Is The A Diffinition For This?

[Guest jangrin]

I was researching the CFRs and was looking at the specific diffinitions for rating PN having to do specifically with the feet and various nerves.

In 38 CFR 4 it has the following (partial text only) for the common perineal nerve. Does any one know what the standard examination findings that qualifiy for the terms

MILD

MODERATE

SEVERE

External popliteal nerve (common peroneal)

8521 Paralysis of:

Complete; foot drop and slight droop of first phalanges of all toes, cannot dorsiflex the foot, extension (dorsal flexion) of proximal phalanges of toes lost; abduction of foot lost, adduction weakened; anesthesia covers entire dorsum of foot and toes 40

Incomplete:

Severe 30

Moderate 20

Mild 10

[JohnM]

I was researching the CFRs and was looking at the specific diffinitions for rating PN having to do specifically with the feet and various nerves.

In 38 CFR 4 it has the following (partial text only) for the common perineal nerve. Does any one know what the standard examination findings that qualifiy for the terms

MILD

MODERATE

SEVERE

External popliteal nerve (common peroneal)

8521 Paralysis of:

Complete; foot drop and slight droop of first phalanges of all toes, cannot dorsiflex the foot, extension (dorsal flexion) of proximal phalanges of toes lost; abduction of foot lost, adduction weakened; anesthesia covers entire dorsum of foot and toes 40

Incomplete:

Severe 30

Moderate 20

Mild 10

I am not sure this is what you want but in John's definition of his rating this is what they put down I hope this will help you.

Service connection for S1 RAdiculopathy on the left to the level of the knee with left food drop as secondary to the service connected disability of degenerative joint disease of the lumbar. an evaluation of 60 % is assigned for incomplete paralysis below the knee wich is severe with marked muscular atrophy. The highest evaluation allowable for this disability under current VA regulations.

I hope this helps you/

[Guest jangrin]

I am not sure this is what you want but in John's definition of his rating this is what they put down I hope this will help you.

Service connection for S1 RAdiculopathy on the left to the level of the knee with left food drop as secondary to the service connected disability of degenerative joint disease of the lumbar. an evaluation of 60 % is assigned for incomplete paralysis below the knee wich is severe with marked muscular atrophy. The highest evaluation allowable for this disability under current VA regulations.

I hope this helps you/

Thanks JohnMs wife,

I think this is the way they applied the percent rate for JOHN. But what I am trying to find out is how they make a determination that something is mild, moderate or severe. Is it based on acute pain or is it rated on lack of use or what. I searched the AMA papers and website. I did find one article where the AMA does NOT even have a set standard for reporting the various stages of peripheral neuropathy.

If the AMA does not have a set diagnostic standard (uniformity) within the medical community, then what criteria is the VA using when they are making a determination of the the level of severity of a debilitating condition. Especially by non medical raters(civilian) as opposed to doctors. I just read my husband C&P report, it give him a diagnosis of PN but it does not state what level, mild, moderate, severe or listed as partial paralysis.(which he has).

If the report doesn't give the level but only diagnosis how is this rated???

Jangrin

Edited February 22, 2007 by jangrin

[Dennis]

Jangrin,

I am SC for peripheral neuropathy in all extremities. My most recent rating decision for left and right peroneal nerves resulted in evaluations of 10% for each. The decision was based on motor nerve conduction studies and neurological examinations.

The motor nerve conduction studies provide quantifiable evidence of the impact to specific nerves while the neurological exam provides visual evidence of the overall impact of motor and sensory nerves on your ability to function.

Although some of this is very subjective, the nerve conduction studies are very specific and a good neurologist can determine the impacts to your extremities.

Good luck with your claim.

Dennis

[Guest terrysturgis]

Jangrin, I was rated at 20% and got raised to 40% Bilaterial lower extremities as the decision is reads as follows:

The evaluation of peripherial neuropathy of both lower extremities is increased to 40 percent disabling effective March 27, 2006, which is the date of the VA examination that showed the condition worsened. Vibratory sense was absent at the ankles and monofilament sensorium was absent over much of the feet. The examination showed that in addition to loss of sensations which had been shown earlier, strength in your quadriceps flexors and flexors in your feet was reduced to 4/5, a medical finding that indicates strength against light resistance only, not full strength. The examiner stated that the neuropathy now involved several nerve tracts and described the severity of the neuropathy as moderate to severe. The findings meet the requirements for increased evaluation to 40 percent from the date of the exam.

A higher evaluation of 60 percent is not warranted unless there is evidence of incomplete paralysis below the knee which is severe with marked muscular atrophy.

When I received the copy of that C&P exam the examiner used range of motion and sensory testing to come to that conclusion. I also had an IMO from a VA doctor and my outside physician.

As you can see the language says moderate to severe in the decision and I got 40 percent bilaterial. I hope this helps. Terry Sturgis