Total Knee Replacement

[jmack]

Hadit:

Will someone tell me how much is the SMC for a total knee replacement? The knee is SC and I am currently 100% P&T. I can't understand that doggone SMC chart. I am married with children under 12.

jmack

[Berta]

I dont know if you are entitled to SMC-

Is the 100% you get now due to the knee and similiar to this case?

This claim at the BVA shows how they rate knee replacements:

http://www.va.gov/vetapp07/files1/0706662.txt

"Under 38 C.F.R. Section 4.71a, Diagnostic Code 5055, when

there is prosthetic replacement of the knee joint, a 100

percent evaluation is assigned for the one year following

implantation of the prosthesis. Since the Board has found

that the veteran's left knee replacement is related to his

service-connected left knee disability, the veteran is

entitled to a 100 percent rating for one year"

After that year they rate the residuals.

My neighbor has two knee replacements service connected-but he doesnt get 100% anymore.

Or is your 100% for some other SC disability? As the P & T status surprises me if this is the knee rating.

Edited October 28, 2007 by Berta

[jmack]

I dont know if you are entitled to SMC-

Is the 100% you get now due to the knee and similiar to this case?

This claim at the BVA shows how they rate knee replacements:

http://www.va.gov/vetapp07/files1/0706662.txt

"Under 38 C.F.R. Section 4.71a, Diagnostic Code 5055, when

there is prosthetic replacement of the knee joint, a 100

percent evaluation is assigned for the one year following

implantation of the prosthesis. Since the Board has found

that the veteran's left knee replacement is related to his

service-connected left knee disability, the veteran is

entitled to a 100 percent rating for one year"

After that year they rate the residuals.

My neighbor has two knee replacements service connected-but he doesnt get 100% anymore.

Or is your 100% for some other SC disability? As the P & T status surprises me if this is the knee rating.

No,

[jmack]

I dont know if you are entitled to SMC-

Is the 100% you get now due to the knee and similiar to this case?

This claim at the BVA shows how they rate knee replacements:

http://www.va.gov/vetapp07/files1/0706662.txt

"Under 38 C.F.R. Section 4.71a, Diagnostic Code 5055, when

there is prosthetic replacement of the knee joint, a 100

percent evaluation is assigned for the one year following

implantation of the prosthesis. Since the Board has found

that the veteran's left knee replacement is related to his

service-connected left knee disability, the veteran is

entitled to a 100 percent rating for one year"

After that year they rate the residuals.

My neighbor has two knee replacements service connected-but he doesnt get 100% anymore.

Or is your 100% for some other SC disability? As the P & T status surprises me if this is the knee rating.

No, I am already rated 100% P & T schedular. I guess my question should be if there is SMC for the total knee replacement while it is individually rated at 100% temporary for 12 months. Maybe some other compensation that I am entitled to.

jmack

[Berta]

If you mean you get 100 % P & T schedular for a separate disability(not the knee) than I would think the 100% temp for the knee- as an additional independent disability should possibly support the SMC "S" award for the period of the temp rating.

38 USC 1114 "S"

"SMC at the housebound rate is payable when a

veteran has a single service-connected disability rated 100

percent and (1) has additional service-connected disability

or disabilities independently ratable at 60 percent, separate

and distinct from the 100 percent service-connected

disability and involving different anatomical segments or

bodily systems, or (2) is permanently housebound by reason of

service-connected disability or disabilities. See 38

U.S.C.A. § 1114(s) (West 2002). The requirement of 38

U.S.C.A. § 1114(s)(2) is met when a veteran is substantially

confined as a direct result of service-connected disabilities

to his dwelling and the immediate premises or, if

institutionalized, to the ward or clinical area, and it is

reasonably certain that the disability or disabilities and

resultant confinement will continue throughout his lifetime.

See 38 C.F.R. § 3.350(3)(i)(2) (2006)."

After the 12 months of 100% temp for the knee they VA will rate the residuals.

[Berta]

Most of the knee replacements decisions I have read at the BVA are rated-after the initial 100% temp- at 30% -yet some present a very severe residual picture- and they are rated higher- such as this vet who needed additional knee surgery:

http://www.va.gov/vetapp95/files2/9507164.txt

This more recent case shows exactly how they rate the residuals:

http://www.va.gov/vetapp07/files1/0706018.txt

[jmack]

Most of the knee replacements decisions I have read at the BVA are rated-after the initial 100% temp- at 30% -yet some present a very severe residual picture- and they are rated higher- such as this vet who needed additional knee surgery:

http://www.va.gov/vetapp95/files2/9507164.txt

This more recent case shows exactly how they rate the residuals:

http://www.va.gov/vetapp07/files1/0706018.txt

Thanks Berta,

They kind of short-changed me anyhow from the beginning by rating both knees at only 10%. And you are the second person that has told me that after 12 months that it is automatically rated at 30%. So I stand to gain in both areas: 1. no more pain in the knee 2. an increase of 20%, I'm I correct?

jmack