TideWarrior

My understanding as I am now in the process of getting a lawyer is a lawyer is legally allowed to charge up to 33% but if the lawyer wants a direct fee agreement, meaning they receive payment directly from the VA once the amount is awarded the fee can only be set for 20%. If they charge a fee over 20% up to 33% they have to collect from the veteran directly after the veteran receives the award. Hence why most prefer the 20% so the VA pays it.

I received a letter that the proposed reduction would take place. The reduction was based on the examiner saying they examined my feet and there was tenderness and it was improved. Again I was never asked to remove my shoes or never asked anything regarding plantar fasciitus. Have requested a hearing for the reduction.

The last month has been somewhat hectic to say the least due to the VA seemingly being aggressive with my current disabilities and claims. 1) I went last June for a C & P for Plantar Fasciitis. I received a rating for 50% in both feet. It well documented in my service record and has worsened over the years. I went last September for a C & P exam for Gout. A decision was made in October denying me a rating but had to call this past April to receive the letter as they never it sent it to me. They said they had my old address but every other letter came to my current. Anyone that letter stated that my Gout was present while on active duty but is was unmistakable that it was was preexisting and that military service did not aggravate it. I never had gout prior to the service. I met the current criteria for 60% for gout in my current condition battling with it. Now that I am looking to appeal because as mentioned I did not have it prior to service. But my real concern here is I received a letter last month stating that during the gout exam the examiner notes regarding my gout should improved condition for my plantar fasciitis and a proposed reduction for it from 50% to 0% would go into effect September 1st. That will currently lower me from 90% to 80%. My question here can the VA propose a reduction without a reexamination and notice of the reexamination. They are using the C & P exam for gout to reduce my plantar fasciitis. 2) I just received two days ago a call from 3rd party, not a letter from the VA, for a scheduled appointment for reexamination of a current disability(50%) in 10 days. I understand the VA can ask for one but I was under the impression that if past the 5 year mark it was considered protected/stabilized the VA can not or needs a very good reason to do so. The disability(Chronic Sinusitis) has not improved and still treated even after two surgeries. I was told to contact the VA for a reconsideration on the exam. Should I contact the VA and should the VA be asking for reexamination for this disability? I have been using a local VA rep to help with my claims. Should I continue or am I at the point I need to contact a lawyer. If my current disabilities remain and no reduction I stay at 90%. If the gout meets the criteria as it shows on the C & P exam but is proven not to be prior to military service I would go to 100%. Maybe that is why they seem to be coming hard at me. Thanks for any advice or help. Mike

First time on here so hoping to get some idea what will happen and what to expect. July 2011 I was seen at the VA(Asheville NC) for my right knee and was issued a brace to wear and since I was moving was told once I have seen my PCP that they could schedule an ortho appt..August 2011 I applied for a claim for right knee. Nov 2011 I added an addendum to the claim for artrits. All this via a VSO. In Dec 2011 I had xray and MRI done on the right knee. All ordered by my PCP and next was scheduled for an Ortho appt in Jan. They did an exam that basically ended up being like the C&P exam and also agreed with the findings of arthritis in the knee. In Feb. they started a regiment that every 6 months I will get an injection to help lubricate the knee. Now when I submitted the claim I submitted my SMR records that showed the injuries and treatment on my right knee while stationed at Okinawa and Camp Pendleton. I also included private medical records for the two knee surgeries in 1997 and 2000, that were to repair torn meniscus. On those records the doctor in 1997 said their is evidence of a prior tear that had healed. Also submitted photos from both surgeries. At the end of March I received a letter from the VA regarding my claim. It said a decision, dated March 2 2012, ... We determined that the following condition was not related to your military service, so service connection could't be granted.... Denial reason no link could be found. Explanation We received your medical evidence which discusses the symptoms of your medical condition. Service connection for this condition requires a nexus(link) between your current knee condition and your knee injuries while on active duty. A medical opinion from your doctor stating that your current knee disability is at least as likely as not a continuation of the knee problem you experienced while on active duty would provide the required nexus(link between your knee conditionthen and now. So I called my PCP the next day since he is who I see and told what I needed. Now understand my PCP at the VA was a former C&P examiner and knew exactly what needed to be said short and sweet. The sweet part being: It is more likely than not that his current condition is directly related to those injuries described. So the beginning of April I met with my VSO and we resubmitted the claim with the nexus letter. Now the end of May and I am glad the C&P called to let me know that had my C&P the following week. The C&P exam in Durham are held a t the C&P clinic at the Durham VA. Never received a letter about the appt until the day of and after I took the exam. So I go to the exam which last about an hour. I was told that in 3 weeks I could get a copy of the exam in my records and did so today. Here are the results. -------------------------------------------------------------------- ROM Flexion right knee 100 and after repetative use 90 Extension right knee 10 and after repetative use 10-(but at the ortho clinic I was limited to 15, so this may have to be something I appeal if not happy because it is the difference of 10 to 20%) -------------------------------------------------------------------- Functional Loss and Additional limitation in ROM Do the Veteran have additional limitation in ROM--yes Does the Veteran have functional loss and/or functional impairment--yes Right knee less movement than normal and pain on movement ---------------------------------------------------------------- Does Veteran have tenderness or pain to palpation for joint line or soft tissue--yes ---------------------------------------------------------------- Muscle strength 4/5 active movement against some resistance on both flexion and extension ---------------------------------------------------------------- This one concerns me because not sure how this will be used to determine ratings or will it now Anterior instability(lachman test), Posterior instability test(posterior drawer test), and Medial-lateral instability---all three was unable to perform the test because of pain ---------------------------------------------------------------- Patellar sublaxion--no ---------------------------------------------------------------- additional conditions-no ---------------------------------------------------------------- Meniscal conditions and surgery Has Vet now have or has had any meniscus(semi-lunar cartilage) condition---yes If yes indicate Meniscal tear Frequent episodes of joint "locking" Frequent episodes of joint pain Has Vet had a meniscectomy---yes 1997, 2000 Does Vet have any residual signs and/or symptons due to a meniscectomy---yes If yes indicate and describe residuals-- weakness and pain ---------------------------------------------------------------------- Joint replacement--no ---------------------------------------------------------------------- Does the patient have scars-yes ---------------------------------------------------------------------- Assistive device Does the Vet use any assistive device--yes If yes indicate frequency--constant ACL/PCL brace issued by the Asheville VA for right knee stability --------------------------------------------------------------------------------- Diagnostic testing Arthrits Have imaging studies been performed--yes Is degenerative arthritis documented--yes MRI was also doen Impression from MRI 1. Untact ACL 2.Superficial and partial thickness cartilage abnormality of the patellofemoral and medial compartments consistent with early osteoarthritis --------------------------------------------------------------------------- In short for her rationale( I could write the whole thing, but it basically sums up every I have posted and the timeline again) It would be more likely than not that condition to the right knee is service connected. -------------------------------------------------------------------------- So now my question is how will this get rated assuming I get the right knee service connected. Looking at the different codes it can be confusing. I have also read they can give seperate ratings for the knee joint specifically. Arthritis it seems to have some relationship with the actual findings on the knee if rated a % or not. A little unclear here. 5257-Not sure how they will rate this is based on recurrent subluxation or lateral instability and I was unable to perform any of the test and was noted due to pain 5258-Cartilage, semilunar, dislocated, with frequent episodes of “locking,” pain, and effusion into the joint(not sure here either but was recorded those 2 in bold but not sure if all need to be there in the findings) understand this rating is 20% if granted 5259-Cartilage, semilunar, removal of, symptomatic- two meniscectomy surgeries-10% 5260- Leg, limitation of flexion of-I understand I would not get a % since I was only at 90 degrees for limitation 5261- Leg, limitation of extension of-10 degrees would be 10% (but in the ortho clinic it was 15 degrees which should be 20% and may be a reason for an appeal on the decision) So if anyone has an idea of what to expect it would be helpful. Does it appear I will be granted service connection for the right knee? I do have a nexus letter in supprt of it from my PCP and it appears the C&P examiner also supports my claim. I understand it could still go against me. If granted what should I expect and how would they rate it? Would their be mutliple ratings or do they take the highest rating among the codes? Also how will it affect my claim since I was unable, due to pain, to do the stabilibilty test? How is arthritis calculated, is it seperate or does it up the rating overall? Also will wearing a brace the ortho clinic at the VA issued, will it factor in the determination process? Again thanks for any help with this and apologize for the long post but I figured the more I posted the better I can be helped. If you need anymore info just let me know. Semper Fi