USAFvet13

I was in a simialr situation. I was rated 10% L and 10% R patellafemoral syndrome for knee pain. I had this rating for 4 years. My knees became worse so I asked for an increase. On the last exam they found arthritis on one knee and gave me an additional 10% for that. From what I understand the knee is the only part of the body that can have two ratings. I'm not sure of the codes they rated mine under but I will look at my files.

It will help if the IMO also states that the doctor reviewed the veterans service medical records. And I may not be reading your post correctly but if you want the IMO to be in the favor of NOT being genetic and instead being due to his militiary service it needs to read: "as likely as not NOT a genetic condition" instead of "as likely as not a genetic condition". If you can get him to maybe instead of as likely as not, he will write " (insert husbands condition) is due to".

I had my C&P on 2 Dec and I called the 800 number the next week to check the status of my claim. The C&P results had been received but they told me they were waiting on my file to get back to them so the can review it. I called again today.. they said the same thing. I asked if taking 7 weeks for my file to make it back to them was excessive and they told me it has been a long time but not considered excessive. The RO is only 45 minutes away from where I had my C&P exam. And my C&P results made it within one week to them. Is 7 weeks for my file to show up excessive? I've heard stories of people's files turning up missing and I'm more than a little concerned with how long my files have been in transit....

Pyramiding isn't allowed but the knees can be evaluated under multiple diagnostic dodes. From what I understand on the knees you can have more than one rating. For instance I have two different ratings on one knee. One is rated under DC5003-5260 for 10% patella femoral syndrome and an additional rating under DC5257 for 10% on that same knee for instability. From what I gathered you could also have two different ratings if you have limitation of both flexion and extension. So if a person had limitations on both they would get two seperate ratings under different codes. I'll do some digging and try to find the source where I read this.

If you get service connected from your original claim then your new injury , (assuming your knee is further damaged now from it giving way), will be secondary. It will not matter that you are now civilian. The key is to have your knee service connected then any future injuries due to your knee, or if your knee worsens in the future it will all be service connected. As will any secondary issues that develop from having to compensate for a bad knee.

It messed up the table I posted.. You can find the ratings for the knee under the electronic code of federal regulations, Title 38: Pensions, Bonuses, and Veterans' Relief, Part 4: Schedule for rating disabilities. http://ecfr.gpoacces...0.1.1.5.2.97.13

Here is the rating table for limited extension of the knee. Also crepitus can indicate arthritis and / or chondromalacia. If you do not get rated for either of those see about getting a medical opinion and file for it and also for a clothing allowance due to your brace. 5261 Leg, limitation of extension of:Extension limited to 45°50Extension limited to 30°40Extension limited to 20°30Extension limited to 15°20Extension limited to 10°10Extension limited to 5°

I just finished my C&P this past week. Just remember to be honest and don't hold anything back. If you do hold stuff in they will not get a clear picture of what you suffer with daily. When he asks how you are doing don't say "good" if you really are not. If you are not doing well that morning and are streesed out from worrying about the C&P and couldn't sleep tell him that. And don't be surprised when they throw an odd question or two in. My doc asked me what I thought "don't throw stones if you live in a glass house" meant.

Since it is in your records of the injury you can service connect it. Go see a doctor, or an ortho and get them to give you a diagnosis and see if they will connect it to your injury while in the military. Get it in writing and sumbit this with a claim. Your knee pain sounds like mine was. While in service I developed extreme knee pain.. it became so bad I couldn't go up or down stairs without sharp pain in both knees.. I couldn't run or squat without pain. I went to the base doctor and they sent me to specalists. They diagnosed me as having Chrodomalacia patella and patellafemoral syndrome. After my discharge my pain continued and my knees only got worse. I filed for service connection and was granted it for both knees. On the paperwork it states the disablities as L and R knee Chroldomalacia patella with patellafemoral syndrome. So yes, pain is enough to get service connection. But it will help if you get a doctor to diaginos you with something. And get a current doctor to write you a letter stating his opinion that your current knee pain is a direct result of your knee injury in 1982. Best of luck! Knee pain is awful.. if not corrected it will eventually lead to an altered gait and a messed up back.

Never mind, found it on the main page.

Where is this article located?

Are you in contact with any of the others that served next to you? You can get them to write "buddie letters" to help validate your working conditions. For the joint pain you need to get a doctor to write you an independant medical opinion stating that the work you did in the service directly contributed to your joint pain. Even though for most of us it is common sense that mechanic work and having to work on your knees and in akward positions will take it's toll on our bodies...the VA doesn't care about common sense, they only care about medical evidence. So get it in writing from your doc and submit it to help support your claim.

John, did it help your claim by delaying your BVA appeal and instead getting a hearing locally? Or did your claim still go to the BVA?

I've decided to take a different route. I was going to ask for my BVA hearing to be put on hold until I can get a DRO hearing locally. But, instead I'm going to ask that my request for a hearing be waved, and that my claim go straight to BVA for a decision. The advice given to me was that I have really good evidence in my favor, and that hearings a lot of the times do not help anything and slow the process down. I'll keep my post updated as my claim goes on so that it may help others in the future.

Not to hijack this thread but that is exactly what the VA is doing with my current claim. Is it possible change how your first claim was worded? Mine says "claiming back condition secondary to altered gait" The "altered gait" is getting me, its also all movement patterns requiring my knees, squatting , climbing stairs, lifting objects etc.. that hurt my back due to my sc knees. hijack over =)

I had just today called and scheduled an appointment with a local Chiropractor that is a state certified IMO, but after reading your post I think I will call one of the Orthos on my list to get the IMO. Can I withdrawl my Form9 requesting a BVA hearing and instead ask for a DRO hearing even though earlier in my process I already did the De Noro Review?

John, I plugged all my info into this bilateral calculator to see if my ratings were applied correctly: http://vets.yuku.com/topic/36441/t/Improved-VA-Math-Calculator.html

Thanks, I'll ask my Primary care doc and see what she says. My main problem is when i put in this claim it read something like "this is a claim for back condition due to altered gait caused by service connected knees" So every time I have been denied they list the reason as no mention of altered gait in my records. They aknowledge a back condition exists, but because I only have mention of an altered gait found twice in my records I keep getting denied. Every C&P exam says gait normal.....but THEY NEVER CHECKED. This last one I only walked a max of 10 feet into his office and that was the only opportunity for him to see my gait. And I keep sending in letters telling them my gait becomes worse with more activity and that other movement patterns of mine are altered due to my knees like squating, stairs, lifting objects etc... and these cause pain because I have to compensate. But they keep coming back to the gait thing.

After reading another thread with a post from Berta talking about having a DRO hearing and a BVA going at the same time I have a question. It seems as though I passed up a DRO hearing option when earlier in my claim process I had a DRO De Novo review and then was denied again. Now I just received my SSOC and was denied yet again but I'm in a similar situation as another member here as some of my IMOs were not mentioned and other evidence was overlooked. So, the SSOC tells me I can send in a Form9 if I haven't already (I did already back in Nov of 2009 with the box checked " I want a BVA hearing at a local VA office".) Here is my question.....Can I withdraw my form 9 and instead have a DRO hearing? Or did the choosing of a DRO De Novo review cancel that option out?

I submitted 4 IMOs. The C&P examiner mentioned 2 of them and that's it. I just finished typing up a letter to send it disputing each piece of detail the C&P examiner left out, or didn't include in his conclusion. It ended up being... lengthy, but would be exactly what I would say if I were to go in person.

That was quick... Received a Supplemental statement of the case today... Denied again. My C&P doc stuck it to me. He really twisted information around that I provided and left off painful motion from his report. To make a long story short I want to get a DRO hearing at my VA regional office in hopes of getting this C&P thrown out and that in speaking to someone in person I can explain my situation better. That is opposed to the alternative of going all the way to a BVA hearing because my rep told me it could take years.... But I don't know where to go from here. As my below time line describes I have already sent in a VA Form9 once with the selection of wanting a BVA Hearing at a local VA office. Then I received this C&P last week and then just today I received the SSOC telling me I was denied again. Is it too late to request a DRO review hearing at my regional office now? I'm a little confused because on the VA Form9 it says specifically not to use it to request a hearing before va regional office personnel.

Sorry, I made it confusing in the way I typed it up. Here is my time-line for this appeal: 1.) Sent it claim 2.) Claim considered based on all evidence and denied (my evidence didn't make it in time because I was too slow gathering them) 3.) NOD sent in 4.) De NoVo Review performed based on all the evidence of record, Denied me again (here is when they said only one mention of altered gait in all my records) 5.) Appeal election letter sent in 6.) I now gather 4 IMOs from 2 chiros, 1 PT doc, and 1 Ortho all saying my knees to cause my back pain. I send all this in. 7.) Finally get a C&P for my back So the first two times I was denied benefits... I didn't ever get a C&P exam for my back. This past one was my first and it was after I filed an appeal. I'm not sure about the DRO... I thought my case and C&P exam would now again be reviewed and if a favorable decision could be met then I would get service connection, if no favorable decision could be met I thought it then goes to my video hearing. Am I incorrect on how this works? I'm going to do some more research this morning and early next week go to the DAV for advice. Lastly, I read that I need to send in a statement ASAP asking that this recent C&P be thrown out and list the reasons. Is that how you request a C&P be thrown out, just by sending in a letter (would this be another statement in support of claim form?)

Ok so after rereading his conclusion he is claiming x-rays of my knees taken in 2009 were normal. And says the structural abnormalities described by the D.C.'s are unrelated to the knee conditions. He then says gait abnormality significant enough to result in back pain would result in anatomic knee abnormalities prior to back pain. He also claims my gait was normal, when in fact I had a slight limp that day because my knee was acting up. No mention of my orthopedic IMO that states "At this time for my professional opinion, I do feel that his back pain is secondary to his knee pain." My Ortho also states that during this visit (visit was 1 month ago) x-rays were taken of my knees and they still reveal lateral translation with patella tilt in both knees. No mention of my recent increase of knee disability from a C&P exam earlier this year where the examiner found arthritis and noted a slight subluxation /instability. Not sure where to go from here....

I found my current rep by searching online for DAV nearest me. You can get them to help or like mentioned there are different reps at VA outpatient clinics that can help you also. You might also consider looking up what the differences are for the symptoms to get 50% compared to 30% and see if you have them. If so, write up a statement in support of claim saying why you deserve the 50% rating and provide your evidence that supports this.

The C&P doc did not mention my IMO's from my other docs individually but instead made a broad generalized statement addressing all of them at the same time in one sentence. I will post the exact wording later tonight. Two questions: 1. Should I wait and see how this will play out from here and see what is decided? I was told it's possible the DRO may decide in my favor and it not need to go to the video conference (not looking good though since the C&P doc gave me a Less likely than not statement) Or should I file now to have the exam thrown out? 2. How do I file to have this C&P thrown out and request another one? I don't remember ever reading about this process in my research. Thanks for all the help so far, its truely appreciated.