Knee Rating

[hayley3]

I have bad knees. Was told I have crepitus but nothing found on xray. However, I cannot squat down or get back up without severe pain. I also have pain going downstairs.

In looking at the regs, it mentions knee replacement, and knee ankylosis, which I don't have. It also shows Knee Other with subluxation or lateral instability, which I guess I don't have either.

The C&P examiner had me move my leg up and down sitting on the exam table, but it doesn't hurt then.

Is there anyway to claim the pain I have when using my knees?

Also the report said about my hips, that my ROM was limited with weakness and pain and the xrays shows some sclerosis and cystic changes of right hip but were otherwise negative. Can't I claim that either? All I see is ankylosis of the hip.

I actually have like a tendonitis which doesn't show on xrays too well. But I didn't think the xrays were as important as pain and ROM. Still learning.

Thanks,

Susie

[MRRRR5]

Hayley3,

in my opinion, if the x-rays show a secondary disability related to a service connected disability, you should file for that also.

Depending on the outcome of your claim, I would consider requesting another C&P from the VARO since the examiner did not apparently address your knee issue while standing/using your knees.

I'm not to versed on the other hip issue you raise, but I'm sure some of the other HADIT family members will chime in.

Good luck and I hope your claim is approved.

Hayley3,

in my opinion, if the x-rays show a secondary disability related to a service connected disability, you should file for that also.

Depending on the outcome of your claim, I would consider requesting another C&P from the VARO since the examiner did not apparently address your knee issue while standing/using your knees.

I'm not to versed on the other hip issue you raise, but I'm sure some of the other HADIT family members will chime in.

Good luck and I hope your claim is approved. B)

[sehinchee]

try functional loss CFR 38 4.40 along with the range of motion regs

[hayley3]

Thanks MRRRR5, they completely ignored my knees and they would be sc'd if I could get them to look at them correctly. I am writing the NOD, so I will mention that she did not have me squat down. Good idea!

Thanks sehinchee. I hadn't read that, so I could quote it when I write my NOD. But I don't know what schedule of ratings code my knee pain should go under.

Thanks,

Susie

[JR Reihs]

hayley3,

Ever thought about having a IMO done by your own Ortho? This kinda throws the ball back into your court.

[Teac]

Thanks MRRRR5, they completely ignored my knees and they would be sc'd if I could get them to look at them correctly. I am writing the NOD, so I will mention that she did not have me squat down. Good idea!

Thanks sehinchee. I hadn't read that, so I could quote it when I write my NOD. But I don't know what schedule of ratings code my knee pain should go under.

Thanks,

Susie

Hayley,

i hate to burst your bubble.. but

The fact that you did not squat down during your C/P exam , doesn't mean squat. The examiner had you move your legs up and down while sitting on the exam table, the examiner was checking your range of motion... that is what the examiminer should do.

Knees are rated on limitaition of motion not pain caused by squating. If you nod based on an inadquate exam it won't do you any good....

Please read your rating carefully it will tell you what is required to get a rating for your knees,

also review the examination sheet for knee exams,

Look at the examination sheet at: http://www.vba.va.gov/bln/21/Benefits/exams/disexm34.htm

and look at the rating schedule for knees:

I wish you luck, but based on what you said I don't think you have a valid appeal, Now this is just my humble opinion, I am not a doctor.. but I know a little about it becasue I have a knee problem and two seperate ratings for loss of range of motion and limited flexion.

You may be able to get rated under other imparement ..I don't know....

Edited July 16, 2008 by Teac (see edit history)

[rentalguy1]

I'm not sure what you are rated for, but if it is your back or a foot/ankle, then you can possibly get the knees rated as secondary. They would most likely be rated under dx code 5257. They are not rated (usually) on limitation of motion, as was previously stated. I would not look for more than a 10% rating for each knee. The key to getting this rating might be an MRI. See if your PC doc can schedule you for one. Try to get them to do one of your hips as well. I am not 100% clear how the hips are rated, as I am not rated for them. I have been rated for knees since 1994, though.

One last thing to keep in mind, the VA may try to come back at you with "painful motion is not a ratable condition, in and of itself." If the MRI doesn't show anything, try to talk your PC doc into some kind of a indisputable diagnosis that is entered into your VAMR's.

[hayley3]

Thanks, Rentalguy, I'm sc'd for Reactive Arthritis and my spine has arthritis in it and knees are normally a secondary condition for that diagnosis, but they said, "upon examination your gait was normal". So I guess that's what they are basing it on...my gait.

I am going to ask my PC doc why I am in so much pain in my knees but the xrays showed nothing and ask maybe for an ultrasound. I don't trust MRI's too much since my last one was messed up.

Also about the painful motion thing, the reg that sehinchee posted does say that painful motion is ratable. So I may quote that and see what they say at least. They forgot to include my spine in the C&P exam, so I have to send in a NOD anyway so I might as well mention it.

Thanks Teac. That was my conclusion too about the range of motion, but they said my shoulders and hips were limited by ROM, but they didn't give me anything for that either. And my hip at least shows something on the xray.

Thanks JR. I did get an IMO to get the Reactive Arthritis rated.

Susie

Edited July 16, 2008 by hayley3 (see edit history)

[sehinchee]

Actually,

I am not sure if painful motion is rateable by itself. What I was refering to is similar to my situation. I had knee replacement surgery for whic I am rated 30%. During the C&P the doc sat me on a table and tested my ROM, which was good. The problem is that the knee is a weight bearing joint, which can have pain free range of motion when not bearing weight, but the same knee can be quite painful when doing simple weight bearing tasks such as walking or squatting. Hence the functional loss.

[Mcafee]

Hello all hope all is well. If I may, I also have bilateral Right and Left Knee conditions.Now in order for anyone to have any type of PAIN common sense tells us mmmmmmm there is something wrong or deficient in this condition .You Can not have PAIN without some type of defect in the Bone or Ligment or Knee Cap or arthritus and so on.There fore an X-Ray or even an MRI will not show the defect the only way for this to be addressed is arhtriscopic surgery or just plain surgery and even so this still may not show the defect.I have a mass behind each of my knees and the VA and there professors say there is absoloutely nothing wrong here its degenerative disease. Go Figure.The point i wish to make is if there is PAIN no matter where there is a defect at that point or area. I am having a Bad day I am so sorry folks argh.Oh sorry as for the codes all that apply are included from the lower level of your Body as this too is split into catagories.hence the Diag. Codes. ankle bone connected to leg bone is connected to the hip bone and so on.