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Pes Planus and Secondaries


ASU_0331

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Hello all again,

So pes planus was noted on my final physicals and been diagnosed by VA doctors here in Tucson.  VA podiatry has already tried two different set of insoles and now ordered a third set and started me on cortisone injections just this last Friday on the 29th to ease the chronic pain.  Have also been tossed to orthopedics by podiatry due to secondary issues with ankles, knees, and hips that are all jacked up due to the underlying pes planus.  So now the first question;

Do I put everything in as a package with the pes planus claim as the primary, with all the other issues as secondary to the pes planus and submit as one package or do I submit the pes planus by itself, wait for a rating, and then submit everything else as secondary?

The pes planus is a no brainer as it was documented in service and since end of service in treatment by the VA.  So far, three different podiatrists with the VA have attributed the plantar fasciitis/calcaneal spurs to the pes planus.  Have also been treated for patellar tendonitis/ITB Syndrome by the VA due to the pes planus.  So now the second question;

With all treatments having been done soley at VA facilities, do I gather everything from Blue Button and submit with claim on my own?

 

Thanks again all.

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  • HadIt.com Elder

Is the Pes already rated? If not  you can submit them all at once because if the Pes is granted they will still see the open claims that are secondary and rate them accordingly.

Have you filed for Pes before? If you have and were denied you'll need to file on a 20-0995 to re-eval that contention, rather than a 526ez. In that case you would best wait until the Pes is connected for the other conditions. 

Blue button is the same stuff we pull off CAPRI (thats what the medical records system is called). We'll pull it all anyway, between whatever date ranges you put on your claim. If you want to download it, mark it all up, and then upload it it would make it a lot easier for whomever is building your claim prior to rating. We'll still pull it anyway, but if you can save us some time digging in your records it is appreciated. 

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I always advise:  Dont burn down bridges and dont "even try" to worry about primary, secondary, presumptive, etc.  

Best:  "I wish to apply for pes planus and issues with knees, back, hips, patellar tendonitis, both primary, secondary (to SC condition) and presumptive, as the medical evidence may so suggest.   

You dont have to decide!  Let a rating specialist decide, dont limit it to "just secondary" or even "just primary".  

Your doctor should opine if its related to a already SC condition.  And, your c and p doc may think otherwise.  

If you try to apply for "patellar tendonitis" secondary to pes planus", a doc may opine something different and you could get denied because you insisted its secondary.  While it could be overturned on appeal, do you want to delay your own claim?  I dont.  

 

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  • HadIt.com Elder

Correct. Lay statements are not medical so don't self diagnose and claim osa for sleep disturbances unless you have a dx for osa. If  you claim osa that's what we have to go with. If you start calling off conditions that you think you have and you're denied when you claim again it's more likely to be taken as a 0995 claim of something already denied because you already claimed that body part before. 

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Thanks all for the input.

My former service officer with DAV is now retired and he was an absolute bear in dealing with my claims and I am saddened he won't be handling this set.

My new service officer reached out to me today and I am pretty confident in her already.  She called me fully prepared with all my previous claims opened up and had already familiarized herself with what had been done on my behalf and what had been previously declined.  Just for anyone else that might have the same scenario;

Previous claim for pes planus denied due to lack of diagnosis in 2017.  Granted, there is a diagnosis of pes planus on my final physical with reoccurring pain during PT noted in my service records due to pes planus.  However, it was not a current diagnosis.  Keyword there, CURRENT.  My current diagnosis for pes planus is dated in 2018 and includes the plethora of issues the VA have associated with the pes planus via MRI and x-rays.  The only one they have not linked yet is my hip issues, which is likely to occur on the 11th of February when I have an orthopedics appointment where they are going to be checking out the knees again and finally the hips.

So, my new DAV service officer is filing the supplemental claim for the pes planus with new supporting evidence.  She is also submitting an intent to file on all the other issues with the existing supporting evidence since 2018 as well as the new stuff coming in from the appointment on the 11th to preserve the date.

 

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Just an update;

Had a C&P exam with QTC on Tuesday (02/16).  Was pretty surprised that I got called up for one so quickly after my VSO submitted the supplemental claim.  The exam was with a FPN and she was very nice and pleasant to deal with. 

She dived into my records pretty hard and was able to pull up something that I didn't even remember from 1995 where I was seen for foot pain and issued inserts for my boots.  She then linked it to final physical exam where pes planus was noted as well as continued complaints of foot pain, especially during cold weather in 1998 and then again when I got out in 2003.  Then she dived into the most current visits I have had with the VA starting in 2017 or so and then end up with the actual physical exam.

She performed a pretty quick exam and seemed to hit all the key points and entered them in her notes and computer.  One thing to note, she had very obvious feet/knee/hip issues and during her exam she continually pointed out how she had to deal with the exact same issues she was seeing on me.  She even went so far as to reach into her purse and show me the cold treatment roll-on she uses for her flare-ups to get her through the day.

I know that QTC gets a bad rap sometimes, as well as FPN, but between my QTC exam for CAD and this one for feet, they have treated me pretty well.  Just waiting to see what was determined now. 

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ASU_0331 It does sound favorable, but you never know how that translates  to exam notes. And, of course she makes the observations, but the VA rater makes the decision.  But I agree it does seem favorable. I've had some really bad examiners and some really good ones. Some have the attitude that they will just pick out the obvious stuff and then some do a little digging because they feel you should receive a fair shake. Hopefully you got the latter. Best of luck on the results. And pay attention to your body as these foot and extremity disabilities can lead to others as secondaries.

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  • HadIt.com Elder

We get the exam review back before we send to rating and read it, and mark the important parts, and so in the meantime we also download your most recent progress notes from vamc if you go there and look those over, also.

 

We electronically tab/annotate things relevant to the claim before sending to rating. We do that with your older notes and private medical that you provide that we send to the examiner, too, so they dont have to dig as much. Page numbers, etc. Most of my day is doing things like this. 

Edited by brokensoldier244th
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