Jump to content

Ask Your VA Claims Questions | Read Current Posts 
Read VA Disability Claims Articles
Search | View All Forums | Donate | Blogs | New Users | Rules 

  • tbirds-va-claims-struggle (1).png

  • 01-2024-stay-online-donate-banner.png

     

  • 0

Presumption Of Soundness

Rate this question


RIVER RAT

Question

I had filed a claim for a sparined right ankle in 1990 shortly after my discahrge from active duty. I had 2 exams and for this the last one in 2002, I was denied service connection both times. This was even though the 2002 examiner diagnosed me with a right ankle spain. He had also said "examination reveals very marked (congenital) Pes Planus bilaterally and certainly that could be a cause of his discomfort." This was also used to deny my right knee claim. I went to get a IMO and had that faxed in to the VA, in the mean time I moved away and tried to have my claim follow me but, the denial became final. I see they said "Service connection is not granted for a congenital disabilty and your SMRs do not show aggrivation by service"

Here I am years later I have found that the doctors office where I got my IMO had missed spelled my name and the evidence in support of my claim went into someone elses file. I have had foot issues since my time in the service and the VA podiatrist supplies my custom orthotics. I looked over my SMR to see if Pes planus was ever noted and it was. I had been prescribed orthotics and a heel lift as part of a work up on my right knee. So with this information I submitted a claim for Pes Planus, which the VA turned into me re-opening and renaming my Right Ankle sprain claim(HOW DOES THAT WORK).I thought I was in good shape, I had my documentation SMR, have current diagnosis and treatment (moderate ecessive pronation of STJ in stance and gait, Mild abducted gait, mild genu varum), documentation of Pes Planus in my comp and Pen files along with their X-ray evidence, a letter from my pediatrician that stated she cared for me from birth until a month before my joining the service and she said that she never treated or diagnosed my with Pes Planus( = not congenital). My entry physical state feet as Normal.

I was on this site and noticed a refernce to Wagner v. Principi, §3.304, and Authority: 38 U.S.C. 1111. "(b) Presumption of soundness. The veteran will be considered to have been in sound condition when examined, accepted and enrolled for service except as to defects, infirmities, or disorders noted at entrance into service, or where clear and unmistakable (obvious or manifest) evidence demonstrates that an injury or disease existed prior thereto and was not aggravated by such service. Only such conditions as are recorded in examination reports are to be considered as noted. "

My question is should this apply to my case where it goes back to 1999 and 2002? If it does apply Do I need to bring this to their attention? I feel like me knee claim is also being held because of the"congenital" notation the examiner made in 2002.

Should my Pes planus been lumped into my Ankle claim or should it be its own claim?

Sorry so long but this has been an exhausting and confusing process with no end in sight.

Link to comment
Share on other sites

  • Answers 12
  • Created
  • Last Reply

Top Posters For This Question

Top Posters For This Question

Recommended Posts

  • HadIt.com Elder

Yes, I do believe it would apply. They're reopening the claim(s) which sounds correct, w/the new evidence, however I believe you'd be better off to file a CUE claim based on the presumption of soundness error. I also believe the pes planus claim should be on it's own but perhaps also a CUE. jmo

pr

Link to comment
Share on other sites

Did the VA acknowledge at all the IMO you had?

If they never mentioned it in any decision, submit it again as new evidence.

I have the same pronation problem-and I need to watch out for sprains so I would think the inservice pes planus aggravated and even caused the sprain.

By all means use Wagner against them.

Your knee problem is certainly quite possibly related to the pes planus.People with pronation can end up with knee,hip and/or back problems.I had a chronic low backache for decades.Nothing medically revealed it's etiology-until I got special orthonics.

I have not had a backache since -unless I do alot of heavy lifting.But many even with orthonics still can have considerable problems. There are plenty of cases at the BVA web site that reveal what I mean.

Years ago I posted here a TDIU award that started out with pes planus and affected the vet's knees, hips and back so much that he was awarded TDIU.

Have you considered getting an additional independent medical opinion to tie these all together?

Edited by Berta

GRADUATE ! Nov 2nd 2007 American Military University !

When thousands of Americans faced annihilation in the 1800s Chief

Osceola's response to his people, the Seminoles, was

simply "They(the US Army)have guns, but so do we."

Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.

Link to comment
Share on other sites

  • HadIt.com Elder

Here is a side bar on a so-called congenital issue that the military and VA use to deny benefits which is the concept of personality disorder. If a personality disorder is not noted in your induction exam and three years later the military kicks you out as a PD where is the presumption of soundness? You were presumbed to be OK when inducted and suddenly you develop a PD. How can that be?

Link to comment
Share on other sites

  • HadIt.com Elder

Here is a side bar on a so-called congenital issue that the military and VA use to deny benefits which is the concept of personality disorder. If a personality disorder is not noted in your induction exam and three years later the military kicks you out as a PD where is the presumption of soundness? You were presumbed to be OK when inducted and suddenly you develop a PD. How can that be?

They will say: You had a Personality Disorder that did not show up until some Drill Instructor started applying psychological pressure at which time the personality disorder that you had had ever since your mother stopped bottle feeding you too early in your childhood...........yada, yada, yada!

Edited by LarryJ

"It is cold and we have no blankets.

The little children are freezing to death.

My people, some of them, have run away to the hills, and have no blankets, no food; no one knows where they are-perhaps freezing to death.

I want to have time to look for my children and see how many of them I can find.

Maybe I shall find them among the dead.

Hear me, my chiefs! I am tired; my heart is sick and sad.

From where the sun now stands, I will fight no more forever."

Chief Joseph

Link to comment
Share on other sites

river rat -welcome aboard

you said, i feel like my knee claim is being held up because of the congenital notation, did the notation say you had a congenital (defect) or a disease ? because congenital defects are excluded usually.

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now


  • Tell a friend

    Love HadIt.com’s VA Disability Community Vets helping Vets since 1997? Tell a friend!
  • Recent Achievements

    • Lebro earned a badge
      First Post
    • stuart55 earned a badge
      Week One Done
    • stuart55 earned a badge
      One Month Later
    • Lebro earned a badge
      Conversation Starter
    • Sparklinger earned a badge
      First Post
  • Our picks

    • Caluza Triangle defines what is necessary for service connection
      Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL

      This has to be MEDICALLY Documented in your records:

      Current Diagnosis.   (No diagnosis, no Service Connection.)

      In-Service Event or Aggravation.
      Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”
      • 0 replies
    • Do the sct codes help or hurt my disability rating 
    • VA has gotten away with (mis) interpreting their  ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.  

      They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.  

      This is not true, 

      Proof:  

          About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because  when they cant work, they can not keep their home.  I was one of those Veterans who they denied for a bogus reason:  "Its been too long since military service".  This is bogus because its not one of the criteria for service connection, but simply made up by VA.  And, I was a homeless Vet, albeit a short time,  mostly due to the kindness of strangers and friends. 

          Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly.  The VA is broken. 

          A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals.  I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision.  All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did. 

          I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt".   Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day?  Va likes to blame the Veterans, not their system.   
    • Welcome to hadit!  

          There are certain rules about community care reimbursement, and I have no idea if you met them or not.  Try reading this:

      https://www.va.gov/resources/getting-emergency-care-at-non-va-facilities/

         However, (and I have no idea of knowing whether or not you would likely succeed) Im unsure of why you seem to be so adamant against getting an increase in disability compensation.  

         When I buy stuff, say at Kroger, or pay bills, I have never had anyone say, "Wait!  Is this money from disability compensation, or did you earn it working at a regular job?"  Not once.  Thus, if you did get an increase, likely you would have no trouble paying this with the increase compensation.  

          However, there are many false rumors out there that suggest if you apply for an increase, the VA will reduce your benefits instead.  

      That rumor is false but I do hear people tell Veterans that a lot.  There are strict rules VA has to reduce you and, NOT ONE of those rules have anything to do with applying for an increase.  

      Yes, the VA can reduce your benefits, but generally only when your condition has "actually improved" under ordinary conditions of life.  

          Unless you contacted the VA within 72 hours of your medical treatment, you may not be eligible for reimbursement, or at least that is how I read the link, I posted above. Here are SOME of the rules the VA must comply with in order to reduce your compensation benefits:

      https://www.law.cornell.edu/cfr/text/38/3.344

       
    • Good question.   

          Maybe I can clear it up.  

          The spouse is eligible for DIC if you die of a SC condition OR any condition if you are P and T for 10 years or more.  (my paraphrase).  

      More here:

      Source:

      https://www.va.gov/disability/dependency-indemnity-compensation/

      NOTE:   TO PROVE CAUSE OF DEATH WILL LIKELY REQUIRE AN AUTOPSY.  This means if you die of a SC condtion, your spouse would need to do an autopsy to prove cause of death to be from a SC condtiond.    If you were P and T for 10 full years, then the cause of death may not matter so much. 
×
×
  • Create New...

Important Information

Guidelines and Terms of Use