Help please, claim was decided but doesn't make sense

[traveler]

Hello again, everyone.

I submitted a claim for 2 conditions secondary to Bilateral Knee Arthritis.  Shin Splints and Plantar Fasciitis.

My claim was completed, and they took the shin splints and just added the word "shin splints" to my existing condition Knee arthritis.  Not as secondary to.....just added shin splints to my existing condition.  So, they combined a new condition to an existing condition.  This can't be legal.  Any advice?

 

Second condition, plantar fasciitis was declined as the C+P doctor stated that my plantar fasciitis was caused by me standing at my job working in a hardware store, and wasn't secondary to my knees.  My contention is that my bad knees and now my bad shin splints CONTRIBUTED to plantar fasciitis, as I have been working at this job LONG before this issue came up.  Does anyone know of a way to link my feet to my lower leg conditions and knees?

Because of the way he wrote this, I am thinking I may need an Independent Medical Opinion or Exam

Any help would be GREATLY appreciated.

 

[jfrei]

Yes to the IMO they are good to have. And in my case is they rate both separately then they may not be beneficial to your money in my case they explained why they rated my TBI and Ptsd together because separate ratings would not have put me over 100%. But that’s what they told me not sure if I believe them but tired of fighting. So just wait for another answer that’s more helpful 

[traveler]

Thanks.  Dr. Dash on the VAWatchdog site seems to be well known.  I shot him an e-mail.

I am being sent off base to a civilian podiatrist.  Perhaps he/she may be willing to write a letter stating that Knee arthritis and pain can cause plantar fasciitis.  That may be enough to get the VA to give me the foot condition as secondary.

Arthritis and shin splints have 2 separate codes (5262, 5003), yet the RO tried to take my new claim and add it to my existing claim...well, didn't try....they DID IT!

Anyone else have any ideas....please?

Edited December 9, 2017 by traveler

[Guest L]

I received am IMO from VA Watchdog - Dr Vallette worth the money.  I spoke with Dr Bash he is amazing! - wish I had contracted with him b/c I have been unable to get my HTN linked to PTSD without an IMO. 

Check the symptomatology of your diagnosis, Shin Splint, nor Plantar Fasciitis are not always  long term - they can be resolved with therapy and compensatory techniques - such as orthotics and ultrasound. 

https://www.webmd.com/a-to-z-guides/tc/plantar-fasciitis-topic-overview#1

https://www.medicalnewstoday.com/articles/242169.php

Hope this info helps good luck - 21 yrs of Occupational Therapy experience

[DivComms]

On 12/8/2017 at 11:28 PM, traveler said:

Thanks.  Dr. Dash on the VAWatchdog site seems to be well known.  I shot him an e-mail.

I am being sent off base to a civilian podiatrist.  Perhaps he/she may be willing to write a letter stating that Knee arthritis and pain can cause plantar fasciitis.  That may be enough to get the VA to give me the foot condition as secondary.

Arthritis and shin splints have 2 separate codes (5262, 5003), yet the RO tried to take my new claim and add it to my existing claim...well, didn't try....they DID IT!

Anyone else have any ideas....please?

Regarding your contention of wanting a separate individual ratings of shin splints. What you wanted would result in a case of pyramiding, being rated twice for the same symptoms.

Shin splints are rated on how they affect your knee or ankle, seeing as your arthritis of the knee covers that already it would be double dipping.

The reason why they added shin splints is that they agreed it was service connected. If your shin splints made/make your knee worse then that is taken into account when a rating is given to the arthritis of the knee.

" Code 5262: Any problems with the tibia or fibula bones in the lower leg are rated under this code. If there is a complete break in either bone that cannot heal and requires a brace, then it is rated 40%. All other conditions are rated by how they affect the knee or ankle joint. If they cause serious problems (can barely use the joint at all), then it is a 30% rating. If the joints can be used, but the condition significantly limits the amount of activity, then it is rated 20%. If the knee or ankle joint is affected only slightly, then it is rated 10%."

Seeing how shin splints tend to be a short term issue, (You can only get rated for things you are suffering from) you would likely get a 0% rating anyway.

 

As far as getting your plantar rated as secondary, you need to find a doctor to review your c file and opine how they believe it is at least likely as not to be related to your service connected knee or other SC issues.