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

[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

[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.