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Neuropathy


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16 replies to this topic

#1 navyvet

 
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Posted 09 October 2007 - 11:27 AM

I had been rated at 10% for left foot 10% for right foot 10% for upper left leg and 10% for upper right leg.

I had the required exam that found my neuropathy had worsened . The VA changed my Rating to 20% for left foot and 20 % for right foot, however there is now no rating for left and right upper.


IS THIS STANDARD ROUTINE OF THEM ?

WHAT SHOULD I DO ?

#2 entropent

 
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Posted 09 October 2007 - 12:40 PM

"I had been rated at 10% for left foot 10% for right foot 10% for upper left leg and 10% for upper right leg."

this is highly irregular, and borders on the prohibition against pyramiding. the rater who did this was incorrect. probably what happened is the next rater came along and corrected the erroneous rating. he did not take anything away from you, you are still 20 percent for each lower extremity. but on the other hand, he did not give you the increase you were seeking. bottom line, it will not do you any good to try to get back a separate rating for your lower and your upper legs. won't happen. best to go after a rating for peripheral neuropathy of the left and right upper extremities. got numbness and tingling in your hands?

#3 navyvet

 
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Posted 09 October 2007 - 01:03 PM

"I had been rated at 10% for left foot 10% for right foot 10% for upper left leg and 10% for upper right leg."

this is highly irregular, and borders on the prohibition against pyramiding. the rater who did this was incorrect. probably what happened is the next rater came along and corrected the erroneous rating. he did not take anything away from you, you are still 20 percent for each lower extremity. but on the other hand, he did not give you the increase you were seeking. bottom line, it will not do you any good to try to get back a separate rating for your lower and your upper legs. won't happen. best to go after a rating for peripheral neuropathy of the left and right upper extremities. got numbness and tingling in your hands?

I have numbness and tingling at times in left hand and the left leg is numb to the hip , maybe a little in left leg but definitely not as bad as the left. I had an Electromyography test about 3 months ago and dr said I had moderate neuropathy in feet . and noted some in upper but not as bad .

#4 entropent

 
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Posted 09 October 2007 - 01:09 PM

see, neuropathy is rated as for incomplete paralysis of the peroneal nerve, which serves the leg below the knee. for neuropathy in the entire leg, it should be rated as for incomplete paralysis of the sciatic nerve, which serves the entire leg. but there should NEVER be two ratings for the same leg.

if you have numbness and tingling in your hands, put in a claim for neuropathy of the upper extremities.

#5 navyvet

 
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Posted 09 October 2007 - 01:57 PM

see, neuropathy is rated as for incomplete paralysis of the peroneal nerve, which serves the leg below the knee. for neuropathy in the entire leg, it should be rated as for incomplete paralysis of the sciatic nerve, which serves the entire leg. but there should NEVER be two ratings for the same leg.

if you have numbness and tingling in your hands, put in a claim for neuropathy of the upper extremities.



Somehow I have the feeling my SO is going to flip . I asked him why they did away with it and got the answer "thats what they decided" with no explaination....
I am on 1200 MG of gabupentin and it has helped but know that its only temporary .I dont have the strength in my left hand like I use to .

If they rule in my favor do you think they will assign disability for sciatic nerve instead of peroneal nerve damage ? I take it its different?

#6 entropent

 
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Posted 09 October 2007 - 02:16 PM

if you have a VSO, ask him for a copy of the "codesheet" from your last rating. that will show what diagnostic code your neuropathy is rated under. 8521 is the coding for the peroneal nerve. 8520 is the coding for the sciatic nerve.
if you are not coded 8520 for the left leg, and you have demonstrable neuropathy in the entire leg, submit a letter asking to be rated under the 8520 coding and explain why. (the evaluations under the sciatic nerve go higher than those for the peroneal nerve). appeal if you are turned down. that is only if you can show by objective evidence that your entire leg is involved.

numbness, tingling, decreased grip strength, and loss of fine motor coordination are hallmarks of neuropathy in the hands. if you think you qualify, make the claim. it costs you nothing to ask.

#7 navyvet

 
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Posted 09 October 2007 - 02:30 PM

if you have a VSO, ask him for a copy of the "codesheet" from your last rating. that will show what diagnostic code your neuropathy is rated under. 8521 is the coding for the peroneal nerve. 8520 is the coding for the sciatic nerve.
if you are not coded 8520 for the left leg, and you have demonstrable neuropathy in the entire leg, submit a letter asking to be rated under the 8520 coding and explain why. (the evaluations under the sciatic nerve go higher than those for the peroneal nerve). appeal if you are turned down. that is only if you can show by objective evidence that your entire leg is involved.

numbness, tingling, decreased grip strength, and loss of fine motor coordination are hallmarks of neuropathy in the hands. if you think you qualify, make the claim. it costs you nothing to ask.

Thank you for your insight , I will get hold of my SO and ask him . Will keep you updated .

#8 navyvet

 
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Posted 10 October 2007 - 09:54 AM

Thank you for your insight , I will get hold of my SO and ask him . Will keep you updated .


Well I talked to my SO he said my codes were 8699 and 8620 for feet . No mention of 8520 or 8521 . He also stated they said the numbness in my leg is not service connected :)

The numbness started when I was diagnosed with Type 2 Diabetes , along with all the other pains .


#9 entropent

 
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Posted 10 October 2007 - 10:32 AM

Well I talked to my SO he said my codes were 8699 and 8620 for feet . No mention of 8520 or 8521 . He also stated they said the numbness in my leg is not service connected :)

The numbness started when I was diagnosed with Type 2 Diabetes , along with all the other pains .



the 8699-8620 code makes sense (it is a variant of the 8520 code), but may not be to your advantage in the long run, because it maxes out at "moderate" incomplete paralysis. but i do not understand the reference to not being service connected for your legs. please elaborate? is your 8699-8620 service connected or not service connected? fyi, va will make no distinction between feet and legs when evaluating neuropathy. so if you are service connected for your feet, that is also considered for you legs below the knees.

#10 navyvet

 
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Posted 10 October 2007 - 10:46 AM

the 8699-8620 code makes sense (it is a variant of the 8520 code), but may not be to your advantage in the long run, because it maxes out at "moderate" incomplete paralysis. but i do not understand the reference to not being service connected for your legs. please elaborate? is your 8699-8620 service connected or not service connected? fyi, va will make no distinction between feet and legs when evaluating neuropathy. so if you are service connected for your feet, that is also considered for you legs below the knees.


I am a Vietnam veteran brown water navy in the Delta of Vietnam. I have Type 2 Diabetes and orignally they assigned 10% each for left and right foot and 10% for each Upper legfor Neuropathy Being caused by the Diabetes. I have no Idea why they would say its not service related now !!!
My SO told me where my Total rating had been raised he figured I would be happy with that . :) I just want whats coming to me , I don't think he understands.

#11 entropent

 
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Posted 10 October 2007 - 01:11 PM

I am a Vietnam veteran brown water navy in the Delta of Vietnam. I have Type 2 Diabetes and orignally they assigned 10% each for left and right foot and 10% for each Upper legfor Neuropathy Being caused by the Diabetes. I have no Idea why they would say its not service related now !!!
My SO told me where my Total rating had been raised he figured I would be happy with that . :) I just want whats coming to me , I don't think he understands.



well, i would hope your VSO is mistaken regarding the neuropathy being not service connected, since you had a rating which changed the two ten percents for each leg into a single 20 for each leg. the rater would not bother to do that if it weren't service connected. i would submit an appeal of the 20 percent for peripheral neuropathy of the left leg and explain you have it up to the hip. the 8620 diagnostic code also addresses the sciatic nerve, so you are in the right ballpark regarding that. and don't forget about a claim for the neuropathy of the hand(s).

by the way, many people find that diabetes can cause ED. VA will pay special monthly compensation for ED if it is due to diabetes. that is in addition to the compensation based on your combined evaluation. so submit a claim if it applies to you.

#12 navyvet

 
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Posted 10 October 2007 - 01:32 PM

well, i would hope your VSO is mistaken regarding the neuropathy being not service connected, since you had a rating which changed the two ten percents for each leg into a single 20 for each leg. the rater would not bother to do that if it weren't service connected. i would submit an appeal of the 20 percent for peripheral neuropathy of the left leg and explain you have it up to the hip. the 8620 diagnostic code also addresses the sciatic nerve, so you are in the right ballpark regarding that. and don't forget about a claim for the neuropathy of the hand(s).

by the way, many people find that diabetes can cause ED. VA will pay special monthly compensation for ED if it is due to diabetes. that is in addition to the compensation based on your combined evaluation. so submit a claim if it applies to you.


My Prostate Cancer got the ED before Diabetes had a chance :) They gave me that. TY


If I submit a claim for the Hands and they find they are not severely affected yet to give a rating.Will that cause me to not be able to claim it if it worsens? Like I said they are only numb and tingling sometimes .They seem normal more with the exception of the left hand not being able to grip like it use to .

#13 entropent

 
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Posted 10 October 2007 - 02:35 PM

"If I submit a claim for the Hands and they find they are not severely affected yet to give a rating.Will that cause me to not be able to claim it if it worsens?"

no. neuropathy is a known complication of diabetes, if you claim it they should order an exam. if they do not find enough to warrant a compensable rating separate from the diabetes, they will service connect at 0 percent and roll it in with the primary diagnosis of diabetes. that way it is service connected, and when it worsens, you have a claim for increase, not a reopened claim.

#14 navyvet

 
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Posted 10 October 2007 - 02:48 PM

"If I submit a claim for the Hands and they find they are not severely affected yet to give a rating.Will that cause me to not be able to claim it if it worsens?"

no. neuropathy is a known complication of diabetes, if you claim it they should order an exam. if they do not find enough to warrant a compensable rating separate from the diabetes, they will service connect at 0 percent and roll it in with the primary diagnosis of diabetes. that way it is service connected, and when it worsens, you have a claim for increase, not a reopened claim.



Does the same apply to my feet ? I know eventually they will get worse .From what I understand the Gabepentin only works for a time , then after all the dosage increases ,it stops working . I really appreciate your expertise I am still new at this. My first rating was about 4 years ago with the Prostate Cancer . Was told about AO and effects by an online friend I was playing cribbage with ,after my operation .

#15 sixthscents

 
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Posted 10 October 2007 - 03:36 PM

OK also in answer:

I f you file a claim and they determine a 0% rating, that does NOT hinder you from filing a later claim if the condition worsens, in fact I would think it would help, since service-connection and diagnosis is already established.

Neuropathy is a normal "secondary" issue with type II diabetes, or diabetes period. So if they have already granted service connection for the diabetes, or even if its pending, filing for neuropathy in the limbs is totally normal "secondary" to the diabetes.

Look at entropents post... he is dead on. Just follow his direction. Also, I have been taking neurontin/gabapentine for 6 years, and if I DONT take it, it is very very obvious that it is still working. So, while your body may "acclimatize" to the neurontin, it has been MY (opinion here) experience that it keeps working, you just may need a slightly higher dosage eventually.

Also, again I think your VSO is... less than ideal. Perhaps you might think of going to another organization, or even better (as you are obviously doing) handle it yourself... thats honestly the best way in my opinion.

#16 navyvet

 
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Posted 11 October 2007 - 07:12 AM

OK also in answer:So I should appeal their decision and add a new claim for my hands at the same time ?
If I do this and my SO doesnt agree with me , how do I go about getting someone else to represent me? Di I formally have to write my SO and ask to be released from his office ? I'm not sure how to go about this properly , I don't want to ruffle any feathers.

I f you file a claim and they determine a 0% rating, that does NOT hinder you from filing a later claim if the condition worsens, in fact I would think it would help, since service-connection and diagnosis is already established.

Neuropathy is a normal "secondary" issue with type II diabetes, or diabetes period. So if they have already granted service connection for the diabetes, or even if its pending, filing for neuropathy in the limbs is totally normal "secondary" to the diabetes.

Look at entropents post... he is dead on. Just follow his direction. Also, I have been taking neurontin/gabapentine for 6 years, and if I DONT take it, it is very very obvious that it is still working. So, while your body may "acclimatize" to the neurontin, it has been MY (opinion here) experience that it keeps working, you just may need a slightly higher dosage eventually.

Also, again I think your VSO is... less than ideal. Perhaps you might think of going to another organization, or even better (as you are obviously doing) handle it yourself... thats honestly the best way in my opinion.



#17 navyvet

 
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Posted 11 October 2007 - 11:08 AM

Im not sure if I am rated correctly or not for feet.
These are my sympthons
1 . Foot pain burning throbbing both feet
2. leg pain both legs below the knee
3.left foot tends to drag sometimes causing me to almost stumble
4.have a hard time navigating on uneven ground
5.balance is not what it use to be (I use to walk on rocks along the cape cod canal to fish , now I have a problem fishing there at all.
6.pain from left knee , up the back of leg and thigh to lowerback
7.sometimes have tingling in fingers left hand and numbness sometimes
8.strength of left hand not what it use to be
9. sometimes have pain in finger joints

DOES THIS ADD UP TO 20% EACH FOOT?