Most veterans think of a podiatrist when they need their nails clipped and don’t consider a podiatrist when pursuing their claim for a foot or ankle condition, like pes planus or plantar facisiitis. But they should.
“Glorified pedicures” has been a phrase used by many veterans when they discuss their podiatrist. While I’m sure many podiatrists at the VA feel like a “glorified pedicurist,” there’s so much more to a podiatrist.
A podiatrist is a physician who is fully focused on the ankles and feet. They know more than most orthopedists about how the ligaments in the ankle and feet function. They know best how the pulleys work during ambulation and have seen how one condition in the foot leads to another condition in the foot or ankle.
The nickname stems from the fact that, at the Va, if a veteran has certain risk factors, like diabetes or peripheral vascular disease, a referral order pops up on the computer screen and the primary care doctor can quickly submit a referral for the veteran to see the podiatrist. In civilian medicine the patient gets a referral to a podiatrist when their conditions are severe enough to warrant one or when the patient specifically asks for one.
When it comes to your foot or ankle disability claim, the VA likes to have their mid levels throw out phrases like “there is no pathophysiologic research which demonstrate that gait changes lead to or cause a foot, ankle or knee condition.”
That’s trash. If you get a denial referencing that phrase or a similar phrase you need to appeal it.
The reason that mid levels at the VA often make that statement about gait changes is because they are not trained on gait analysis and most often they don’t work directly with the foot and ankle. There are tons of kinesiology and physical therapy text books about gait changes. Kinesiology and physical therapy are not the direct practice fields of a mid level practitioner. Additionally, physiatrists or the “Physical Medicine and Rehabilitation” department at the VA, can provide formal gait assessments. So to say that there is no research regarding gait changes just to deny you is. Flat. Out. Trash.
Unfortunately, because I was brainwashed by the VA I, too, wrote these trash opinions at one time in my career.
Because of that pattern I saw being a C&P examiner at the VA and in my current work of helping veterans, I have made sure to include a podiatrist on the medical expert team at Valor 4 Vet and it’s proven successful.
A phrase written by our podiatrist recently really hit the nail on the head when discussing one veteran’s plantar fasciitis:
“The veteran’s foot symptoms would be expected to cause compensatory mechanical strain on the joints in it’s kinetic joint chain in trying to off-load the foot. This change in biomechanics would cause the ankle to take on mechanical forces it was not designed to handle, leading to injury and accumulation of damage over time upon the ankle…”
While the phrase is not overly scientific it is exactly the phrase a layman at the VA needs to hear in order to understand cause and effect. This phrase, combined with specific reference to the veteran’s medical records, carries its weight it gold.
So when you get a denial for your foot and ankle claim, consider having our podiatrist take a look. The podiatrist knows best how the pulleys work during ambulation and have seen how one condition affects the other. Their education and experience is greater than a mid level writing trash opinions.