Drop foot, posted on another thread, needs to be a topic for visibility and effectiveness.

[jamescripps2]

Posted Sunday at 11:49 PM

John999, 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 any 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. Someone can have drop foot involving only one lower extremity or it can involve both lower extremities.

If you have drop foot 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.

Drop foot in the veteran population seems to be heavily related to diabetes and neuropathy. The most common cause of foot drop is peroneal nerve injury. The peroneal nerve is a branch of the sciatic nerve. It supplies movement and sensation to the lower leg, foot, and toes. Conditions that affect the nerves and muscles in the body can lead to foot drop.

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!

 

[jamescripps2]

This is an excerpt from 38 CFR 3.350

(2) Foot and hand.

(i) Loss of use of a hand or a foot will be held to exist when no effective function remains other than that which would be equally well served by an amputation stump at the site of election below elbow or knee with use of a suitable prosthetic appliance. The determination will be made on the basis of the actual remaining function, whether the acts of grasping, manipulation, etc., in the case of the hand, or of balance, propulsion, etc., in the case of the foot, could be accomplished equally well by an amputation stump with prosthesis; for example:

(a) Extremely unfavorable complete ankylosis of the knee, or complete ankylosis of two major joints of an extremity, or shortening of the lower extremity of 3 1/2 inches or more, will constitute loss of use of the hand or foot involved.

(b) Complete paralysis of the external popliteal nerve (common peroneal) and consequent foot drop, accompanied by characteristic organic changes including trophic and circulatory disturbances and other concomitants confirmatory of complete paralysis of this nerve, will be taken as loss of use of the foot.

[blahsaysme2u]

Aren't these just examples....not the only ways to be judged loss of use? 

[jamescripps2]

Yes, there are other avenues to get to loss of use of a hand or a foot. I am pointing out the path of least resistance. Being permanently confined to a wheelchair might do it and so would having claw hand. In any case one would need to comply with the definition of loss of use of a hand or foot as set forth in 38 CFR 3.350 (2) as posted above.

The point that I am trying to get across is the fact that if you do have drop foot, then this is your ticket to have the VA concede loss of use, because drop foot is caused by paralysis of the peroneal nerve, and paralysis of the peroneal nerve causes drop foot.

complete paralysis of this nerve, will be taken as loss of use of the foot.

 

[broncovet]

Again and again, I have seen Vets win benefits "but not" with the "entitlement theory" they proposed upon appeal.  It even happened to me.  I appealed the effective date, based on 38 cfr 3.156.  I did not win that, but did win another year of effective date because of an often overlooked regulation which follows:

(3)

The effective date of an award of increased compensation shall be the earliest date as of which it is ascertainable that an increase in disability had occurred, if application is received within one year from such date. source: https://www.law.cornell.edu/uscode/text/38/5110

[john999]

I have 40% SC for each foot due to PN, but I don't have foot drop as defined here.  My balance is not too good and my feet hurt like crazy at times.  I am afraid of falling in the shower or tripping because I do tend to drag my feet a little bit and shuffle when my legs are tired.  I would like to get an electric cart because when I go to the VAMC it is an ordeal for me.  By the time I head for the remote parking lot my feet are just hurting so bad I swear I will never go back to that place.  VA has all sorts of programs but if you are really disabled it is hard to gain access.  The VA is there but I can't get there and get around and they know it.

[jamescripps2]

John, it could be that you are only a diagnosis away from having drop foot. As a general rule, podiatrist do not check for drop foot unless there is a complaint that happens to ring a bell. Make an appointment  and then just ask your podiatrist out right. Explain your symptoms and ask, "do I have drop foot"? As you already have neuropathy at the amputation rate, chances are that you will probably get the diagnosis when the proper test are preformed.

That is exactly how I got my diagnosis. I too had foot pain and had to be extra careful that I did not fall. The prescribed braces really helped.

As far as a scooter. Ask your PCP for a scooter clinic consult. Explain to the scooter clinic about your foot pain and fear of falling. Expect to be denied, but be adamant about the need for the scooter and remind the person that you have a 40%rating for your lower extremities and the fact that 40% is in fact, the amputation rate. 

In the end, it is like all things VA. If you are nice, but at the same time adamant and tenacious, you will prevail and be issued a scooter.