Confused On Final Disability Rating?

[merryberry]

Hi all. I've been looking through the forums and am still struggling to figure out why my total disability rating is 70%. I'd much appreciate any feedback.

Based upon e-benefits, my ratings are as follows...

* Patellofemoral syndrome, LEFT knee (claimed as knee pain) 10%

* LEFT ankle sprain 20%

* LEFT lower amputation umbrella (I am not an amputee) 40%

*Osteoarthritis with p. syndrome, RIGHT knee(claimed as knee pain) 10%

*RIGHT knee limitation of flexion (previously rated as p. syndrome)

- claimed as knee pain 10%

*Tinnitus (claimed as ringing in ears) 10%

*IBS 30%

*bilateral hearing loss 0%

*LEFT foot plantar fascittis with 1st and 2nd MTP joint degenerative changes 0%

*Bilateral plantar fascittis (previously rated as LEFT foot plantar fascittis) 50%

** (secondary) LEFT foot metatarsalgia 10%

*LEFT knee limitation due to p.syndrome (previously rated as p.syndrome)

- claimed as knee pain 10%

I understand that some of the 10%s won't count, as they were previously rated. As far as I can tell, the amputee umbrella cancels out the other percentages given for the lower left leg, but what about the bilateral plantar fascittis? Thanks so much for any info.

[Navy04]

I am know expert, but I came up with 90% when I put it in the VA disability calculator. Really don't know what to say bud, I guess wait for one of the more knowledgeable folks to chime in. Good luck and keep me posted

[USMC_VET]

i believe that is correct

§ 4.68 Amputation rule.

The combined rating for disabilities of an extremity shall not exceed the rating for the amputation at the elective level, were amputation to be performed. For example, the combined evaluations for disabilities below the knee shall not exceed the 40 percent evaluation, diagnostic code 5165. This 40 percent rating may be further combined with evaluation for disabilities above the knee but not to exceed the above the knee amputation elective level. Painful neuroma of a stump after amputation shall be assigned the evaluation for the elective site of reamputation.

so any extremity in and of itself cannot exceed 40%, so while they have rated specific conditions they cannot exceed 40% and you were granted the amputation umbrella that rates it at 40%, which then nullifies the other specific conditions.

that means your list is correct but what the raters combined was only...

* LEFT lower amputation umbrella (I am not an amputee) 40%

*Osteoarthritis with p. syndrome, RIGHT knee(claimed as knee pain) 10%

*RIGHT knee limitation of flexion (previously rated as p. syndrome)

- claimed as knee pain 10%

*Tinnitus (claimed as ringing in ears) 10%

*IBS 30%

*bilateral hearing loss 0%

which puts you at the 69% level, rounded to 70%

however if you are rated at 50% for bilateral plantar fascitis then you should have received a seperate rating for just the right foot

From BVA Decision...

The RO has evaluated the plantar fasciitis under 38 C.F.R. 
§ 4.71a, Diagnostic Code 5276, as analogous to acquired 
flatfoot.  That code provides the following rating criteria:

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 percent
Unilateral  
......................................
.......... 30 percent

Severe; objective evidence of marked 
deformity (pronation, abduction, etc.), 
pain on manipulation and use accentuated, 
indication of swelling on use, 
characteristic callosities:
Bilateral  
......................................
............ 30 percent
Unilateral  
......................................
.......... 20 percent

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 percent

Mild; symptoms relieved by built-up shoe 
or arch support ............................................... 0 
percent

so sounds like it was bilateral sever and you should continue to receive the additional 30% rating for the unilateral foot (right) which would put you at 78% rounded to 80%.

I would fight it, but i would possible get an attorney, or at least consult with one. however i dont think you will get much help unless you are going to get a significant retro.

if not I would read over that CFR for the amputation umbrella, and file a NOD stating that the amputation umbrella only extends to the left foot and not the right and the right foot was rated as severe and deserves consideration at an additional 30% level for compensation computation.

[merryberry]

OK, I was still factoring in the plantar fascitis since it was bilateral. I didn't realize the amputee umbrella would knock that out too. I'll look into getting that changed to a unilateral claim.

I was also just reading about the bilateral factor since I have injuries on both legs, would that factor in here? I'm not sure how to do that either.

Thanks so much for your information! I feel like I've been going in circles with all these numbers!