Knee ROM

[ShuMan]

Can anyone tell me how they measure knee ROM at a C&P exam?

[broncovet]

They are supposed to bend your knees until you feel pain.  Then measure the angle.  However, docs often use this to see if you are faking it.  If you yell out it hurts, then he can bend it a lot more, that is kind of a dead giveaway you are faking it.  Does your knee issue show up on xray?  If its on xray, then they know you are not faking it.   You dont fake xrays, but some people may exaggerate the pain to get a higher rating.  Dont exaggerate.  That will bite you and probably get you denied.  

You might be getting the cart before the horse.  Are you SC for your knees?  If not you need to focus on the Big 3:

Current diagnosis, in service event or exaggeration, and nexus, or medical link between the two. 

Is one or more of your knees swollen?  If so, point that out, tho an experienced doc should notice that, but that will be difficult to tell  if both knees are swollen the same amount.  

Some docs do exams that are unqualifed.  Try to catch that.  It needs to be a doc experienced with knees, such as knee surgury or at least treatment.  You may need that later if its a bad exam.  You can ask the doc if he is a knee surgeon, or otherwise has experience.  Dont insult him.  Just ask, "gee doc, how many TKR's have you done?"  

Take mental note of his answer.  Then read your c and p exam.  If its highly unfavorable, then challenge the credentials of the examiner.  The VA sometimes hires examiners that are unqualified.  A NP is qualified if she has experience with knees.   A PHD in Computer science, however, is probably unqualifed to examine your knee.  Dont always assume VA will hire a qualified doc, they hire the one available, and hope you dont notice if they have never seen a knee before.    

Edited April 15, 2017 by broncovet

[ShuMan]

18 minutes ago, broncovet said:

They are supposed to bend your knees until you feel pain.  Then measure the angle.  However, docs often use this to see if you are faking it.  If you yell out it hurts, then he can bend it a lot more, that is kind of a dead giveaway you are faking it.  Does your knee issue show up on xray?  If its on xray, then they know you are not faking it.   You dont fake xrays, but some people may exaggerate the pain to get a higher rating.  Dont exaggerate.  That will bite you and probably get you denied.  

You might be getting the cart before the horse.  Are you SC for your knees?  If not you need to focus on the Big 3:

Current diagnosis, in service event or exaggeration, and nexus, or medical link between the two. 

Is one or more of your knees swollen?  If so, point that out, tho an experienced doc should notice that, but that will be difficult to tell  if both knees are swollen the same amount.  

Some docs do exams that are unqualifed.  Try to catch that.  It needs to be a doc experienced with knees, such as knee surgury or at least treatment.  You may need that later if its a bad exam.  You can ask the doc if he is a knee surgeon, or otherwise has experience.  Dont insult him.  Just ask, "gee doc, how many TKR's have you done?"  

Take mental note of his answer.  Then read your c and p exam.  If its highly unfavorable, then challenge the credentials of the examiner.  The VA sometimes hires examiners that are unqualified.  A NP is qualified if she has experience with knees.   A PHD in Computer science, however, is probably unqualifed to examine your knee.  Dont always assume VA will hire a qualified doc, they hire the one available, and hope you dont notice if they have never seen a knee before.    

Thank you so much for the advice! I have the big three for SC, this i believe is going to tell them the severity of the knee disability. No unfortunately I do not have X-rays evidence. Do you know if they take these measurements laying down or in a seated position?

[broncovet]

Your question assumes VA is a "unified body", that all VA employees do the same thing.  This is an incorrect assumption, VA is not a unified body, but a bunch of independent employees, all of which have their own ideas, and have varying ideas on if/how much they comply with regulations.

Remember, there is no accountability, so they can do whatever they want.   

VA is a place where there are no cops.  So everyone just does as he pleases.  One VA employee actually got away with murder:

http://www.disabledveterans.org/2015/11/23/scheming-va-executives-demoted-not-fired/

Edited April 15, 2017 by broncovet

[ShuMan]

1 hour ago, broncovet said:

Your question assumes VA is a "unified body", that all VA employees do the same thing.  This is an incorrect assumption, VA is not a unified body, but a bunch of independent employees, all of which have their own ideas, and have varying ideas on if/how much they comply with regulations.

Remember, there is no accountability, so they can do whatever they want.   

VA is a place where there are no cops.  So everyone just does as he pleases.  One VA employee actually got away with murder:

http://www.disabledveterans.org/2015/11/23/scheming-va-executives-demoted-not-fired/

Great point!