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Problem is.....right service connected knee has gotten to a point that now I can hardly walk on it at times, since the surgery for the hip replacement...when it acts up...the knee that is! the surgeon basically said that my orthopedic problems were made worse and sped up by my military service. he also said that I had abnormally small hips....could that be viewed as "aggravated by military service vs secondary condition that I filed it under? so many questions....uggg

Thanks a lot Hoppy, will get it submitted ASAP! Some quick facts for any additional thoughts; 1. Military Police 2. AASLT Qualified, many missions 3. Traumatic Injury to Right knee while in Panama 4. 2 Recorded Incidents of 'falls" but their record talks about the fall, but wasnt real specific as to each body part that was injured. I wrote a letter clearing those two incidents up Whats your "ballpark" idea? Winner/Loser/ Too many variables to make an assumption? Thanks Again

I am service connected for right knee patellar femoral pain syndrome with degenrative arthritis(%20). I recently had a total right hip replacement. My left hip will need it soon. I reopened my case claiming hips as secondary and my depression(rated 10%) has gotten worse. The depression has and is causing me to miss work. My other ratings are Tinnutis 10%, Chronic Left Shoulder Bursitis 10%...overall 40% I recently (yesterday) recieved an IMO from my surgeon who performed the hip replacement here were his words; ""(name) is a 45 year old male with end- stage arthrosis of his right hip. I performed a right total hip arthroplasty on him 10/14/2011. He is doing well and has returned to work. He also has mild to moderate degenerative changes on his left side. I understand he served approximately 8 years of active duty for the United States Army. Pertaining to the question of whether or not his hips are directly related to his service is not possible. However, given his underlying hip morphology,certainly his condition could have been exacerbated by the demands of his military duties. As a result, it is my opinion that his hip condition is as likely as not related to his time of service." As of 2-19-2012 I have done the following; 1. Submitted several releases for all records to the VA, including MRI's and XRAYS 2. Submitted a copy of my work attendance for 2011-missed 18 days Should I? 1. Submit the IMO from the Doctor that I recieved yesterday? 2, Should I submit evidence that my Doctor now has me on Prozac for the Depression? Please be candid in your opinion, Me Personall? I think it has a fair to decent chance...there is absolutely no doubt in my mind that my hips are connected to my time in service, but my opion doesnt matter...yours does...please help!!!!!!! Thanks All!

I'm guessing a bit here but now that I have read the letter and more code, heres what I think....I filed this under a secondary condition to my right knee....thinking now its more "aggravated by service" either way I truly believe its connected. My Doc laughed after surgery and said you have "Women's Hips" other words small for a man.....when the Doc said in him IMO letter " given his underlying hip morphology" he appears to be talking about my small hips, and given the riquors of military service, I think he means that my small hips took a beating and thus wore out more quickly than what they would have. So then it makes me think aggravated by service...so I looked up the code... (Authority: 38 U.S.C. 1153) (b) Wartime service; peacetime service after December 31, 1946. Clear and unmistakable evidence (obvious or manifest) is required to rebut the presumption of aggravation where the preservice disability underwent an increase in severity during service. This includes medical facts and principles which may be considered to determine whether the increase is due to the natural progress of the condition. Aggravation may not be conceded where the disability underwent no increase in severity during service on the basis of all the evidence of record pertaining to the manifestations of the disability prior to, during and subsequent to service. I think its evident that the pre exsisting condition aka "abnormally small hips" underwent an "increase" in severity during service without exception (1) The usual effects of medical and surgical treatment in service, having the effect of ameliorating disease or other conditions incurred before enlistment, including postoperative scars, absent or poorly functioning parts or organs, will not be considered service connected unless the disease or injury is otherwise aggravated by service. The IMO states that it is a likely as not (2) Due regard will be given the places, types, and circumstances of service and particular consideration will be accorded combat duty and other hardships of service. I was an MP The development of symptomatic manifestations of a preexisting disease or injury during or proximately following action with the enemy or following a status as a prisoner of war will establish aggravation of a disability. Either way like I said, its connected, or so I believe...but yes I know doesn't really matter what I think...lol

"(name) is a 45 year old male with end- stage arthrosis of his right hip. I performed a right total hip arthroplasty on him 10/14/2011. He is doing well and has returned to work. He also has mild to moderate degenerative changes on his left side. I understand he served approximately 8 years of active duty for the United States Army. Pertaining to the question of whether or not his hips are directly related to his service is not possible. However, given his underlying hip morphology,certainly his condition could have been exacerbated by the demands of his military duties. As a result, it is my opinion that his hip condition is as likely as not related to his time of service." Though not totally a winning ticket, do you think this will help my cause? I also know that it might not be in the correct format for IMO, but it should help somewhat, correct? Should I go ahead and submit as evidence to my claim? Thanks All!

Current Ratings: Patellar Femoral Pain Syndrome with Degenerative Arthritis intial rating 10% 2000, increase to 20% 2006 Left Shoulder Bursitis Chronic 10% 2006 Bilateral Tinnutis 10% 2000 Depressive Disorder 10% 2006 Hearing Loss Service Connected 0% 2006 Dental Service Connected 0% 2006 2011 October 2011 Total Right Hip Replacement Knee has flare up periods where I can barely walk upon it Left Hip will need replacement soon according to surgeon Depression has definetly increased now taking medication, missed 15 days from work in 2011, etc etc Left Shoulder becomes very tired and sore with extensive repetition 2012 I have reopened claim with a October 2011 effective date Currently waiting for IMO from Surgeon, hoping he gives me some idea? Sent release forms to regional office for medical records Submitting to VA my work attendance records Submitting to VA evidence that I had two falls onto my right side that resulted in heavy leg bruising while in service Should I do anything else?

I truly believe that my bilateral hip issues are connected to the right knee issue. However, I do have within my service medical records that I was seen for falls onto my right side, both times resulting in heavy thigh bruising. The record doesn't say anything about my hip, could it be presumed by the VA that those 2 falls could have resulted in an injury to the right hip. Should I point those records out to them? I have moderate to severe Osteoarthritis in both hips, the right has been replaced, and the left will need it soon, I am 45 years old, and that is definetly not normal. My service connected knee is Patellar femoral pain syndrome with degenerative arthrits also know as "Osteoarthritis"..Osteoarthritis can be caused by overuse/repetitve movement. Could the degenerative arthrits of the hips had its onset while in service due to the falls? Either way....I believe my hip issues are connected either directly or secondary. Currently working on my Doctor to write an IMO. My right leg was also 1cm shorter than the left prior to hip replacement. Could it also be that the 1 cm shortening was a direct result of the degenerative arthritis of the knee? Follow me? Do or should I do anything else?

Not to mention I fell in AASLT School onto my right side 1994, and again fell hard onto my right side while running in Alaska 1998, icy surface.....both times I went to medical with bad brusing...should I point these two incidents out as well? To me, its a no brainer...if you have a "bad knee"....you limp at times, gait is abnormal....etc etc....hence your hips and back will eventually be effected, why is that so hard to understand for the VA?

Hey all, finally got it reopened. I had my right hip replacement done on 14 October 2011. Now, the surgeon tells me its a short matter of time, and I will need my left hip replaced. I am service connected for patellar femoral pain syndrome 20% with degenerative arthritis. I am trying to get it all connected as a secondary condition to my right knee. I have sent in the forms to release all my records to the VA. I have also wrote the referring surgeon and actual surgeon letters asking for opinions. These are my ratings; Right Knee PFPS w/ degenerative arthritis 20%.....Depressive Disorder 10%....bilateral tinnutis 10%.....Chronic Left Shoulder Bursitis 10%......SC for hearing loss 0%......SC dental 0% ...overall 40% In addition to asking for the secondary for the hips, I have asked for an increase in the depression. The question is that due to moderate to severe Osteoarthrits of both hips, 1 has been replaced, the other one will be done soon <1year...do you all think I will get awarded the secondary? Both the refering surgeon and actual surgeon said to me..." How old are you?"...I said, "45"....they both said " wow, thats really young for as bad as your hips are, what happened"....I said, "well, they only thing I can think of is that I spent almost 8 years in the Army running all the time, road marching, and other stuff"....they said.."well that would do it, all the wear and tear".....just hoping they will now say that on paper! Any thoughts, comments, or ideas would be greatly appreciated! Also, is there anything else I should/need to do? Should I have my spouse write a letter? Thanks!

Everything is now reopened...I got the replacement surgery on 14 October, wrote the Va asking for secondary hip (right side) to service connected right knee and an increase for my depression. Currently I am awaiting to see if any of my Docs are willing to write me a letter stating it is or it's as likely as it is not...also have sent releases for all my records to be sent to Regional Office, is there anything else I should do? Thanks All1

by the way my last decision had a "Deluca" rating for the shoulder and knee and they said they were both "errors"

Do you think its possible to connect? Do you know of any similar people you have dealt with? If so did they have a successful outcome? Thanks for the help! I certainly know that if my doc says its likely then I should be good to go, correct?

Here is the beef of my issue. I have a very very bad right hip. My recent MRI results were; fracture, severe osteoarthritis, I think the nurse also said severe osteoporosis, ligament damage severe, and bone marrow swelling. They said I would definetly need right hip replacement surgery very soon! This hip is the right one same as my service connected right knee at 20% with degenerative arthritis. I know a lot of people say, well its usually your opposite side from your service connection that ends up with secondary issues. My thought is that due to the way I walk stand etc etc has caused these problems. I happened to look at my shoes and its very evident that I walk more on the outside edges. My right shoe definetly shows a lot more wear to the outside edge than the left one. Since osteoarthritis allegedly doesn't jump around like Rhuematory arthritis then this must have caused by trauma/stress. I did suffer a nasty fall while climbing rope in AASLT school. However when I went to the clinic it mentions my arm, shoulder and bad right thigh bruise but no mention of my hip contusion. So the osteo had to develop from some point?! The damn point is that I know this is a secondary connection its just a matter of putting it together correctly. I also am rated for 10% depressive disorder which has certainly gotten worse i.e., not sleeping well, have averaged missing work 1/2 days per month (non social), dont go anywhere where there are large gatherings of folks so on and so forth. There is mention from my last VA C/P Exam of; osteophytes in the lumbar region in my back ad right knee. My SC right knee has also now become very painful but I hear thats common with hip issues? My PTSD screen says basically is PTSD present? YES with a GAF of 75. I just don't know how I should now proceed, any advice would be appreciated! Butch

Sorry I have the following SC 20% right knee with degenerative arthritis, 10% depressive disorder, 10% chronic left shoulder bursitis, 10% tinnutis, Currently am being told by private Doc that I will have to have right hip replacement. severely depressed about it all, chronic pain hip...knees ....lower back. Cant sleep very well. Thinking I may have Fibormyalgia but thats just a guess based upon symtoms. Trying to figure out the best approach to it all! Butch

I also feel like a tin man in a rain storm, could I possibly have fibormyalgia or some type of chronic pain throughout? I'm not sure just know that its ridiculous also have chronic sleep issues...probably part of the depressive disorder I imagine.....arggggggggggg.....really really fed up with it all want to go on a drunk and disappear off the face of the earth never to be found, good thing I do have family!