Question about lower leg SMC K

[Army man 2]

Just had Toe surgery Cheilectomy with plantarflexory bunion osteotomy and screw fixation right metatarso palflexory joint 

According to Code 5280 When the big toe points toward the second toe, a bunion can form on the outside of the big toe. If the bony bump is removed by surgery, then it is rated 10%. If it is so severe that it is as though the big toe had been amputated, then it is also rated 10%. Otherwise, it is not ratable.

This is what was told me the absolute maximum evaluation (with the exception of a temporary surgical or convalescence rating) for the foot is 40 percent.  Actually this is the maximum combined evaluation that can be assigned for all disabilities below the knee which includes the lower leg, ankle, and foot. 

 I was told the most VA give is 40% on the lower leg which consist of foot, ankle, and toe. In most cases when various disabilities reach the point that they combine to a 40 percent or greater evaluation they are all closed out and a single 40 percent is assigned under the diagnostic code for loss of use of the foot.  This 40 percent would also include smc "k"

Total rating is  VA Disability 90%

Current VA rating on right lower leg    

Right foot hallux valgus with hallux rigdus    0%        (This could be increase to 10% base on Code 5280)

Morton neuroma right foot              10%

right foot pes planus (also claimed as right foot arthritis       30%

degenerative joint disease right ankle                         10%

 If get at least 10% more for this foot surgery listed above then I will be at 30-10-10-10 meaning my right foot would be at 60%

So will they give me closed me out or continue to rank each items separated. Does anyone know for sure?

Edited February 18, 2016 by Army man 2

[green]

20 minutes ago, Army man 2 said:

I was told the most VA give is 40% on the lower leg which consist of foot, ankle, and toe. In most cases when various disabilities reach the point that they combine to a 40 percent or greater evaluation they are all closed out and a single 40 percent is assigned under the diagnostic code for loss of use of the foot.  This 40 percent would also include smc "k"

I don't think this is true.  I believe smc k is awarded due to loss of use.  Also, the 40% rating  for lower leg cover's  everything below the knee.  So you could have a rating of 40% for peripheral neuropathy and 20% for chronic venous insufficiency.  The most you could receive would be limited to the 40% which would be paid if you had an amputation.  However I don't believe the rating alone qualifies you for a schedule k rating if you have continued use.

[broncovet]

If you are trying to get another 10% to go from 90 to 100, be advised that it takes 50 percent, or more, to go from 90 to 100%, because of the VA math and combined ratings table.  

[broncovet]

I will also add that if your reduced mobility due to your foot problems causes you to be unable to maintain substantial gainful employement, you can/should apply for TDIU, which would bring you to 100percent, and you could get SMC also for loss of use of foot.  

I have not seen many people going to work "hopping on one foot", so its possible or even likely that if you can not use your foot, then you could not work and be eligible for unemployablility.  

If you have some sort of job (dont ask me what job that would be) where you could work with only one foot, then that may not apply.  

[Gastone]

Have any of your Drs recommended seeing a VA MH professional regarding possible Depression? My lay readings and some of my personal experiences support the possibility of Chronic Pain conditions often causing a person to become to one degree or another, Depressed. If at some point down the road, an SC Secondary for Depression were DX'd, an IU Claim either Scheduler or Extra-Scheduler would be strengthened.

I don't think a major loss of use of 1 or both feet, would necessarily support an IU Award, think Sedentary work. Many wheelchair bound individuals earn well in excess of the VA's SGI cutoff for earned income ($12,400 under 65). VA Raters look at your education, work experience past and present, when deciding if a Sedentary Employment Denial is warranted.

Research the Pros of a VA Vocational Rehabilitation Counselor's "Denial Letter," with respect to IU claims.

Semper Fi

 

[Army man 2]

Thank you all for you responses Just a quick history of all this process.

I am presently at 90% rating but with 93% VA math I have 12 SC disability items with my lower leg area three disability items hook to it.

R/ankle 10

R/foot 30%

R/Foot morton 10%

if award another 10% for buinon removal from Surgery  Then I would be at 94% 

 If they only give me 40% over all my rating (Lower leg) it will go down or stay the same at 92.89%.

If I can get rated at 10% more I would be at 94% very closer to 100%.

I have four more disabilities in a deferred status with one with a good chance of get 10% or more.   I rather not have a SMC K at this time but I have been constant told that if my disability rate keep going up on my lower leg VA will stop it at 40% 

Right know (Lower Leg Only) I have 30-10-10 it equal out to 43% at 40% but with another 10% added to it will be 48% at 50%

Thank

 

[FormerMember]

A good story is in order here. I had a Vet with about 16 disabilities ranging from hammertoes to tinnitus to otitis media. He even had 10% for hemorrhoids. The largest were  20%. He had a combined rating of 86% which bumped to 90% but never got TDIU. The reason was simple. Besides not having any one rating over 40%, VA said no disability in and of itself or any combination precluded gainful employment. In simple terms, having crooked toes and a sore butt doesn't make you unemployable. Keep that in mind if any of you try to string together 22 10%ers for a 100% rating. TDIU stands for Total Disability due to Individual Unemployability.