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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!

Please help...these are my service connections....20%Right Knee w/ degenerative artritis, 10% Tinnutis, 10% Left Shoulder Chronic Bursitis, 10% Depressive Disorder...currently at 40%....fast forward about 16 mos or so since my last review. My hip started bothering me about 15 months ago or so and has progressively gotten worse....I did suffer a groin strain when I slipped on the ice, knee gave way and down I went...result groin strain out of work for 30 days or so and got a 3% rating from Workmens Compensation back winter of 2007-2008. When I had the review(va) I had healed from the strain and didnt mention it. Now I just had a right hip MRI which revealed fracture/ligamanet damage/severe osteoartritis and osteoporosis I thought she said along with bone marrow swelling and a lot of fluid build up, my hip is in agony and not walking well at all. The depressive disorder is also worse because of my health, unavailability to work most paying good jobs, though I currently am a Counselor within a prison, but wished I could go to the coal mines or gas drilling rigs "big bucs" to better support my family! So I'm thinking that with the no sleep, missing work (1-2 days per month) and absolutely little to no social interaction (not interested have become recluse basically) I should/might get an increase for the depressive disorder. The hip thing could be a few different things actually. First of all the damn thing never bothered me until the past year or so...I feel the osteoarthritis was building/wearing until the joint became unstable and hence all the problems. I also fell while climbing rope in AASLT SCHOOL but the record does not mention my black and blue hip, but does other stuff. I'm thinking its possibly a myriad of issues. The knee caused me to walk on the inside line of my feet, shoes show proof, thus resulting in an slightly abnormal gait, not very noticable but certainly possibly damaging thus resulting in a slight misalignment of the hip, resulting in abnormal wear/osteoarthritis. The osteoarthritis eventually got bad now I need total hip replacement. Then again the weakened knee might have caused me to slip lose my balance and fall on that hip thus resulting in the hip groin strain. The strain weakened the joint and allowed the hip to mistrack. My original doc said I was likely to develop hip problems after the strain incident (I have requested all my private records) ad just recieved my CFILE. Within the CFILE there is mention of osteoarthritis a few times in the knee and back...I'm a mess seriously...please help if ya'all can! Butch

Hello All, Well I have read until my eyes are now hurting and burning, lol! I have the following service connected conditions; 20% Right Knee with degenerative arthritis...10% Tinnutis.....10% Chronic Left Shoulder Bursitis and 10% Depressive Disorder secondary to my right knee. My last Cp for the listed was decided in 2009. Now fast forward approximately 15 months (which would be like several months ago) I started developing pain in my right groin and hip, my private physician ordered xrays of the hip which showed degenerative change in the hip but really nothing else was said or done because he lost his license and over the past few months I have seen a few different docs. I now have a perm. one who ordered an MRI of the hip. The results showed that I have the following; hip fracture, ligament damage, severe osteoarthritis and I thought they said osteoporsis and bone marrow swelling, bad yeah I know, I am at my wits end because I have to have total replacement surgery and in constant pain. The question is wouldn't it be secondary to my right service connected knee since its the right hip? At the moment my left leg feels and acts ok. I plan on filing for an increase because the depression has gotten worse for sure and now my hip and knee are really hurting! So what do you all think, please help its driving me crazy. Thanks All!

Well all the inquiry must have worked. I called my Rep the other day and began a real !@#$% session. They said they understood and would go find my file. Well it turns out that when they went looking it was with someone, right in front of them and they were in the progress of addressing the email inquiry. They emailed me back and said it was indeed a mistake on the shoulder issue, it would be corrected and they were reviewing the hearing issue. I emailed them back and said why couldnt I be paid for the error while the hearing was being reviewed. Then they called me and said thats what we intend to do, is to correct the overall percentage, pay you and the other will be reviewed. They actually were a great bunch, very understanding, and helpful. I asked for a timeline for the percentage correction and he said Ive done my part and handed it to my supervisor, and he said surely within 30 days it will be done. He said my file was marked in some kind of way that it should get priority treatment. Thanks all....we will see from here. :D

Im readying the troops and on 1 October I will declare war. They told me that if I dont have an answer by then to call back. So.....I will give it until then and only then!

Beta what does my post sound like to you, and should I call the director or wait for IRIS response first? Your'e the best, if you ever need anything please let me know Im an avid researcher. Keith

Berta the Varo Office is Huntington West Virginia Fact #1 On the intial page of my ratings decision its say " 10% is granted for chronic left shoulder bursitis, when you continuing reading the decison in the subsequent parts that break down each issue it states that under Deluca an additional 10% is added to the intial 10% for an overall of 20% for the left shoulder. A higher evaluation of 30% is not warranted due to blah,blah, blah. Fact #2 I was intially denied hearing loss of the left ear that was service connected at 0%. Had the rating specialist used the correct chart contained in title 38 (in which under those charts it states that the ratings specialist is supposed to use whichever chart benefits the veteran) I would have been rated at 10% not 0% because they used the chart that takes in consideration for speech recognition, well no doubt when you have ear muffs on setting in a booth and they say repeat the words hotdog, airplane etc. in which I scored 96% in voice recognition while being an average decible loss in my bad ear at 105+ decible loss. In the other chart they use the decible loss for your good ear then youre bad ear cross refrence them and thats the point of your percentage which would be 10% im my case. So from what I would gather my ratings if corrected would be; 20% knee issue, 20%shoulder (if they ever fix it) 10% bilateral tinnutis, 10% mild depressive disorder and 10% for the hearing if they fix it - currently recieving an overall of 40% which should be at least 50% if not 60% argggggg these people have me fighting mad my family and I need this money. The Va acts like well you know....we'll get to it and you will get it when its complete and blah, blah blah I really feel like turning politicians loose on it maybe that will make them move a little. PLEASE HELP ME AT MY WHITS END!

Berta I cannot find this section on there page, please help as I am fighting mad about this. The whole thing is an ABC issue nothing hard about it, I feel it should have been rectified by now approaching 6 months to fix an error on there part. Thanks Keith

Berta, from your post you seem like one of the formost authorities on this stuuf, and I could really use your help because I seem to be in a lull or stonewalled. My self and my family really need this money, and my case seems to be quite simple, but they just keep dragging me around. Surely there should be something I could do, but I dont know what. Will you help me, could I call you? or do you want me to just send the paticulars of my case if you are indeed willing to help me Thank You Keith

Hey all, they told me today that I am in final review. I have been waiting on a request to correct an error in a ratings decision and relooking an old issue that according to Title 38 I should have been granted way back in 2000. How much longer should it take and I was always under the impression that a final review means large retro? Anyone know? Thanks all!

Hello all, Ive been going through the process of requesting an error correction in my ratings decision. I called the VARO the other day and they said I was halfway through the process. How much longer do you all think it will take to get this done (the correction to my rating %) Thanks Keith