Bunion info/update

[Andyman73]

Hey all, just found out something very interesting regarding bunions.  I know a few of us on here posted about bunions, and I thought this would be the quickest way to get this out. 

I recently was DXd by my PCP with a bunion on R foot.  X-rays confirmed this finding.  So then I scheduled an appointment with my local VAMC Podiatry clinic.  That was Tuesday the 13th, a few days ago.  Podiatrist was very nonchalant and laid back, while looking at my feet.  Lots of hmming and uh huh..ing to himself while looking.  He said it looks like a bunion, but will need x-rays to confirm.  I says, just had some done a few weeks ago.  He says; they will need to be standing weighted. Lo and behold, yep, standing x-ray.  He says good.

Then using his computer he made direct lines with an anchor point to get the angle of departure(such as it is) to show how much the bunion has changed my foot.  He said anything less than 15 degrees of angle is usually treated with custom orthotics and looser shoes.  I already have VA custom orthotics, have had for years.  My angle of departure is 23 degrees.  He said that all they can do for that, now, is surgery. 

Now...here is the real meat of this post....he said that medical studies have shown, and the VA stands by it, bunions are an inherited condition! The medical study showed that shoe type has less effect to cause bunions than previously thought.  The study covered native people groups in regions not known for wearing shoes, where people are barefoot all the time.  And the study showed the same frequency rate of bunions among  the bare foot as among the shoe wearing folks.

So...if you have issues with Bunion claims....perhaps this will give ya'll some insight on how to change your attack.

For me, that means I will file my bunion claim as secondary to my feet due to aggravation caused by my SC pes cavus bilateral w/plantar fasciitis.  Since the VA identifies secondary conditions as caused by or aggravated by existing service connected disabilities.

[broncovet]

Interesting.  Gee, who'd a thought VA would try to tell you that was inherited?  (sarcasm intended).  I do think Vets try to get too specific when they apply for benefits, and here is why.  

If you apply for "bunions secondary to plantar fascitis", then it looks like there is a lot of weasel room for VA.  

Instead, I recommend you dont play podiatrist, and apply for an increase in your SC condition TO INCLUDE symptoms of bunions.  

Reason:   A C and P doc could look at you and say:  Nope, you dont have bunions, you have plantar fascitis.  Then, its back to the drawing board for you:  no diagnosis, no sc.  

Veterans do not have to have a degree in advanced medicine to apply for benefits, and it could hurt you to try.    "My foot hurts" is sufficient to "identify the benefit sought".  Maybe even better is, "my foot hurts, and the pain goes up my knees and into my back, and I walk crooked, and have decreased mobility."  Let the doc diagnose you..they wont accept YOUR diagnosis anyway.    You see, even if your foot has multiple diagnosis, pyramiding prevents you from being paid for any SYMPTOM TWICE.  So, you can get paid for pain (once), if you dont walk right, or have limited range of motion, you can get paid for that.   If your foot is twisted to the right or left, then you can get paid for that once, but you can not stack these symptoms on different diagnosis.  

Edited September 15, 2016 by broncovet

[Buck52]

 Andyman first thing get this taken care of.

  I understand on bunions  they ''break the toe bone  and place it  in a direct line  so-to speak  so it will grow back straight  but even then they some times tend to grow back like they were.

 Here's the thing to think about

I would think a sharp rater would tear this up...to deny b/c they can look at your claims records and see what your trying to do (get more $$) and then they go to there little manual and dig deep on this type claim and dig deep and read about ''pyramiding'' as broncovet mention above.

so you may want to think about  filing for an increase on what your rated for now &  check out the symptoms  for  your condition to include other conditions that would be a cause for increase on that condition your S.C for at present.

and Again I could be wrong  this is just my opinion.

Although your certainly entitled to file for any claim you think is or should be service connected.

jmo

...........................Buck

[Andyman73]

Bronco and Buck,

Yeah, I wasn't going to jump in with both feet, with out looking first, on this one.  I'm just in the "gathering evidence/intel" phase. 

As for getting it fixed, I'm way past bone break and reset stage. He explained how the surgery would go.  I do have a little intel on this as my wife had bunion surgery about 6 years ago.  I would have to be off work 2-3 months, since I must wear steel-toe shoes, and that wouldn't be allowed during recorvery.  So I need to build up my sick leave first. 

It hurts like a ....well, like a bunion! But when I bump it....literally blanks my mind!!! Putting it in a fire would probably hurt less!!!

I am already SC for pes cavus w/plantar fasciitis, bilateral at 30%.  And the doc told me that bunions are not caused by other foot conditions.  So secondary via aggravation by other SCDs is the only way.

2 hours ago, broncovet said:

Veterans do not have to have a degree in advanced medicine to apply for benefits, and it could hurt you to try.    "My foot hurts" is sufficient to "identify the benefit sought".  Maybe even better is, "my foot hurts, and the pain goes up my knees and into my back, and I walk crooked, and have decreased mobility."  Let the doc diagnose you..they wont accept YOUR diagnosis anyway.    You see, even if your foot has multiple diagnosis, pyramiding prevents you from being paid for any SYMPTOM TWICE.  So, you can get paid for pain (once), if you dont walk right, or have limited range of motion, you can get paid for that.   If your foot is twisted to the right or left, then you can get paid for that once, but you can not stack these symptoms on different diagnosis.  

I know it didn't hurt noticeably on it's own, when I was going through my foot claim process.  That was 14 months ago.  Now, however, it does quite so, and is very noticeable as well. 

So...sounds like best option is file for increase due to more pain, and it dominoes up the body.  With that, should I send copies of the Podiatry clinic visit, x-ray and notes from my PCP as evidence?

[broncovet]

Yes, Andyman.  Of course, I dont know if they already have that on record or not.  But I will share "a bit" about 38 CFR 3.156 and its affect on effective dates, since you may well be submitting New and material evidence such as your podiatry clinic, and/or PCP notes.  

I will try to paraphrase, and not cut and paste 3.156.  

In a nutshell, if you submit new evidence IN THE APPEAL PERIOD, your effective date will be the first time you applied.  

Also, if you submit new evidence that is SERVICE RECORDS, your effective date will be when you first applied.  

However, if you submit new evidence, and you are NOT in appeal, and its not service records, then the earliest effective date you can get is the date you submitted new evidence!  

[Andyman73]

This would be a new claim for increase, my effective date is 03/06 for my feet since I won my EED last month.  Which was my appeal. And I can tell you, I certainly did not have this bunion pain all those years ago.

Should I give it a FDC shot, or regular claim?

Thanks again,

Andy

[kirpakirpa]

Can I have a claim for bunions on both feet, as well as plantar fascitus on both feet? I have had bunion surgery on both feet, and have seen the podiatrist about plantar fasciitis on both feet. My question is do they limit the rating percentage for feet problems?