Supplemental Claim

[Wise Guy]

I submitted my supplemental claim 3 days ago for the following diagnosis with evidence:

- Flat Feet (Primary) - Bilateral Plantar Fasciitis (Secondary) - Bilateral Pronation to mid and rear foot (Secondary)

- Intra-articular Hip Pain (Primary) - Femoroacetabular Impingement (Secondary) - Right Adductor Groin Pain (Tertiary) - Athletic Pubalgia (Tertiary) - Osteitis Pubis (Tertiary)

- Right Knee Pain

 

- Low Back Pain

- Left Tennis Elbow

- Bilateral Tinnitus

 

The VA updated va.gov 2 days ago with these pending diagnosis:

 

- Impairment of femur

- Flatfoot

- Limitation of leg motion (flexion)

- Lumbosacral or cervical strain

- Limitation of forearm motion (flexion)

- Tinnitus

 

Through my own insurance, for all of the injuries listed in the first group of injuries above, I got doctors to diagnose me with them and they added, "More than 51% probable that the injuries occurred during military service" since the same injuries got denied in the past. I used those evidences to file my supplemental claim. I called the VA today to request for them to change what they put back to how I had it. The missing items like "Pronation", I had them annotate where to find the diagnosis on the doctors notes so that they can add it. I think they overlooked it. They also left out my right adductor pain. For the hip injury, it's not just, "Impairment of femur" as they put it. Why did they do this? Are they trying to gyp me? Why didn't they annotate the secondaries and the tertiaries like I annotated it? Instead of "Right Knee Pain" they put "Limitation of leg motion (flexion)". For "Low Back Pain" they put "Lumbosacral of Cervical Strain." For "Left Tennis Elbow" they put "Limitation of forearm motion (flexion)". Are they trying to gyp me or did I make the mistake of calling them asking them to change it back to how I had it?

[brokensoldier244th]

Because not every medical term under the sun is in the schedule of ratings or the m21. The schedule breaks it down by body system and part for ratings. There is no diagnostic code for plantar fasciitis, for example, so it’s usually rated under flat feet diagnostic code 5276. That’s why some of the wording is changed. Va can only rate based on what’s in the ratings schedule. 

“When a disability is encountered that is not listed in the rating schedule it is permissible to rate under a closely related disease or injury in which the functions affected, the anatomical location and the symptomatology are closely analogous to the condition actually suffered from.-38 CFR 4.20“