C&P Exam for Left Ankle-Please provide feedback!

[Navy4life]

Well first off, SHOUT out to BUCK!!!!  Thank you for the advice to go and get copies of my C&P exams from the BVA office at the VA Dallas Hospital!  It worked like a charm!  BTW these C&P exams were done at a QTC facility!  So with that being said, I need your input on this C&P exam.  I applied for an increase to my Left Ankle Synovitis 10% - totally loss on this and would love feedback!  Please see attached the report.

C&P left ankle increase.pdf

 

[Navy4life]

Bump....Does anyone have any opinions based on the attached C&P Exam?

[green]

That is a hard one N4L, I don't really have a feeling of how it will rate.  Guessing your entire package will be researched to help the RO rater come to a rating decision.

 

[Navy4life]

Yeah my whole situation is weird!  I have the FDC for the increase to the Left Ankle and the 100% temporary for right foot and then I have my NOD for the feet/toe/ankle issues.

The C&P exam from what I read seemed to be favorable but due to my limitations b/c of my broken foot, I am wondering if they will have me do another C&P???

[pwrslm]

Im not studied on ankle ratings, but your rater noted that you have problems w/mobility, in pain, and noted atrophy, and limited ROM.  This should be rated higher than 10% easy.  I dont see much over 20% rating on the ankle, the exam verifies your talus surgery, but not if it were removed, which would increase the rating to 20% right off.  I dont find any mention of atrophy in the ankle ratings, so that would probably be rated as something else.

 

Principals for rating muscle injuries might help some;

– If there are injured muscles in the same region but that aren’t all connected to the same joint (i.e. all in the arm but not all attached to the elbow), then the rating for the worst injured muscle in the arm will be increased and then used as the only rating for all muscle injuries in the arm. So if Group I in the arm is moderately severe (30% for the dominant hand), and Group VII in the arm is moderate (10%), then the 30% rating for Group I would be raised to the next level (severe: 40%) and then the total rating for all the muscles in the entire arm would be 40%.

Muscle conditions can be rated on the Slight to Severe Scale. The severity of a muscle disability is decided by the presence of the “cardinal signs and symptoms.” These include loss of power, weakness, easily fatigued, pain with fatigue, lack of coordination, and decreased movement control. Definitions of the different severities are listed below, but each bullet point does not have to be met in order for the condition to qualify under that severity. For example, many muscle conditions are not caused by injuries, so the requirements for the type of wound or scar would not apply.

SEVERE muscle disability:

– A through-and-through or deep penetrating wound with shattered bones and lots of debris, prolonged infection, and seriously limiting scarring in the muscles.
– This wound would need lengthy hospitalization for treatment, have the constant and very serious presence of the cardinal signs and symptoms, and a definite inability to work.
– Scars would be very large and jagged and would stretch across a large area. Serious loss of muscle substance and tone (even causing muscles to be flabby and weak) would cause significantly abnormal muscle function.
– Other evidence of severe disability could include X-ray evidence of foreign bodies in the muscles, skin attaching directly to the bone instead of the bone being covered by muscle, decreased response in the muscles to electric shocks, significant atrophy, other muscle groups having to compensate for the injured muscle group, and atrophy of connected muscles not directly damaged.

A lot of info on this topic here;

http://www.militarydisabilitymadeeasy.com/theankle.html

and here;

http://www.militarydisabilitymadeeasy.com/musculoskeletalprinciples.html

 

 

Edited March 30, 2016 by pwrslm

[Andyman73]

You know how the VA works, apparently pain is given only the slightest consideration any more.  So ROM is the big player in that game, now.  Also athritis, too. 

Hope you get your increase.

 

[Navy4life]

I appreciate all the information my fellow Vet's!!!  Wealth of information!

I sure hope I finally get the s/c I deserve and I hope all my fellow Vet's get what they deserve too!