hypertension Filing For Increase

[Charleese]

Hi everyone,

As many of you know my husband has a service connected left knee injury and gets 60%. However, since knee injury his medical records from both VA and private doctor states that he has Osteoarthritic changes which is secondary to his left knee injury.

He has never asked for an increase for secondary Osteoarthritic changes and wants to do so now. My question is he has other conditions thats associated with arthritis and not associated with arthrits. He has medical records to prove all of them, but how do you think they will rate him and what is SC or secondary. These are the conditions that he wants to put in an increase for:

1. Osteoarthritic changes - Secondary to left knee injury.

2. Knee Brace - Fitted by VA in January 2007 (not metal knee brace), this knee brace does not help him. Secondary to left knee injury.

3. ED - Takes Vardenafil HCL for it.

4. SMC - for ED

5. Clothing Allowance - for Knee Brace

6. Gout - Secondary to Osteoarthrtic changes - Takes Diclofenac NA for it.

7. Atrophy of Left Thigh - Don't know whether this is because of left knee injury or because of Mumps he had when he was in the service.

8. Right Knee - Secondary to Osteoarthritic changes or left knee injury. Has been diagnose with arthritis in right knee and has swelling, pain and have 2 cc of yellow fluid drained from it several times a year. Right Knee has deteriorated as a result of his having to compensate for my left knee disability. He has reported to VA as recently as 5/17/07 chronic pain for both knees. He takes Diclofenac NA.

9. Left Shoulder - Secondary to Osteoarthritic changes or left knee injury. Diagnose as Chronic for over 40 years as Degenerative Joint Disease. VA also states "H/O of DJD left knee and left shoulder. X-Ray in 2004 states Extensive Degenerative changes. He takes Diclofenac NA for it.

10. Right Shoulder - Secondary to Osteoarthritic changes or left knee injury. In 1997 Final Hospital Report states that he has Spurs at the inferior aspect of the AC joint which is consistent with an impingement syndrome. VA Progress Notes in 2000 under Impression plan states "L/knee/R/shoulder pain/start Naprosyns 500mg/bid". Ch;ronic pain for both. He now takes Diclofenac NA for it.

11. Bilateral Carpal Tunnel Syndrome - Secondary to Osteoarthritic changes or left knee injury. He was diagnose with this in the early 90s and in 1997 the hospital did a Spine Cervical Routine Exam on the request of his private doctor which states "cervical arthritis". Impression: Mild intervertebral disc space narrowing and spurs, C4-5, C5-6 and C6-7. Also Final Consultation Report, Exam date 2/12/98 Cervical Spine - Impression: Degenerative disc disease at all levels studied. Mild canal stenosis is evident from C3 through C6. Left lateral recess compromise is evident at C6-7. A small central bulge is evident at C2-3. Right Hand was operated on (2004 not sure of date or year), but operation was not a success and because it wasn’t a success he will not have other hand operated on. Chronic pain in both hands. Current Medication – Diclofenac NA.

12. Hypertension - Secondary to Osteoarthritic changes or left knee injury. Diagnose with Hypertension. Because of the multiple complications he has experienced with his left knee, which includes prolonged periods of forced inactivity, have caused him to be obese, which in turn has caused him to develop HBP, and diabetes mellitus. Also, Secondary Osteoarthritic Changes for his service connected left knee injury is treated with a variety of medications including steroids and non-steroid anti-inflammatory agents. A combination of these medications prescribed for his Secondary Osteoarthritic Changes have resulted in his developing Hypertension. He takes Losartan 3 times a day.

13. Hypertensive Heart Disease - Secondary to Hypertension. This report was done on 5/18/05 but we cannot understand what they are saying about this even though they devoted a whole page to it. Would like to put this down for increase just in case. Also, they said on 5/26/05 that an Echo Report was sent to him and they state that patient is scheduled to RTC in 6M, whatever RTC means we don't know. In 4/20/2005 VA report states "EKG done: NS with occasional premature VEN Complex otherwise Normal EKG." His Hypertension medication (Losartan) states it is for both HBP/heart.

14. Diabetes - Secondary to Osteoarthritic changes, Hypertension and Obesity. Because of the multiple complications he has experienced with his left knee, which includes prolonged periods of forced inactivity, have caused him to be obese, which in turn has caused him to develop HBP, and diabetes mellitus. He takes Glipizide and Metformin for it.

15. Diabetic Eye - Secondary to Diabetes. 2006 VA Medical Records state " Also Has History Of “Glaucoma". He takes Travoprost every night for both eyes. Travoprost is used to treat high pressure inside the eye due to glaucoma (open-angle type) or other eye diseases (e.g., ocular hypertension).

16. Cholesterol - Secondary to Diabetes and Hypertension. 1/10/2006 VA Medical Record Progress Notes, state “Hyperlipidemia". He takes Simvastatin for it.

17. Mumps - While in service, at USAF Hospital, Chanute AFB, Illinois, June 1955. Don't know whether Atrophy of theigh or ED is associated with this.

Sorry this is so long, but these are the conditions that he has and has have them for years but never put in an increase for.

Please tell me (1) how and if you think they will rate him; and (2) what is SC or secondary.

Thanks in advance for your ansewers.

[john999]

I think it may be a stretch to get SC for carpal tunnel syndrome seoondary to knee injury. You have to have some rational to show the connection. If he is SC for DMII the HPB is probably good to go. The other knee may be good as well since compensation for SC knee can cause all kinds of back, knee, and hip problems. When you claim for secondary conditions you need a medical report to show the connection. They will not accept random evidence. Your doctor should say in a report that the secondary condition has been caused or aggravated by the primary SC condition.

[Charleese]

Hi,

Doesn't any of the experts or anyone have any opinions about this?

[Alex]

Charlese --

Only medcal evidence cam say what is connected to the service, eiter directly or secondarily or by aggavation and give some information about possible ratings by listig signs and systems.

There is a condition known as polyarthitis where the disease attacks multiple joints simultaneously. See if this is involved.

Alex

Edited June 8, 2007 by Alex