C&p Exam Lead To Reduction, Filing An Nod Opinions

[COLTTEAM3]

'There is no recent evidence of any left ankle symptoms or treatment in your VMAC records. You reported to a va examination, you noted stiffness and pain. You also noted not having any current treatment. Upon examination, the examiner noted decreased range of motion of plantar flexion at 20 degrees and dorsiflexion at 5 degrees. However, the examiner went on to say that the decreased range of motion was exaggerated, as the examiner noted that you were able to walk on heals and toes at examination. The examiner did not note any functional impairment with repetitive motion or flare ups. No objective pain was shown on examination. No arthritis was noted. The examiner noted that your left ankle condition has resolved, and that a tiny avulsion fracture of unclear significance was noted in your medical history. The examiner stated that your range of motion deficit and weakness documented is not considered reliable as there is no record of an ankle condition for several years, no swelling or deformity was noted on exam, and weakness was inconsistent. Therefore we cannot use your decreased range of motion noted above for evaluation, and there is no objective evidence of pain noted on examination."

So I have three questions.

1. Should I now go to the VA to seek medical documentation to put in my VA file, I have already initiated a NOD. Or does that not look good on my part. My VSO said it doesn't just wanting to get other opinions?

2. Can I challenge the narrative as it shows and extreme amount of biases from the "exaggerate", i didn't seek treatment for it because i was told there is not much that can be done. however the VA has me on meloxicam.

3. Should i not even bother with the appeal and just leave it at 0 and not poke the "bear" anymore than needed, as it seems to have bitten me this time.

Thanks for all your help brothers and sisters

[Navy4life]

Coltteam3

Yes the VA will see all your VA medical notes BUT I would still submit them as evidence for your appeal. I too suffer from both ankles being broken while in the military. My left ankle is 10% but they denied me my right ankle stating nothing to back it up..really? so me being 8 months preggo and falling and being rushed to the ER to have a cast on my right leg and giving birth at Bethesda Naval Hospital with ankle in cast up to my knee wasn't enough proof??? Come on!

So like you I am in the appeal process for my right ankle as well as my morton's toe on my left foot.

I go to the Podiatrist regularly for injections, have an ankle brace but it does not good. My outside Podiatrist years ago recommended I have scoping done but I lost outside insurance and I am reduced to only VA care.....UGH

I too take joint pain pills for my ankle...

[Andyman73]

Navy4life,

I feel your pain...well, the ankle part, anyways. I develped plantar fasciatis(sp) during my final 12 months. It got to the point I couldn't walk with out limping. It was an easy 10, even tho only one or two entries in my SMR. It took 18 months for a bilateral 10 for my knees, and there are 6 or more entries covering my knees. I had orthotic inserts made by VA, 10 yrs ago, and again 2 months ago. My foot has never stopped hurting. Had 2 injections, but stopped due to possible side effects to my "swimmers". I recently went through C&P for ankle increase, and had X-rays done, my primary ordered one of the foot to see why it was hurting more than it used to. Radiology tech called me at home to say it showed bone restructering of the 4th metatarsal due to long term stress related fracturing.

Guess what!?! Ankle increase denied. They never even factored it in to the ankle claim! I went to the VAMC on Monday to get copies of all X-ray and MRI reports and copies of C&P exams. Besides finding all questions of pain, for all C&Ps listed as no pain, the C&P examiner actually wrote that the bone recalcification of 4th metatarsal, of L foot has no bearing on ankle condition, and doesn't even see why ankle is SC!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Oh, also, none of the examiners even looked at any evidence from SMR, VAMR, C-file or anything, with sole exception being for knee C&P(but marked no pain, as well.).

Foot examiner also wrote that since I managed the 8th mile walk to his office, with out complaining of pain, it must be minimal or non-existant. Ok, but after waiting 45 minutes in his waiting area, the pain had subsided. Who is he to suppose what my pain and discomfort level is? He noted I take no pain meds for my ankle. What I told him was I take 800mg Ibuprofen 2-3 times a day for pain, for all pain. Guess I should have said yep! That's in my VA record, as well, since I've been prescribed that and Tylenol for 10 years or more by my VA primary dr.! Back in 05, they tried to bill me personally for treatment, X-ray showed bone spurs, which is the direct result of plantar fasciitis. Podiatrist said it's not covered since it's not listed with the SCD! I told them that it should be, since they said it was caused by the SCD. And I stopped going there for a few years.

I emailed my county VA rep about what I found out, and what was noted on my C&P exam notes...he was astounded to say the least.

[Navy4life]

Andyman73

I too have documentation of a Talus Fracture as well as the 5th metatarsal of my right foot (status post avulsion fracture, 5th metatarsal) yet DENIED! I had two SMR documentation showing I first injured the R ankle while on AD and then some how the medical records are missing for my R ankle towards the end of my service when I broke it while pregnant. I am not sure I will ever get my R ankle S/C but my L foot/ankle/toe has pissed me off! 10% for Left ankle condition...Well what about my toe? It clearly shows in the SMR that at ER and Ortho visits it was injured.

Ridiculous! So her I wait on an appeal that will take years for my right ankle and left foot/toe issues to be resolved because get this....When they sent me a partial S/C in June 2014 with the denial of contentions, they noted the denial of my foot/toe on the RIGHT foot/toe...It was for my left foot/toe...Thought I had a CUE but instead I was advised to file an NOD citing the discrepancy...

[Andyman73]

Navy4life,

Sounds to me like you may want to email Allison about that. You've been waiting far too long for something so cut and dried!

As for me, I've been floating along where ever the current took me. I had no idea I was getting screwed so much. No body was telling me, my own father was no help, as he hasn't been in touch with the VA since 1993. And my problems pale in comparison to his. I didn't want to rock the boat and end up capsizing it in the deep end. It was only just recently that I finally decided to get myself in gear and start moving. I will be filing appeals and such on all my denied claims, since they all can be verified by my SMR or VA records. And my secondary claims are nearly slam dunk as well.