Loss of use more VA games to watch for

[Mr cue]

Well I just thought I would bring this up it may help other watch for this game.

Loss of use under smc benfits.

Well the game is the VA will  keep ordering exams stating the examiner need to tell if you have remaining function.

The VA manual even state to use considerable care when ordering exams.

Well in my case I have had 6 comp exams  the specialized loss of use exam.

An they still wouldn't address my case smh .

Just venting a little 

Ok here is the rule on smc .

Responsibility for Determining LOU The responsibility for determining whether there is loss of use (LOU) of an extremity

• rests with the rating activity, and

• cannot be delegated to the examining physician.

c. Information to Request From an Examiner to Determine LOU When requesting an examination to determine LOU of an extremity, ask the examiner to furnish a

• detailed objective description of remaining function

• quantitative assessment of strength for each extremity involved, and

• description of any pain that affects use.

Do not request that the examiner

• determine LOU, or

• express an opinion as to whether there is, or is not, LOU of an extremity or extremities.

Note: If LOU cannot be determined upon review of an examination report, request an appropriate specialized examination.

References: For more information on

• considering functional loss due to pain in claims for SMC, see Tucker v. West, 11 Vet.App 369, 374 (1998), and

• requesting a specialist examination, see M21-1, Part III, Subpart iv, 3.A.6.

d. Determining the Extent of Examinations in Claims Involving SMC Under 38 U.S.C. 1114(l) Through (n)

Example: A prior examination clearly established LOU of both lower extremities at a level preventing natural knee action. Do not request a complete medical examination if the only issue in question is the extent of involvement of one or both of the upper extremities. Instead, request an examination with a notation that the examination be restricted to the degree of functional impairment of the upper extremities.

[Mr cue]

The thing I found is that the decision don't address lost of use.

Not been able to make a fist or put arms over head etc.

The denied is the veteran doesn't have loss of use equivalent to a amputee.

That is the cretia for loss of use.

[jamescripps2]

By design, the "O" award is very elusive and hard to obtain.

A doctor can dx foot drop, but only the VSR or rater can make the determination that you have foot drop to the degree justifying loss of use of foot. Not being able to make a fist or reach above the head has nothing to do with anything except maybe range of motion.

Loss of use of a hand exist when you loose pinch grip and have other organic signs, Loss of use of a foot exist when you loose the ability to propel, along with other organic signs, muscle loss etc. 

As you mentioned, loss of a hand or foot has to be to the degree that you would be equally well served with an amputation and a properly fitted prosthetic. Not that an amputation would be required.

If you read 38 CFR 3.350 you can see that loss of a foot will be held to exist and conceded if you have permanent loss of the perennial nerve, accompanied by other organic signs. (muscle loss etc. 

[jamescripps2]

John, to tell you more about foot drop, as you asked. When you have foot drop, you can no longer lift the front of your foot. When you take a step on a tile, or other solid surface, your foot strikes the floor toes first instead of heel first. That situation trips you and you have to run to catch up in order keep yourself from falling.

You can stand on your toes but you can no longer stand on your heels.

You can press down on the gas pedal and the brake pedal, but you can't let off of the gas or brake pedal unless you lift your entire leg from the hip.

In the case of foot drop, an Ankle Foot Orthotic brace (AFO) is prescribed. The AFO, with its spring action causes your foot to raise at the toe when lifted off of the floor. An amputation is never prescribed for foot drop. As far as driving, a person who has foot drop most probably has already adjusted and actually, without realizing it, raises the entire leg at the hip to decelerate or come off of the brake pedal. 

If you are awarded the automobile grant, because of the foot drop and resultant loss of use, you will also be awarded the adaptive equipment grant. A steering wheel knob with hand controls will solve the driving problem.

Once you know what foot drop is, you can sit on a bench or chair in the hallway at the VA and watch the guys feet as they walk. You can pick out the ones who have foot drop. Some drag their toes, some have developed a high stepping gait, some swing a foot out sideways to keep it from dragging, but you can hear the foot slap the floor as they walk. They are not even aware that they have foot drop. 

All of those guys that you spot walking down the hall with foot drop would qualify for shoes and braces (AFOs). All would qualify for one or two $971.00 each yearly clothing allowances. Some would qualify for special monthly compensation "L" and some would qualify for SMC at the "O" rate, All would qualify for the approximately $22,000.00 automobile allowance w/ adaptive equipment and some would qualify for the special adaptive housing grant (SAH), of $108,000.0. IF THEY ONLY KNEW!

 

[Mr cue]

Here are the cfr for loss of use smc benefits.

Responsibility for Determining LOU The responsibility for determining whether there is loss of use (LOU) of an extremity

• rests with the rating activity, and

• cannot be delegated to the examining physician.

c. Information to Request From an Examiner to Determine LOU When requesting an examination to determine LOU of an extremity, ask the examiner to furnish a

• detailed objective description of remaining function

• quantitative assessment of strength for each extremity involved, and

• description of any pain that affects use.

Do not request that the examiner

• determine LOU, or

• express an opinion as to whether there is, or is not, LOU of an extremity or extremities.

Note: If LOU cannot be determined upon review of an examination report, request an appropriate specialized examination.

References: For more information on

• considering functional loss due to pain in claims for SMC, see Tucker v. West, 11 Vet.App 369, 374 (1998), and

• requesting a specialist examination, see M21-1, Part III, Subpart iv, 3.A.6.

d. Determining the Extent of Examinations in Claims Involving SMC Under 38 U.S.C. 1114(l) Through (n)

Example: A prior examination clearly established LOU of both lower extremities at a level preventing natural knee action. Do not request a complete medical examination if the only issue in question is the extent of involvement of one or both of the upper extremities. Instead, request an examination with a notation that the examination be restricted to the degree of functional impairment of the upper extremities.

[Mr cue]

I think veterans let the VA play games with loss of use.  A veteran doesn't have to have total loss of use.

This is from the lawyers hill& poton might not have spell that right be the law firm.

 

 

To make the VA definition easier to understand, let’s take a look at an example: picture a coin on the center of your kitchen table. Are you able to pick the coin right up with your fingers, or do you need to slide the coin to the edge of the table and push it until you can allow it to fall into your hand? If you’re unable to grasp the coin immediately, that is an indicator that your hands may not have a substantial remaining function.

When considering whether you may qualify for Loss of Use of Hands, some other questions to ask yourself are:

• Do I have problems lifting pots and pans in the kitchen?
• Do I frequently drop my eating utensils?
• Is it difficult to wash myself in the shower due to lack of control of my hands?
• If someone places something in my hand, can I feel it?
• Am I able to type on a computer?
• Can I pick up a pen and write a grocery list?
• When I am driving, do I have full control over the steering wheel?
• Am I able to button my own shirt?
• Can I tie my shoes?