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This is the third in a series of blogs documenting my conditions in which and for which my wife Linda, acting as my Caregiver, aids and abets my ability to soldier on. In the first blog, I discussed dialysis-related tasks, cardio yesterday, and the situation with my legs today.

The VA has assigned me the following disability ratings for “extremity diabetic neuropathy “in my legs: upper right 40%, lower right 20%, upper left 30%, and lower right 20%. Given my VA ratings for diabetic neuropathy—40% for right upper extremity, 30% for left upper, 20% for right lower, and 20% for left lower—the actual combined VA disability rating is 73%, which in and of itself exceeds the Caregiver Support requirement of at least 70%. For clarification, just what is “extremity diabetic neuropathy?”

Extremity diabetic neuropathy is nerve damage caused by diabetes that most often affects the legs, feet, hands, and arms. High blood sugar over time injures nerves, leading to symptoms such as pain, numbness, tingling, weakness, and sometimes loss of coordination or muscle function in the affected limbs145. In severe cases, neuropathy can cause significant disability, increase the risk of falls, and make everyday tasks, like walking, driving, or using your hands, difficult or unsafe. I am experiencing most of these traits – falling, getting up from a chair after sitting down, and legs going to sleep, ditto driving, etc.

Relation to the VA Caregiver Program

For veterans, extremity diabetic neuropathy is often recognized as a service-connected disability, especially if linked to exposure to Agent Orange or as a secondary condition to diabetes. Both of these apply to me, and I have been so rated.

The VA’s Program of Comprehensive Assistance for Family Caregivers (PCAFC) provides support to veterans who need in-person personal care due to serious service-connected conditions. Neuropathy qualifies if:

  • It causes an inability to perform activities of daily living (like bathing, dressing, or moving safely). Again, two of these apply to me.
  • It creates a need for supervision or protection due to neurological impairment (such as loss of sensation in the feet, leading to falls or danger while driving). These conditions apply directly to my situation.
  • The combined VA disability rating is 70% or higher, which I qualify for in spades..

If neuropathy limits your mobility, safety, or independence, which it does, then –

My situation—having significant diabetic neuropathy in all four extremities, with symptoms such as my right foot “going to sleep” while sitting or driving—directly relates to the eligibility and assessment process for the VA’s Program of Comprehensive Assistance for Family Caregivers (PCAFC). Here’s how my leg and foot issues factor into our application and the program:

How My Neuropathy Affects Eligibility

  • Combined Disability Rating: Your ratings (40% right upper, 30% left upper, 20% right lower, 20% left lower) likely result in a combined VA disability rating of 70% or higher, which is a threshold for PCAFC eligibility34.
  • Need for Personal Care Services: The program requires that the veteran needs in-person personal care for at least six months due to:
    • An inability to perform activities of daily living (ADLs), or
    • A need for supervision, protection, or instruction due to neurological or other impairment. I indeed do.

How Your Symptoms Relate to “Need for Care”

  • Safety and Supervision: The numbness and loss of sensation in my right foot, especially when driving, create a significant safety risk. This kind of impairment means I may need supervision or assistance to prevent injury to myself or others, particularly during activities like driving or transferring from sitting to standing.
  • Mobility and ADLs: Neuropathy can interfere with walking, standing, balance, and transferring, as well as with tasks like bathing, dressing, and toileting if you have difficulty feeling your feet or legs. If your spouse needs to help you move safely, prevent falls, or assist with these tasks, this supports your case for needing personal care services. Again, this applies to my situation.
  • Instrumental Activities of Daily Living (IADLs): Your spouse may also need to take on household tasks, manage medications, and ensure you are safe from hazards due to my impaired sensation and mobility. As a caregiver, my wife has assumed the duties of ensuring I’m correct in all aspects of medications.

In summary, I meet, no! exceed, the VA’s requirements for Cargiver Support based just on what’s going on with my legs. I have an appointment with my cardiologist in July, the soonest appointment I could get, to discuss my leg situation. In the interim, we have purchased a foot electronic device that provides programmed and adjustable shocks to my feet in an attempt to treat my extremity diabetic neuropathy.

Wish us good luck.