P&T Determinating Factors

[ASU_0331]

So I am 60% on CAD, 50% bilateral pes planus w/plantar fasciitis, 20% DM II, and 10% tinnitus.

My CAD will never get better.  In fact it has only progressed since my heart attack in 2005.  DM II has plateaued with medication, but again, never going away.  Barring dsurgery to "release" the plantar tendon, there is nothing to do there except keep suffering with the crap insoles they continue to fit me with.  The DM II basically screws me out of corticolsteroid shots as it messes pretty bad with my blood sugar.

Currently have claims in for newly diagnoses Osgood Schlatters for both knees, degenerative arthritis of great toes, IT Band Syndrome of both legs, and calcaneal spurs of both feet (all secondary to the service connected bilateral pes planus). 

If awarded at minimum on these remaining, I will be at 100%.  The questions arises is if it is possible to get P&T for any of the issues in combination or on their own even if not at a full 100% individually?  I am guessing getting permanent would be a no brainer, but it is the total that seems to be the hurdle.      

[ASU_0331]

19 hours ago, Whodat said:

Doing my research on Pes Planus and Plantar Fasciitis, there was a new law change around February 2021. I will try to find it again. 

Anyways, my bilateral Pes Planus with plantar Fasciitis was rated together which had given me a 50% rating. According to the new law, it is now rated separately. I have met the criteria for 50 just for Pes Planus years ago.

ASU has brought up a really good point. 

The problem I have experienced with this is that they consider the foot pain associated with the plantar fasciitis and the foot pain associated with pes planus as pyramiding symptoms or whatever the hell they call it.

During my C&P exam for pes planus, the examiner was astonished at the condition of my feet.  She was dropping all the keywords in her notes for 50% rating on pes planus alone. and then spent the rest of time telling me all about how bad her feet were due to pes planus.  I think the issue at hand for me was that my VA doctor had just recently diagnosed me with bilateral plantar fasciitis before my C&P so it was in my medical records.  So despite only filing a claim for pes planus, they did a combined rating and included plantar fasciitis in the 50% rating. 

I appealed once already, pointing out that since 2017, my treatment had been for pes planus and pes planus alone and that not one doctor had diagnosed me with plantar fasciitis in that time.  So logically, that would mean that pes planus was the primary condition that then caused the secondary condition (plantar fasciitis) and therefore it should have its own separate rating.  The denial letter basically pointed out the pyramiding symptoms argument, despite the rating for plantar fasciitis being having been released as its own rating.

My main issue is that the two types of pain are very, very different.  The flat foot for me is a bone-aching, deep throbbing pain all the time whereas the plantar fasciitis pain is more akin to getting a knife stabbed into the soft tissue of the foot.  Yes, they are both foot pain, but on completely different spectrums.

[Whodat]

58 minutes ago, ASU_0331 said:

The problem I have experienced with this is that they consider the foot pain associated with the plantar fasciitis and the foot pain associated with pes planus as pyramiding symptoms or whatever the hell they call it.

During my C&P exam for pes planus, the examiner was astonished at the condition of my feet.  She was dropping all the keywords in her notes for 50% rating on pes planus alone. and then spent the rest of time telling me all about how bad her feet were due to pes planus.  I think the issue at hand for me was that my VA doctor had just recently diagnosed me with bilateral plantar fasciitis before my C&P so it was in my medical records.  So despite only filing a claim for pes planus, they did a combined rating and included plantar fasciitis in the 50% rating. 

I appealed once already, pointing out that since 2017, my treatment had been for pes planus and pes planus alone and that not one doctor had diagnosed me with plantar fasciitis in that time.  So logically, that would mean that pes planus was the primary condition that then caused the secondary condition (plantar fasciitis) and therefore it should have its own separate rating.  The denial letter basically pointed out the pyramiding symptoms argument, despite the rating for plantar fasciitis being having been released as its own rating.

My main issue is that the two types of pain are very, very different.  The flat foot for me is a bone-aching, deep throbbing pain all the time whereas the plantar fasciitis pain is more akin to getting a knife stabbed into the soft tissue of the foot.  Yes, they are both foot pain, but on completely different spectrums.

I will have to agree with your argument. I have read that the law had changed in Feb 2021. Pes Planus as well as Plantar Fasciitis are separate ratings now. I put the link on your forum post.