so
good afternoon and welcome to cck live my name is jenna zellmer joining me today are matt fusco
and rachel foster and together the three of us represent veterans before the va
and before the court of appeals for veterans claims today we are going to be discussing
va disability for some common ankle conditions as always please feel free to check out our
website at cckdashlaw.com and as we go through today's video we will be um linking some of our
blog posts and our other videos um for you to check out so as a little bit of a background
ankle in injuries are fairly common among veterans um pressure is often put on the ankle um
which is one of the main weight variant joints in the body veterans go through rigorous training and
physical demands during active duty or active duty for training which includes frequently
carrying heavy gear for long periods of time so ankle conditions are common and they can lead
to the development of other issues such as disabilities of the feet and of the knees so
today we will be breaking down some common ankle conditions that we see in veterans and explain
how they are rated so matt why don't you kick us off by talking a little bit about arthritis
thanks jenna um so ankle arthritis is a clinical condition where the joints that
connect the foot to the leg um have damaged or worn out cartilage the three bones involved in
this joint are the tibia the fibula and the talus and ankle arthritis can involve
excuse me any or all of these bones um symptoms of arthritis in the ankle include things like
tenderness when you touch the joint pain when you move it stiffness and swelling especially
after sitting and sleeping and trouble moving walking or putting weight on the joint as well
now there are two main types of ankle arthritis or arthritis in general
and they can both occur in the angle the first is osteoarthritis which is the most common type
of arthritis and this occurs when the cartilage in a person's ankle joint breaks down it can be
painful because the breakdown of that cartilage can cause the bones to actually rub together
osteoarthritis can also damage the cartilage and change how the entire ankle works over time
second we have rheumatoid arthritis which is actually an autoimmune condition categorized
by the body's immune system attacking its own tissue including joint tissue rheumatoid arthritis
can be extremely painful and it mostly impacts smaller joints such as the joints and ankle some
specific things that it can affect ara can make standing and basic walking painful and that stuff
becomes more difficult as it advances as well now typically a veteran is just gonna know that he has
pain in his ankle um and like you said matt that he's having trouble walking or standing and so
rachel how exactly does a veteran know whether or not they have osteoarthritis or rheumatoid
arthritis and how do they kind of go through the steps of getting that initial diagnosis
sure so doctors will look at the veteran's medical history examine the ankle and take
imaging tasks to diagnose arthritis and determine what type it is and while there
is no cure treatment options that may offer some relief include things like non-steroidal
anti-inflammatory drugs or nsaids for short oral corticosteroids and steroid injections
other treatments can include topical creams which are applied directly to the skin
you can also treat it with heat ice and physical therapy
if you need some additional support for the ankle joint you can use things like ankle braces ankle
braces and assistive devices and in more severe cases the ankle disability may require surgery
and once the veteran has a diagnosis the next step you know we're going to talk
we've talked a lot in our other videos about how to get service connected for disabilities not
just ankles but all of our disabilities but once a veteran is service connected for his
ankle diagnosis um let's talk a little bit about how va rates those ankle disabilities
yeah so the way that arthritis is rated depends on the manifestation of the symptoms
if there is osteoarthritis in the ankle that is not compensable based on the limitation of motion
then it will be rated under 38 cf cfr section 4.71 a um diagnostic code 5003 at either 10 or 20 so
a rating under this diagnostic code depends on the involvement of major and minor joint groups
and whether there are incapacitating episodes importantly the ratings under diagnostic code 5003
are based on x-ray findings and this will also not be used in combination with raiding ankles
arthritis based on the limitation of motion va also rates the ankle based on multi-joint
arthritis so if there's a diagnosis of something such as rheumatoid arthritis and the ankle under
38 cfr section 4.71 a diagnostic code 5002 to be rated under this code the arthritis must be active
it must be affecting at least two joints and the veteran must submit a definitive diagnosis of
the condition readings here depend mostly on the number of incapacitating episodes that a veteran
experiences due to their multi-joint arthritis and they can be rated at either 0 20 40 60 and 100
in other cases va may assign a rating for arthritis in the ankle under diagnostic code
5271 and that's based on the limitation of motion of the ankle itself this rating could
be a 10 or 20 based on whether that limited motion is considered moderate or marked great
yeah i think the takeaway so far is that the va rating system is incredibly complicated and as
is you know getting that initial diagnosis so it's really important to one go to your doctor and make
sure that you're being diagnosed properly and once you have that diagnosis and get service connected
you really want to talk to your va rep whether it's a service officer or an attorney to figure
out what the best diagnostic code is that will appropriately compensate you for your arthritis
um it's you know the the term and incapacitating episodes and um the limitation of motion are both
things that um there are some um ways to interpret them and and there's some medical evidence that
i'm sure that you can um talk to your rep about to make sure that you are presenting
the best um and most accurate representation of of your disability um so moving on from arthritis
another common ankle disability is ankle tendonitis which is also called
peroneal tendinitis which is a little bit of mouthful which is why we call it ankle tendonitis
um and that's inflammation of one or two of the tendons that's around the ankle joint tendons are
thick bands of tissue that connect muscles to the bone and enable the movement of the joints so the
main function of tendons is to stabilize the foot and the angle and that protects them from injury
so if you are experiencing anki and pain on the outside or the back of the ankle
some swelling or tenderness of the ankle warmth around the ankle
or pain during physical activity such as walking or turning the foot inward these are all signs of
ankle tendonitis um so you'll want to talk to your doctor and describe um what types of symptoms you
are experiencing to make sure that you're getting that proper diagnosis some common causes
of tendonitis are overused traumatic injury or wearing the wrong type of shoes so these are all
situations that many veterans experience while they're in service
and as with arthritis treatments range from rest and physical therapy all the way to surgery
in severe cases um and so going back to how va rates tendinitis as opposed to arthritis matt
can you tell us a little bit about what ratings veteran with tendinitis could get
sure so ankle tendonitis is typically rated under 38 cfr section 4.17 using diagnostic codes 5270
or 5271. um under diagnosis diagnostic code 5270 ankle tendonitis is rated according to
the ankylosis of the ankle and ankylosis refers to abnormal stiffening or immobility of that joint
and those readings can typically be 20 30 or 40 percent under diagnose gnostic code 5271
ankle tendonitis is rated at 10 or 20 based on limited motion of the ankle and as we previously
mentioned diagnostic code 5271 can actually also be used to rate arthritis in the ankle as well
yeah so that's a good that's a good note to kind of call back is that regardless of
what your diagnosis is there's a possibility that you're going to be rated under the same
um the same diagnostic code so while it's important to make sure that you're getting
the diagnosis correct um i think the more important thing is to make sure that your
rating is accurately portraying your level of functional impairment
rachel why don't you talk to us a little bit about the last common ankle disability
that we have today sure so that would be ankle instability ankle instability is a condition
that's characterized by a recurring giving way of the outer or the lateral side of the ankle
typically this condition is caused by repeated ankle sprains the reason for this is because
during an ankle sprain the ligaments in the ankle may have been stretched out or torn so even
after that strain heals ligaments often remain weak and stretched out some common symptoms of
instability include a repeated turning of the ankle especially if there's uneven surfaces
um or if you're participating in sports or other activities if there is persistent or
chronic discomfort and swelling in the ankle if someone might also experience symptoms of pain
that is dull or intense or maybe tenderness in the ankle and this is probably the most
hallmark symptom of instability where the ankle is feeling wobbly or unstable as far as
diagnosis and treatment of instability as with other ankle conditions ankle instability
is diagnosed through physical examination and imaging tests such as x-rays the treatment options
also vary depending on the severity generally they can include things like physical therapy
braces to provide additional support medications and in some cases possibly surgery yeah so i
think we're sensing a pattern here with both the types of symptoms and the types of treatment and
all these different ankle disabilities um and so again the way the va rates and ankle instability
is similar to the way that va rates other ankle disabilities and that's under diagnostic code 5271
um and again this code is based on limitation of motion of the ankle and so um a doctor is going
to look at your ankle examine it and try to move it in different directions and based on how far
your ankle can move um they'll assign a rating of either 10 or 20 percent um as i mentioned before
sometimes ankle disabilities can lead to other disabilities of the foot and the knee so veterans
who have developed an ankle condition as a result of service um may also develop another condition
that would qualify for something called secondary service connection we have a lot of videos on
service connection in general and secondary service connection specifically so i would
really encourage you to check out our website and our blog posts um but just for the sake of
this video for example an ankle disability um can cause a veteran to favor one side by walking with
a limp and that can ultimately result in knee or hip or back conditions because of the way um
your feet really provide the foundation for the way the rest of your body moves
um and so ankle disabilities can also be secondary to other conditions such as your feet so it's
always really important to talk to your doctor about the way that your different disabilities are
interacting together in your body um and to make sure that when you talk to your veteran service
organization your rep your attorney whoever it is that you're talking to make sure that you're
describing the full extent of your disabilities because they might have um an idea of how to get
service connection that um you might not have thought of before so um as always you know if
your ankle condition is worsened or if you believe it deserves a higher rating you should definitely
reach out to an accredited attorney or a veterans advocate um rachel do you have any final thoughts
i think the only i think the only thing i would say is you know just as you mentioned before
jenna once you get service connected for an ankle disability definitely take a look at the different
symptoms if there's no limitation of motion there could be another basis for you to get
compensable symptoms so having someone thoroughly review what your symptoms are is very helpful
thanks rachel thanks for joining us matt do you have any final thoughts just to really stress
the importance of talking about secondary service connection jenna as you explained
um i think that's really important to be assessed um when veterans are you know trying to determine
whether or not they may be entitled to a higher rating for a specific disability
um so you know obtaining things such as medical opinions speaking with your treatment provider
all that type of stuff will really help to get an entire picture of what's going on with your
disability um and so that's just really important for veterans to keep in mind when they're trying
to figure out what they may be entitled to in terms of higher rating awesome thanks matt so
as always thanks so much for tuning in please feel free to reach out to cck for our free consultation
if you think that you have um an ankle disability that you would like some help with
and please subscribe to our channel to stay up to date on all veteran related news my name is jenna
zellmer thanks matt fusco and rachel foster for joining me today and we hope to see you next time
you