of the exam. This is also why it is very important that you include evidence of being prescribed foot orthotics, and their failure to alleviate your problem.

[john999]

The C&P exam said "mild pes planus". I don't think you get to 30% with that diagnosis. That is why I say get an IMO. The C&P doctor points to his impression that there is no explanation of how the flat feet contribute to the vet's other problems. This exam is weak. You need an exam that says your knees, back are connected to the flat feet and how this has happened over the years. The way to get a higher rating overall is to also go to a shrink and get a diagnosis of chronic pain due to general medical condition. If you say you can't work,and I believe,you then you need more than flat feet to get there. The C&P doctors exam is not tight. There is room for raters to just run all over you. You could work at a sedentary job with flat feet and that is what the VA will probably say if you are going for IU. Don't fight with the VA over their half ass exam. Get one of your own that nails it. I have foot problems as well and it can disable you, but doctors seems to think unless you can't walk you have minor problems. I have PN and my feet swell and burn and hurt but I only got 10%, and I can't even get my shoes on at times.

[vaf]

I mentioned in a post several months ago that I saw a C & P exam pre-typed on an examiner's computer, and he was filling in the blanks. There's certain canned text that is part of the C & P exam. The examiner is supposed to change it if it doesn't apply, but they often overlook it.

I saw it with my own eyes while accompanying my husband to a C & P exam. Canned text includes phraseology about how the veteran looks, how he traveled to the exam, how the veteran behaves in speech and action, etc.

I saw it myself. Blocks of text pre-typed, with blank lines to be filled in.

That's part of the reason why C & P exams often state things or repeated statements that never happened or were never made, respectively.

[john999]

Idiopathic means they don't know the cause. If they are saying your PN in your feet is idiopathic then they are trying to weasel out of connecting to the flat feet. Considering how much pain you are in for all these things I would get a lawyer for my IU claim. Going from 10% to IU is a big jump and you have a lot of loose ends to tie up. I understand very well how foot pain can morph into so much pain you can't work. If you can't walk it is hard to exercise so it is easy to put on weight which makes the feet and back and knees worse. It is a feedback loop of one condition aggravating the others. You have to break the loop somewhere. My foot problems led indirectly to my losing my good job. It went from miserable foot pain to being sedentary to getting more depressed to back problems and on and on.

[Pete53]

Shoe inserts hurt. Funny as it may sound the best thing I have found are crocs sandals.

[rentalguy1]

I'm 40%, 10% pes planus, 20% ankle, 10% tinitus and bilat hearing s/c but @0%.

They won't award TDIU based upon those ratings. You need to work on getting the knees and spine sc'd secondary to the feet and ankle prior to asking for TDIU. I know people here say that the regs allow for TDIU without the 60/70 rule, but realistically, that almost never happens. I can guarantee you that a TDIU claim is to 10% and one 20% ratings as the basis will be denied, and then denied again, repeatedly, on appeal. You are setting your self up to lose here, and permanently. Once you have exhausted your appeals, then you will have to come up with new and material evidence in the future to re-open the claim. I advise for you to write the VARO and formally drop the TDIU claim TODAY. Then work on getting a higher rating for your feet and ankle, and getting the knees and back sc'd secondary to these claims. Once you meet the 60/70 rule, you stand a much better chance at getting TDIU.

I know some people are going to jump all over this, and this is why I don't post much any more. I prefer to be realistic, and tell a vet like it is, rather than sugar coat something and assist a vet in losing their claim.

[john999]

I agree that you have to get the secondary conditions service connected before you will get TDIU. I also advise you to start to see a VA psychiatrist and get a depression secondary to general medical condition claim up and running. If you are taking methadone then you have something to be depressed about!!!!! Have you applied for SSD?

[rentalguy1]

I also advise you to start to see a VA psychiatrist and get a depression secondary to general medical condition claim up and running.

I second this opinion.

[MikeR]

I would drop the TDIU claim post haste.

[Stretch]

Yes you can go for depression without taking pills...Alcohol is a depressant...Alcohol is a form of self medication...You can discuss this with MH at your VAMC...

[Testvet]

mental health conditions as being secondary to physical problems is easy to SC many people become depressed due to physical limitations, many use booze and drugs to self medicate much the same as vets with PTSD do.....sometimes the back door is easier than going thru the front door do you want to be right or do you want to get SC?