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Question
Friedman
The evaluation of healed sprain, left ankle is increased to
10 percent disabling. The VA (QTC) examination of the left ankle shows
weakness, tenderness and guarding of movement. There are signs of edema,
instability, abnormal movement, effusion, subluxation or ankylosis. The range
of motion of the left ankle is dorsiflexion of 12 degrees with pain and
additional degree of limitation of 2 degrees and plantar flexion of 15 degrees
with pain and additional degree of limitation of 4 degrees. There is additional
limitation of function due to pain, fatigue, weakness, but not by lack of
endurance or incoordination after repetitive use. X-rays reveal tiny old healed
fracture deformity at the distal tip of the medial malleolus and minimal soft
tissue swelling at the lateral malleolus. The outpatient treatment records from
the VA Medical Center shows a history of left ankle pain.
A 10 percent evaluation is assigned because there is
evidence that you have pain and some limitation of motion of the left ankle. A
higher evaluation of 20 percent is not warranted unless the record shows marked
limited motion of the ankle.
We have assigned an effective date of July 8, 2010 the date
we received your claim.
HISTORY:
Sprained left ankle approx. 11 times while on active duty
which made is very loose and would come out of place and turn easily, even on
flat surfaces. Nov 2009 I was walking on flat surface (sidewalk) and hear a pop
and ankle swelled. Went to VA, they ordered a MRI and saw a partially torn ligament/tendon
(forgot which). Had ankle surgery March 2010 filed claim after temp disability
was over.
Questions:
Effective date should be November 2009 since that is the
date it was revealed that it was torn?
What is "marked limited motion"?
12 degrees and 15 degrees a lot? My ankle doesn't move left
or right very much, wondering if QTC falsified degrees of movement to keep them
out of range?
Just feel it should be 20% due to lack of movement and
effective date should not be date I filed since its not the diagnosis date.
Any Suggestions or Comments?
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