Amputation Rule

Jason Perry

Jason Perry

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This is the text of 38 CFR §4.68, "Amputation rule.
The combined rating for disabilities of an extremity shall not exceed the rating for the amputation at the elective level, were amputation to be performed. For example, the combined evaluations for disabilities below the knee shall not exceed the 40 percent evaluation, diagnostic code 5165. This 40 percent rating may be further combined with evaluation for disabilities above the knee but not to exceed the above the knee amputation elective level. Painful neuroma of a stump after amputation shall be assigned the evaluation for the elective site of reamputation."
 
So what you are telling me no matter what is wrong with my foot there is no way i should be able to get more than 40 percent for my foot? Did I get that right?
 
I think that is right, though not because of the example above in the CFR, but because all the amputations involving the foot look like they rate at 40% (except partials, involving toes). Interesting to note, though, prosthetic ankles rate at 100% for a year following implantation of prosthetic (Code 5056).
 
Yes, the rule is meant to apply to those without amputations. It says you can't be rated for MORE than an amputation would get you to an unamputated extremity.
 
Well thats crappy! The doctors have talked with me about the possibity of it but im and still far to attached to it. I told them if i have to get the surgery of fuseing the foot to a Right angle then i will consider it.
 
Yeah, I think you have to separate out the medical decision from the impact it has on your case. Do what you think is best for your health. I wouldn't want the amputation, unless your quality of life would be much better without the foot. Something only you can judge, probably.
 
Used to Be Army Strong said:
Well thats crappy! The doctors have talked with me about the possibity of it but im and still far to attached to it. I told them if i have to get the surgery of fuseing the foot to a Right angle then i will consider it.
Click to expand...

Hey there. I know you don't know me, and I don't know anything else about your case than what's in this thread. As the result of a non-combat accident I'm a right side above knee amputee, and my left knee and ankle are pretty severely messed up.

When I woke up and found my right leg missing, I was a little shocked, to say the least. I was able to accept it, but my left leg was still very touch-and-go for a while. I have to say that had I been told I was losing my left leg, too, at that point, it would have absolutely broken me. Like you, I was pretty attached to it (no pun intended... maybe).

Here we are going on two years later. I am now able to ambulate with crutches and a bit with a cane, but my knee is absolutely shot and my ankle doesn't flex past neutral. I can't tell you the hell my left leg has caused me all this time. Having been through all this time (and I don't know how long you've been injured), having dealt with just trying to get this far and knowing what my future holds for me physically... I'd be a bilateral amputee tomorrow if given the choice.

I'm not trying to butt into your life, but I dont' think you should completely rule out the option of amputation for your foot if you have a solid knee and bone structure in the leg. I know it's almost unthinkable to imagine yourself as an *amputee*, but it could honestly improve your quality of life presently and in the distant future when you are an old man trying to get around on an ankle that hurts but doesn't bend. Just something to think about.

Sorry for intruding on your conversation.
 
Chet,
By all means thats what we are about here, putting out two cents in. It truely is part of what keeps this forum running if you ask me. but I thank you for you input because that was one of the hardest parts for me to think about is letting them take it. Now if I was in an accidect weather it be stateside or in the box, I think I would handle it alot better and this isn't going to be something taken litely I will make the VA/ARMY give me plently of counseling and maybe hopefully groups with other amputees. But this I feel like I will hold off till the fuse my ankle.
Thanks agian for your input.
 
No problem. Again, I'm really not too sure what you are going through, but I'm dealing with both an amputated limb and a limb that SHOULD have been amputated. So, if you have any questions about either aspect of that, please feel free to ask away. I'm not too sensitive to any questions...
 
Hey all,

I guess I am trying to just get information. So background info

15y AD

Stage III/IV Closed Talus FX displaced 2 months ago surgically repaired within 7 hours (2 deck screws from Lowes I think).

Moderate (%50) feeling medial to lateral side of foot with sensation but sparky and i can scratch my toes (or it feels that way) when i scratch my lower leg through the nerve impulses.

DVT in Calf from Surgery discovered 30 days after surgery and now on anti-coagulant therapy for 3-6 months.

My Ortho, through xrays, says the Talus head is already 1/2 dead and stil necrotizing. The Mortice between the Talas head and Tib/Fib shows crumbling, my fracture line is slowly dissolving and shows both talus head and body deterioration.

Ortho's decision is when anti-coagulat therapy is done I will be getting my Right Ankle fused and wont move on it till I have completed the therapy (1-4 more months).

That being said I am about to start the LIMDU process and I am aware I am most likely going to go to MEDBOARD.

With this ankle fusion:

1) I have been told and read running is done for me.
2) I will most likely be boarded out do to non-deployability at sea or distant lands.
3) Does anyone know of any other who has had this injury and or any other outcomes.
4) I have toyed around with amputation so I will be able to run in the future.

What are your thoughts? I know this is most likely premature information as I am just getting all the Info myself but I am just tryin gto get questions answered.

Thx
 
Sounds like you may have some peripheral neuropathy related to the fracture. I would ask the Ortho docs about this. I had a DVT from my leg fracture which was treated with coumadin injections. However now I am predisposed to DVT's and when I had my hardware removed I had to go through the whole injection routine again. I developed compartmental syndrome due to the 12 week period of limb imobilization that probably resulted in the clot. Anyway the nerve issues are important because they will trouble you permanently if not resolved.Good luck and hope the forum is helpful.

fdm
 
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