Loss Of Use

[Ricky]

Hey guys could some one please break this down into laymens terms for me:

Loss of use of a hand or a foot, for the purpose of special monthly compensation, will be held to exist when no effective function remains other than that which would be equally well served by an amputation stump at the site of election below elbow or knee with use of a suitable prosthetic appliance. The determination will be made on the basis of the actual remaining function of the hand or foot, whether the acts of grasping, manipulation, etc., in the case of the hand, or of balance and propulsion, etc., in the case of the foot, could be accomplished equally well by an amputation stump with prosthesis.

The part that I have a hard time understanding is the last part about the determination. Does it mean that if you can walk with a prosthesis then it is not considered loss of use?

Thanks

[Berta]

What a good question!

Makes me think about a friend I have-

He has PTSD and also lost his leg in Vietnam.Navy Seal-highly decorated-

famous in the county and his experiences in Vietnam are documented in 2 books-

I am 100% sure his PTSD is 100% SC P & T-

Even though he has a prothesis- I always thought he got SMC for this but now not sure-

He did get a large Housing grant and it even covered a inground swimming pool for exercise due to his loss of limb.

I have not found anything yet at the BVA that would show, with a prothesis , they would grant SMC.?

[LarryJ]

What they are trying to say is, if you get around on your existing foot (for example) like you would get around with a prosthesis..........then they will (supposedly) consider you as having "lost the use of" your foot.

Of course, trying to explain what the VA was trying to say in this case, to some 20-something twit at the VA is kinda like trying to teach Harley (that's my dog, Harley) how to ride my hog Harley.........which I can't ride anymore because of my "loss of use of" one of the legs/foot necessary for holding up the Harley(s), either the HOG or the DOG.

[Rich T]

Actually, the answer is yes. They have two sentences,the first sets the condition based on "...well be held...". Then the second sentence gives the reasons for the determination. With or without the prosthesis, it is the function that is the determining factor (assuming the best to be achieved is with a prosthesis). Therefore, if your limb can ONLY function as if it were not there and your only remaining function would be as good as if you had a prosthesis.

[Chuck75]

I looked at the statement as a whole. Translated, if the remaining function of an arm & hand or a leg and foot is the same (or less) than it would be if an amputation existed, and a prosthesis is used --- special monthly compensation is appropriate. The question arises what does this mean, since there can be a great difference in functionality from one prosthesis to another. They are not created equal these days.

"The part that I have a hard time understanding is the last part about the determination. Does it mean that if you can walk with a prosthesis then it is not considered loss of use?"

Hey guys could some one please break this down into laymens terms for me:

Loss of use of a hand or a foot, for the purpose of special monthly compensation, will be held to exist when no effective function remains other than that which would be equally well served by an amputation stump at the site of election below elbow or knee with use of a suitable prosthetic appliance. The determination will be made on the basis of the actual remaining function of the hand or foot, whether the acts of grasping, manipulation, etc., in the case of the hand, or of balance and propulsion, etc., in the case of the foot, could be accomplished equally well by an amputation stump with prosthesis.

The part that I have a hard time understanding is the last part about the determination. Does it mean that if you can walk with a prosthesis then it is not considered loss of use?

Thanks

[sixthscents]

OK, I actually have some experience here.

If you are able to ambulate with a cane, you are still able to push foreward with your feet. Essentially if your able to balance, and move foreward at a steady rate without a brace then no loss of use.

However, if you are deemed to need an AFO (Ankle Foot Orthotic) brace, then they are essentially saying that the foot is useless.

So - with loss of use where the limb still remains, a brace is critical for a successful claim.

Personally I have 2 AFO's, and am rated at 100% T&P just for loss of use of both feet and legs below knee. The funny thing was I claimed the left leg 2 years after the right since the condition worsened. Since I stated that me "left foot was now essentially the same as my right" the VA scheduled an EMG to verify. I expected them to test the left leg, and they did... but then they compared it to the right which they also tested.

The EMG was conclusive and showed a mirror image, but... the VA was smart enough to check my claim that they were both the same now.

So, a brace or orthotic device is significant.

Bob Smith

[gwvet90]

What about pain -

If there is no function except propulsion - so it is basically a prosthetic - He "should" be rated SMC L

but then also has sever nerve pain/damage - is that rated seperatly?

[Ricky]

That is my problem. I do not have PN so an EMG is usless. I have Centeral Nerve Damage due to a stroke. The pain is so intense I want to kill myself. The other problem is I can not tell when my foot touches the ground. Ambulating at night is a no go without a flash light. The pain rotates from a swelling that feels like the flesh is going to explode to the feeling that a wild animal is ripping the flesh from the bone. Will they consider the pain and my inability to not feel the foot? The last CP indicated that balance and forward motion was a problem and the leg displayed a loss of muscle.

Edited December 18, 2006 by Ricky (see edit history)

[Philip Rogers]

What they are trying to say is, if you get around on your existing foot (for example) like you would get around with a prosthesis..........then they will (supposedly) consider you as having "lost the use of" your foot.

Of course, trying to explain what the VA was trying to say in this case, to some 20-something twit at the VA is kinda like trying to teach Harley (that's my dog, Harley) how to ride my hog Harley.........which I can't ride anymore because of my "loss of use of" one of the legs/foot necessary for holding up the Harley(s), either the HOG or the DOG.

LarryJ - they make an apparatis for m/c's works like training wheels - in that when your stopped the wheels are down and on acceleration they retract and then extend when slowing at about 5 mph. There's also a trike but to give up riding is to die. Bad enuf they named a bike Harley, but your poor dog. lol jmo

pr

[LarryJ]

Phillip, thanks.

I've been riding since I got my first Cushman Eagle in 1960.

I've ridden most anything at one time or another. Even owned a Vicent Black Lighting for several years.

But, I guess my riding days are over. If it comes to the choice of being able to keep this one useless foot/ankle/leg or trying to ride and injuring it even worse, well, I guess I'll have to hang up the leathers.

I thought about a three-wheeler, but I can not get over the fact that the darn things LOOK LIKE TRI-CICLES!

Besides which they do not "ride" like a motorcycle, but instead, like a car with three wheels.

Oh, well, I've had a pretty good run, I guess, haven't I?

Had to sell the Ultra-Glide, couldn't afford it anymore anyway.

But! I ain't selling my Harley Dog.............(the world's LARGEST English Springer Spaniel. I swear he is).

[Philip Rogers]

Phillip, thanks.

I've been riding since I got my first Cushman Eagle in 1960.

I've ridden most anything at one time or another. Even owned a Vicent Black Lighting for several years.

But, I guess my riding days are over. If it comes to the choice of being able to keep this one useless foot/ankle/leg or trying to ride and injuring it even worse, well, I guess I'll have to hang up the leathers.

I thought about a three-wheeler, but I can not get over the fact that the darn things LOOK LIKE TRI-CICLES!

Besides which they do not "ride" like a motorcycle, but instead, like a car with three wheels.

Oh, well, I've had a pretty good run, I guess, haven't I?

Had to sell the Ultra-Glide, couldn't afford it anymore anyway.

But! I ain't selling my Harley Dog.............(the world's LARGEST English Springer Spaniel. I swear he is).

Larry, I got a friend rides a trike and he's got cerebral palsy. Of course he's never ridden a real bike though, either. Gonna have to hang mine up too, one of these days. I think about it . . . . then think nawwww, not yet. At least ya got Harley Dog. Later . . .

pr

[nlualum82]

I rode cycles since I could touch the ground on the first mini-bikes, dirt biking early on and throughout, times I had a street bike and no car.

The last few bikes I've broke down and bought ended up sitting around, so when I got my retro and thought "BIKE", I thought hard about how many opportunities I'd capitalize on for the bike to do my mood any good.

I bought a street rod instead, a '36 Chevy rat rod pickup, fenderless, hoodless, 350 Chevy and powerglide, plain gray finish, wash it at the quarter car wash before a car show.

I drive it alot, to events and often just like a regular car, to work, to the store. I call it my 4 wheeled motorcycle. It gives me a little leeway with the weather as well as balance, moving limbs for circulation, eating, etc.

A local mechanic has asked a few times about putting a heater in it for me, I tell him "motorcycles don't have heaters"! (subject to old age)

I guarantee if I parked it at a local bar amidst the Harleys, it'd get the most attention from the people. Hard to get my wife in it, hard to keep my son and granddaughter out of it.

Harley, huh! I was shopping for a street rod when my granddaughter got the blackest lab you ever saw and took my suggestion to name her Lizzy, after Henry Ford's tin lizzy - available in any color you want as long as it's black.

I wish I still had good joints - the knees are among the worst - and could still run for exercise. If I had a dog to go with me I'd name it scissors so that the answer to alot of questions (where ya been, what to do do for a hobby, etc.) would be "running with Scissors"!

[Bound4heaven]

Greetings,

I have loss of use of both feet and I do not wear braces nor have even been fit for them. My feet issues are related from aquired flat foot I got in the military, and 4 other issues that have been rated as service connected. I have extreme pain when I walk. I do use a cane when I walk, however I cannot walk far because of the pain. I cannot take steps because ofthe pain I have in the feet.

I was rated at 60% for bi-lateral foot conditions, and I applied for increase and they granted me loss of use. I never even had a claim filed for loss of use. My VARO looked at all the edivence that was submitted. I have seen my foot doctor at the VA for 6 years twice a year. He wrote many IMO's on my behalf stating my limitations and my foot problems. I believe it varies from situation to situation. The VA has a standard of issues that must be met in regards to loss of use. However in my case some of the requirements I half way met and others I overly met.

However the key here as with all VA claims is having your VA doctor's on board with you and willing to do what ever they can to made sure you get justice in the broken VA system. I hope this helps. God bless and Merry Christmas.

Bound4Heaven

[LarryJ]

"running with Scissors"

I like that.

[LarryJ]

Oh yeah, something else. I can't ride anymore, but I have me a little shop out back, got me a bike lift, and a roll-around stool, so's I can get the bike up high enough that with me sitting on the stool, it's at about the right height.

Now, I'm one of those that always did all the work on anything I have ever owned, be it a Piper Cub, Harley, BSA, whatever.........

So, I've got me a pretty good little shop, and I will continue to build some good scooters. It just hurts a lot more than it used to, and takes me forever to get anything done..........but, it beats the heck outta watching Ophra or As The World Turns.....!

Can't just walk away from a part of my life............heck, leaving my first wife was a whole lot easier than giving up the H-D.

[windy city]

OK, I actually have some experience here.

If you are able to ambulate with a cane, you are still able to push foreward with your feet. Essentially if your able to balance, and move foreward at a steady rate without a brace then no loss of use.

However, if you are deemed to need an AFO (Ankle Foot Orthotic) brace, then they are essentially saying that the foot is useless.

So - with loss of use where the limb still remains, a brace is critical for a successful claim.

Personally I have 2 AFO's, and am rated at 100% T&P just for loss of use of both feet and legs below knee. The funny thing was I claimed the left leg 2 years after the right since the condition worsened. Since I stated that me "left foot was now essentially the same as my right" the VA scheduled an EMG to verify. I expected them to test the left leg, and they did... but then they compared it to the right which they also tested.

The EMG was conclusive and showed a mirror image, but... the VA was smart enough to check my claim that they were both the same now.

So, a brace or orthotic device is significant.

Bob Smith

Sixthscents,

I read your note and I have a? for you. I alsouse a AFO for my right leg whicg is sc but I also been diagnosed with fibromyositis and Fibromyalgia in which they cause amounts of great pain in my ankles and knees causing me to have loss of use of my lower extremities. Should I file for this condition.

[Ricky]

I have an upcoming DRO hearing (16 Apr 07). In Aug 05 my neuro provided a statement that due to complete loss of propositional sense I had complete loss of functional use. Since that time, Jan 07, they decided to try a custom AFO to assist me with walking. It pushes into the back of the calf muscle when it hits the floor which allows me to tell that the foot has hit the ground. This allows me to walk without having to watch my foot however, due to the pain I still have problems with forward push off. He also diagnosised that I have complete loss of functional use of the left hand due to complete loss of propositional sense. I can not hold or grip things. The hand remains closed and only opens when forced by an outside force which causes unbearable pain. I am going to aruge that I meet the rating requirements for 5111 which provides a 100 percent rating for loss of use of one foot and one hand. My neurologist provided me with a new statement for the DRO hearing whichs recaps all of this. These disabilities are from residuals of a SC'ed stroke. The residuals are caused from damage to my centeral nervous system which is called Dejerine-Roussy Syndorme. This is a strange bugger in that the nerves work they just work in a different way. They read feelings as pain (such as touch, wind blowing, tempature changes, real pain etc...) It changes from a ballon feeling to severe buring to a ripping/tearing to severe throbbing pain. If touched lightly it sends me into no mans lands. The burning is constant and mixed with the other feelings. I am on 3200 mg of neurontin, 1800 mg of trileptal and 80 mg of cymbalta daily for the pain as narcotic pain relivers are not effective. Talk about side effects - most days I dont know if I am coming or going. I still work - the work allows me to stay focused as a matter of fact it forces me to focus. Without the work I probably would just end it all. I can not hardly stand to be around the family cause of the multiple actions that go on at one time in a family enviornment such as the grandkids running and playing, the wife trying to tell me about what happened at home, the dog barking etc....... most of this is form the medications however, the pain plays a big part of it. I can't sleep cause the pain is constant, 24 hours per day. And lord help me if I hurt myself cause the nerves will over react to true pain and cause it to feel like it is a 1000 times worse than it is. I am currently being assessed to see if a brain stimulator will work. They want to put some kind of electrical device in the thalamus of my brain that will send some kind of electrical impulse to the nerves. The other option is surgey to completely kill the nerves which will leave me with a whole leg and arm that is dead. I do not really want this. Any comments will be appreciated. Thanks

Edited April 1, 2007 by Ricky (see edit history)

[sixthscents]

Sixthscents,

I read your note and I have a? for you. I alsouse a AFO for my right leg whicg is sc but I also been diagnosed with fibromyositis and Fibromyalgia in which they cause amounts of great pain in my ankles and knees causing me to have loss of use of my lower extremities. Should I file for this condition.

Sorry about the late reply, I have been on "vacation", or so they call the Hell that is DisneyWorld... anyway... in short, the definition of "loss of use" is simple, if you could function "equally as well" as with a prosthetic. So, an AFO, is very strong evidence that they consider the foot or limb to be non-functional to the point that a complete brace is needed. If you suffer equally debilitating effect in the other limb as well, and have good documentation, I'd certainly file for it.

Ricky, the PN makes no difference really in your case I would argue. While it can be VERY significant in cases involving nerve damage due to low back injury,in your case the pain and "loss of sensation" ... thats key, is very important. They have issued the AFO. It immobilizes the limb... I cannot fathom how they could say that you would function equally as well with a prosthetic when in all probability you would function better if the nerves were actually deadened. However, I cannot understand how this would not show up on an EMG. Something should show up if the nerves aren't working right. Pain is a signal... if the limb is "at rest", and a signal is detected, its not supposed to be there. They should see anonoymoulous(sp?) signals, random in nature that spike, and decrease also randomly.... In fact that is part of what they "saw" on my EMG.

I AM NOT doubting for a single second that what you say is true and correct. I am wondering that if you have had an EMG, was it done correctly, and was it interpreted correctly? In any case I think you have a really good claim for loss of use of 2 limbs, and yes its a single 100% rating. I'd argue it, especially with the documentation you have. You may have to fight it, but honestly my "opinion".... "opinion", is that if they actually see the evidence, they will make the correct decision. Generally the VA is like a blind dog, you have to push the food bowl near it, but once it smells it, it knows what to do....

WOW, I need to drive for 13 hours and then answer posts more often, I LIKE that analogy... anyway, I'd say your good Ricky, and if they say no, I'd take it on up the food chain. I just cant see them saying no, but with the VA you can NEVER be sure.

Also for all you new vets out there in repayment of your severance, a 100% rating that is service connected for another issue than that for which you were seperated causes "recoupment" of the severance to cease. Happy happy joy joy... its in M21-1, uhh. I'll give the refernece if someone wants it... but I'll have to look it up again, its a table that is kinda confusing until you really read it thru..

[sixthscents]

Oh, and Ricky I had them add a "butterfly" velcroe at the ankle of the braces, since they kept sliding foreward, and putting on shoes, even the extra height velroe ones was sheer ... well it was diificult anyway. Basically they put a strip of loop velcroe on the back part of the ankle of the brace, then you wrap a piece of "pile" velcroe around and over the top of the foot of the brace at the ankle level... its kinda hard to describe but it makes a butterfly pattern, and makes putting on shoes a world easier, and helps to hold the brace firmly in place without rubbing etc. I can send you a pic if you want to see what it looks like, you can just get the velcroe yourself, I do now, since I know what I need. Like I said, I bet ya have to fight to get the brace and front of the foot in a shoe at the same time, and this fixes that completely.

[Bound4heaven]

Greetings,

I have loss of use both feet. I use cane, however my foot doctor(VA) perscribed a brace for both feet very small in size. Almost 2 years ago I asked for increase for my bi-lateral foot issues (I was already rated at I believe at 50 %). I get a letter back stating I was awarded 1oo% for my feet (Loss of use) I was granted a car grant and housing grant which I have used.

I would say the key here is to get your VA doctors to perscribe some type of foot brace and then file for loss of use. It seems that is the key at lest in my situation. God bless.

Bound4Heaven

[windy city]

Greetings,

I have loss of use both feet. I use cane, however my foot doctor(VA) perscribed a brace for both feet very small in size. Almost 2 years ago I asked for increase for my bi-lateral foot issues (I was already rated at I believe at 50 %). I get a letter back stating I was awarded 1oo% for my feet (Loss of use) I was granted a car grant and housing grant which I have used.

I would say the key here is to get your VA doctors to perscribe some type of foot brace and then file for loss of use. It seems that is the key at lest in my situation. God bless.

Bound4Heaven

Bound4heaven,

I use an AFO brace, so how should I write my claim as loss of use of lower extremities or loss of use of feet. Thanks for the advice.