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Have I Messed Up My Claim?


mcall008

Question

First off, let me say I wish I had found this site a few months ago (before submitting my 21-526c) as I have learned much about the process.

I am on active duty and am in the BDD process. When I turned in my form 21-526c I wrote that I was claiming "chronic left foot pain". I have a history of (multiple episodes) of severe metatarsalgia, diagnoses of a tarsal coalition (MRI), suspected pes planus (MRI) as well as a loss of ROM with my left ankle. I wear orthopedic inserts to try and soften the impact of running/walking on my feet.

I was just told that because I wrote "chronic left foot pain" instead of listing each medical diagnoses that the metatarsalgia, pes planus, tarsal coalition etc will not be evaluated in my C&P exam (scheduled for 11 July) due to the fact that I did not specifically write them out. I did not know this was required, and am now being told that I must wait for my current BDD claim to finish and then I can initiate a new claim for the ankle, pes planus, etc.

Can anybody confirm/deny that the multiple conditions of my left foot will not be examined? Is there anything I can do? Ask the doctor to take a look at my arches, toes etc in the exam?

Thanks

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Thanks...

I feel cautiously more optimistic now that I have reviewed the DBQ for foot miscellaneous. I appears that the metatarsalgia, tarsal coalition, and toe stiffness are all part of that exam...

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  • HadIt.com Elder

You can send in an addendum, etc. to your claim, don't wait, unless you signed something to the effect that you wanted the VA to judge the claim with existing evidence.

(And, you might want to send it in anyway, since you don't have a notice of decision.)

Beyond that, the VA has, under law some responsibility to "help" you "develop" your claim. It doesn't sound like they are doing so. The medical history should have been submitted with the VA claim. Pain is a legitimate claim, and a veteran is not required to know or state the exact medical cause, that's for the experts. If a veteran does, the VA usually will ignore it anyway, since the veteran is usually not a "medical expert".

On the other hand, the more specific a claim is, the easier it is to get through the VA's system. (Award or Deny)

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Officially, no, you did not mess it up. The courts have ruled that the Veteran is not competent to make a medical diagnosis, oh say, one like pes planus. The VA is required, instead, to "develop the claim to its optimum before a decision on its merits".Roberson Principi, 2001,

available here: http://www.ll.georgetown.edu/federal/judicial/fed/opinions/00opinions/00-7009.html

However, the VA has "shown you their hand". That is, they intend to fight you on this! Get ready for this fight, and remember the 5 P's: Proper Preparation Prevents Poor Performance.

Go to your C and P exam with this in mind. Your malady will likely be rated on its symptoms, not the diagnosis, since its the symptoms that cause you problems, not the doc's diagnosis. If you have pain from Pes Planus, and cant walk more than 10 feet, then so state. If you have lost the ROM on your feet, then so state. If it limits your daily activities, or even the ability to maintain substantial gainfull employment, then tell the doc.

As soon as possible after the C and P exam, check to see if the doc included in his report. If he did not, then write a letter to the doc, and ask him to include your statements. To find out more about C and P exams, try reading this, for starters:

http://asknod.wordpress.com/2012/07/02/6-key-issues-at-your-c-and-p-exam/

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  • HadIt.com Elder

When I filed my claim my Service Officer had also requested service connection for anything that was in my Service Medical Records. Seems like when I entered service it was not noted that I had pes planus or flat feet. Anyway it was noted on my last physical and I got 30%. It was very straight forward I saw a Doc he looked at my feet asked if I had trouble with them and I answered yes.Asked what I did to treat problems and I told him took a couple of aspirin when I had pain which was fairly regular. He had my feet xrayed and about 9 months later I was awarded 305 for flat feet.That 300 dollar check I got from the VA helped me put food on the table. My claim for panic disorder was denied and I was finally awarded 100% in November 1996

Good Luck on your claim

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