Received three related SC ratings of 0% for my left ankle, foot, and toes?
Doesn't the need to wear an ankle brace factor into the rating?
This is long, but I included all info from VA decision letter.
Background: Fell from 8-10 feet with 60+ pounds of gear strapped on back in Iraq compressing my left ankle…caught my leg on jagged rebar cutting left leg (5 in scar…I'll talk about that later). I'm still having joint pain (continue to get cortisone shots for pain relief) and ligaments so stretched I have little control of ankle. Podiatrist & Physical Therapist worked on it up until my retirement on 1Sep08 (so I do have more info the VA my not have had), but PT will not correct overstretched ligaments. Podiatrist recently suggested surgery, but also stated I will likely need to continue wearing the custom ankle brace to support ankle. I also have shin splints (but not claimed and was not mentioned in letter). Keep in mind I'm wearing a metal ankle brace during the C&P exam and hobbling down the hall behind the doc to his office, and here is the result….Zero….and it states my gate was normal?? I have notes from PT and Podiatry stating just the opposite. The VA was nice enough to find two additional problems on the VA X-ray the SC, but both got zero.
Here is the VA Decision Letter:
#1) SC for Left Foot and Ankle Sprain = 0%
We have granted service connection for left foot and ankle sprain as directly related to military service. Your service treatment records reveal treatment in April 2004 for a left ankle sprain, in December 2007 for compression Arthralgia and February 2008 for left ankle pain. During VA examination, you reported you had a left ankle compression injury from trama in 2006. You said you continue to have pain. You stated that you wear a brace at all times and have orthotics in your shoes bilaterally and that your activities are limited in that you do not run.
VA examination reported your gate was grossly normal. You demonstrated marked laxity on aversion of the ankle and inversion was intact. The examiner observed full range of motion without report of pain on motion. There was no edema, effusion, tenderness, redness, heat, subluxation, or guarding of movement reported. After repetitive use, the joint function was not additionally limited by pain, fatigue, weakness, lack of endurance, or incoordination. X-rays of the left ankle were normal. The VA examiner diagnosed left ankle sprain and left foot sprain with residual laxity.
We have assigned a noncompensable evaluation, as the diagnosis is left ankle sprain and left foot sprain and you have full range of motion without painful or limited motion of the ankle. We have combined the evaluation of the left foot and sprain with the left ankle sprain, as each would be noncompensable when rated separately.
This disability is not specifically listed in the rating schedule; therefore, it is rated analogous to a disability in which not only the functions affected, but anatomical localization and symptoms, are closely related
#2) SC for Left Foot Hammer Toe = 0%
Although not specifically claimed, we have granted service connection for left foot hammer toe, as directly related to military service. The claim is established by X-ray evidence on VA examination. Your service treatment records show Intermetatarsal Neuroma were identified on the left second and third toes in October 2007. During VA examination, your reported use of orthotics for both feet.
VA examination revealed X-ray evidence of hammer toe on your left fourth and fifth toes. The x-rays showed flexion deformities of the fourth and fifth toes, milder at the second and third toes. Your gate and posture were observed to be normal. The VA examiner diagnosed left foot hammer toe.
We have assigned a noncompensable evaluation as the diagnosis is hammer toe and it involves the left second through fifth toes. A noncompensable evaluation is assigned unless hammer toe affects all toes on one foot.
#3) SC for Left Hallux Valgus = 0%
Although not specifically claimed, we have granted service connection for left hallux valgus as directly related to military service. No report of hallux valgus of your left foot was found in your service treatment records. During VA examination, you reported that you use orthotics for your feet. You made no report of left foot surgery.
On VA examination, X-ray evidence revealed mild hallux valgus on your left foot. Thre was mild bony bunion formation at the medial head of the first metatarsal. No evidence of surgical resection was noted. The examiner noted no significant callus formation. Your gait was observd by the examiner to be normal.
We have assigned a noncompensable evaluation as the VA diagnosis was left hallux valgus from X-ray evidence, and there is no evidence of surgical resection. A noncompensable evaluation is assigned unless the metatarsal head has been surgically resected, or the condition is functionally equivalent to an amputation of the great toe.