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C&p Exam For Peripheral Nerves


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21 replies to this topic

#1 Dave

 
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Posted 16 August 2008 - 03:46 PM

I am serviced connected for diabetes and filed a new claim for peripheral neuropathy (PN) secondary to diabetes (burning feet and hands). The VA is sending me, according to the VCAA letter, for a C&P Exam for Neurologic Peripheral Nerves and Endocrine Diabetes Mellitus at the local VA hospital. Does anyone know how the VA tests for peripheral neuropathy?

Thank you

Dave

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#2 john999

 
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Posted 16 August 2008 - 06:56 PM

yes, they will prick your feet to see if you feel it and ask you about your symptoms. They should have done an EMG before the C&P exam. They want to see if your feet and hands are numb. If you have pain tell them you have burning and tingling pain. It is pretty subjective.

#3 Pete53

 
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Posted 16 August 2008 - 11:24 PM

They may do a nerve conduction test where the put a needled in one place and a second needle zap you and measure how long it takes for electricity to go from A to B

#4 MRRRR5

 
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Posted 17 August 2008 - 06:39 AM

They may do a nerve conduction test where the put a needled in one place and a second needle zap you and measure how long it takes for electricity to go from A to B


I had one from a civilian doctor and it came back as "normal"; the reflex test where they take the mallet and hit you on the knees was abnormal. :P

Still I am on neurotin for the burning and tingling in my leg and feet.

#5 terrysturgis

 
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Posted 17 August 2008 - 07:06 AM

When I had my C&P for PN, the examiner checked for range of motion, strength of grip in my hands, sensitivity of both upper and lower body and how I walk. I believe the walking is called gait.
My outside doctor also wrote a letter saving PN is a known secondary condition of DMII and I have it.
Also use the search funtion and find the VA DMII training letter to see if you have any other secondary complications, HBP, eyes, etc.
Take care. Terry Sturgis

#6 Dave

 
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Posted 28 August 2008 - 06:00 PM

Thanks for the advice. My private diabetic doctor also wrote that my PN in my hands and feet was caused by my service connected diabetes. I provided that statement to the VA. Should that at least service connect the PN as secondary to DM II, but probably at 0 percent? How is PN rated?


Thanks

Dave

#7 terrysturgis

 
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Posted 29 August 2008 - 09:01 AM

I do not know how to connect the 38 cfr regs for PN but I can tell you that in my claim the lower body rating is 40% bilaterial and upper body is 20% bilaterial. Range of motion and sensitivity is what my examiner used to apply the ratings. My DMII is rated at 40%. When the examiner moves your legs or hands, if it hurts, say so. I usually try to ignore the pain but I need several medications to help get to sleep at night. Take care. Terry Sturgis

#8 Dave

 
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Posted 29 August 2008 - 04:29 PM

Well I had my PN "test" by the VA. I kid you not, it entirely consisted of the nurse (not a doctor) taking a Q-Tip and breaking it and poked my hands and feet and told me to close my eyes and say "sharp" or "dull". No EMG test, no test to measure blood flow differences between the upper and lower body -- no, just a broken Q-Tip test -- unreal.

Dave

#9 john999

 
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Posted 29 August 2008 - 07:42 PM

Dave

That is about what my test for PN consisted of was pin pricks on my hands and feet. I did have EMG but that was ignored.

#10 Dave

 
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Posted 29 August 2008 - 08:32 PM

Thanks all. I guess the best I can expect is a service connected zero percent for PN in the hands and feet.

#11 terrysturgis

 
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Posted 30 August 2008 - 06:29 AM

Dave, you should go to the records office and request a copy of the exam. Usually takes about a week. You should be able to tell from that information how the exam went. Good luck. Terry Sturgis

#12 Pete53

 
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Posted 30 August 2008 - 06:37 AM

Yes wait and see what the nurse has to say before you complain about an inadequate exam.

#13 Dave

 
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Posted 30 August 2008 - 09:47 AM

Thanks Pete and Terry,

The nurse was very nice, but the exam was quick. I thought they would do an EMG and I thought I was going to see a doctor. Anyway, at very least, my doctor says I have PN and it was caused by diabetes. So, I think VA will have to connect it secondary to diabetes. I saw where PN is usually rated complete or incomplete as mild, moderate and severe. I think PN is rated as complete (70 dominent or 60), incomplete severe (50/40), moderate (40/30), mild (20/20). I would think mine warrants between moderate and mild for upper and lower hands and feet. Again, I was just expecting a doctor and the EMG. The nurse, again, was very very nice. Now, I'll just wait and coninue taking my medication.

Dave

#14 vietvet

 
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Posted 09 October 2008 - 08:36 PM

Hello.
I just had an appt. at the VA to check whether I have P/Neuropathy, secondary to my Diabetees II. The VA doc stated in his report that I have do. Do I now have to get an official C&P exam, or should I just submit paperwork for a claim secondary to Diabetees II, and the raters will by pass the C&P. Not sure how to proceed. Thanks for any help.

#15 jbasser

 
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Posted 09 October 2008 - 08:45 PM

DID you ask for the appointment yourself or did someone else ask for it. Let the claim fly as it may be inferred at the RO. As far as a C@P exam, you may have just had it. If not the RO may or may not ask for an opinion as to the etiology of your PN. But in my opinion, you will be ok if they dont lowball the secondary.

J

#16 vietvet

 
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Posted 09 October 2008 - 09:35 PM

Thanks so much for your response.
My VA primary doc arranged for the appt.

What is lowballing the secondary?

#17 halos2

 
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Posted 12 October 2008 - 07:24 AM

What is lowballing the secondary?

Offerring you a lesser amount or giving a 0% rating would definately be lowballing.
Not giving you a fair and substantial award.

#18 Toposurveyor

 
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Posted 26 October 2008 - 10:44 PM

Dave,

Just to let you know, my C&P exam for PN consisted of the Dr, using his pen to determine where I had feeling or no feeling in both feet. The results for the exam was 30% PN for lower lt extremity and 30% PN for lower rt extremity.

At my recent annual exam by my PCP, the nurse, after telling me to close my eyes and not cheat, was surprised at the small area of the bottoms of both feet that I was able to feel anything.

Ed

#19 DMTREX

 
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Posted 14 September 2009 - 12:28 PM

The other day I went to a diabetes specialist Iwas aasked a question that no one ever asked do I have pain in my hands (neuropathy). No one has ever asked this question and I never gave it any thought, but I do have pain, tingling, and the drops in both hands. Is this rated separately from the feet and if so should I put in a claim for this. I am already rated for diabetes II.

#20 Pete53

 
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Posted 14 September 2009 - 12:59 PM

The other day I went to a diabetes specialist Iwas aasked a question that no one ever asked do I have pain in my hands (neuropathy). No one has ever asked this question and I never gave it any thought, but I do have pain, tingling, and the drops in both hands. Is this rated separately from the feet and if so should I put in a claim for this. I am already rated for diabetes II.


Unfortunately it can be in hands and other places.There are medications that can help.

#21 john999

 
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Posted 14 September 2009 - 01:26 PM

Yes, they do rate it separately from the feet. They rate each limb. I got PN in all four limbs. All I got was the pin prick test on my hands and feet. They call it the glove/stocking type PN. They ask you to point your big toe up or down. It is really a pathtic exam to determine a disability. You should have an EMG, but the C&P doctors don't require it. They can crank out 15 exams a day for PN using the pin prick method.

#22 billy2

 
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Posted 14 September 2009 - 02:00 PM

Dave,

If you are diabetic you may have ED also. Thats worth $96 but I would have woody than the money.

Bill




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