Sunrise Shoes and Pedorthic Service
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Standard of Care

Type 1- Precautionary, safeguard footwear
Level 1 - Low Risk*
Are intended
for use in the normal activities of daily living
as a platform for prescription in-shoe orthotic products
Are not purpose intended
as a platform for customized shoe construction
as brace compatible devices
as ankle stabilization devices
for use as rugged service work shoes
for use as uniformed service boots
for waterproof applications
as oil/solvent resistant footwear
as dedicated industrial/commercial, skid resistant, footwear
for use as under water mobility footwear
for use as performance athletic wear
for use as rugged all terrain footwear
These individuals demonstrate one or both of the following:
(1) Foot deformity or minor foot infection (and a diagnosis of diabetes).
(2) Patient education, preventative care and annual brief foot check are required.  The patients in this category and the following two categories (Level 2 and Level 3) should not walk barefoot. Special attention is to be directed to shoe style and fit.

Type 2- Specialty service and extra duty,  pre manufactured and customized footwear
Are intended for
use in the normal activities of daily living
use as a platform for customized shoe construction
integration in lower extremity orthotic/brace devices
use as lower extremity orthotic/brace devices
use in the management of venous and arterial insufficiency
use as ankle stabilization devices
use as rugged service work shoes
use as uniformed service boots
use in waterproof applications
use as oil/solvent resistant footwear
use as dedicated industrial/commercial skid resistant footwear
use as under water mobility footwear
use as performance athletic wear
use as rugged all-terrain footwear
Level 2 - Moderate Risk*
These individuals demonstrate sensory loss (inability to perceive the Semmes-Weinstein 5.07 monofilament) and may have one of the following additional findings:
 (1) Diminished circulation as evidenced by absent or weakly palpable pulses.
 (2) Foot deformity or minor foot infection and a diagnosis of diabetes.
 (3) These individuals require therapeutic footwear and orthoses to accommodate foot deformities, to compensate for soft tissue atrophy, and to evenly distribute plantar foot pressures. NOTE: May require Diabetic Socks and Depth Inlay Shoes based on clinical judgment.
 (a) Diabetic Socks are defined as hosiery specifically designed to reduce pressure or friction to the foot (see subpar. 3d(4)(b)1).
 (b) Depth Inlay Shoes which are prefabricated shoes with a higher toe box to accommodate for hammer toes and other foot deformities. This shoe may also accommodate the insertion of special inserts (see subpar. 3d(4)(b)2).

Type 3- Specialty service and extra duty custom molded footwear
Are intended
for use in the normal activities of daily living
for integration in lower extremity brace devices
for use as ankle stabilization devices
for use in the management of venous and arterial insufficiency
for use as oil/solvent resistant footwear
for use as industrial/commercial skid resistant footwear
Are not purpose intended
for use as rugged service work shoes
for use as uniformed service boots
for waterproof applications
for use as under water mobility footwear
for use as performance athletic wear
for use as rugged all terrain footwear
Level 3 - High Risk*
These individuals demonstrate peripheral neuropathy with sensory loss (i.e., inability to perceive the Semmes-Weinstein 5.07 monofilament) and diminished circulation and foot deformity, or minor foot infection and a diagnosis of diabetes, or any of the following by itself:
 (1) Prior ulcer, osteomyelitis or history of prior amputation;
 (2) Severe Peripheral Vascular Disease (PVD) (intermittent claudication, dependent rubor with pallor on elevation, or critical limb ischemia manifested by rest pain, ulceration or gangrene);
 (3) Charcot’s joint disease with foot deformity; and
 (4) End Stage Renal Disease. These individuals are at highest risk of lower extremity events, because:
 (a) Individuals in this category require extra depth footwear with soft molded inserts. They may require custom molded shoes and braces (e.g., double upright brace, patella tendon bearing orthoses, etc.)
 (b) More frequent clinic visits are required with careful observation, regular preventive foot care, and footwear modifications to include, based on clinical judgment: Diabetic Socks, Depth Inlay Shoes, or Custom-Molded Orthopedic Shoes

Type 4- Prescription in-shoe orthotic products
Are intended for
increased mobility.
increased comfort.
pain management.
wound management.
use in the normal activities of daily living.
integration with lower extremity bracing systems.
integration with specialty footwear.
use as joint stabilization devices.
*Source: http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2778

Sunrise Shoes and Pedorthic Service
3127 Fite Circle, Ste G
Sacramento, CA 95827

Tel: (916) 368-7700, Fax: (916) 368-7717
Email:
schedule@sunriseshoes.com
For Appointments call: (916) 368-7700 ext:201
Toll Free: (800) 487-5857