tdiu C&p Exam

[Charleese]

Hi everyone,

Today, my husband and I went to his RO and got a copy of his C&P exam for his sc left knee condition. That was an espisoe in itself, which I will comment on in another thread. As many of you know, his claim for increase for left knee condition was denied in its entirety, and at his exam Doctor told him he needed a Full Knee Replacement and he was now unemployable. In Decision to deny him there is no mentioned of full knee replacement, nor about him being unemployable.

C&P exam Assessment: Osteoarthritis of the left knee with significant loss of joint space and a genu valgus deformity as noted on the exam. He has atrophy of both thigh muscles as a result of limited range of motion and he has had a recent fall that is at least as likely as not the result of the weakness and locking of the left knee. This fall was significant, as it resulted in a herniated cervical disc requiring fusion and discectomy as stated aove. As a result, he has moderate to severe functional loss and limitations. The veteran should consider a total knee replacement, given the extent of his severe osteoarthritis and limitation in his ADLs.

My question: Shouldn't osteoarthritis be rated separately as secondary to his left knee condition and atrophy of left thigh muscle secondary to his left knee disorder, also be rated separately as well? RO decision states: "you submitted a claim for increased evaluation of your left knee osteoarthritic changes and chronic chondromalacia as well as a claim for service connection for left thigh atrophy. A separate evaluation is not warranted for the left thigh atrophy because this condition is considered part of the left knee disorder. There is no evidence of a disability associated with the left thigh atrophy. The examiner related the atrophy of the thigh to the left knee disability (examiner related both thighs to left knee disorder). However, C&P exam states: Atrophy of oth thigh muscles - He has a 10-degree genu valgus deformity of the left knee and a 5 degree genu varus on the right side. There is bilateral atrophy of the right and left thigs with the left thigh measurin 48 cmknee circumference and 53 cm on the right.

My question: How can decision say separate evaluation is not warranted for left thigh atrophy because there is no evidence of a disability associated with the left thigh atrophy. Isn''t my left knee disorder the disabiity that's associated with the left thigh atrophy as examiner has said in C&P exam. Am I missing something here, please tell me. How can he get this rated separately? Now that both thighs have been associated with his left knee disorder, we will put in claim for that as well.

C&P exam states: The veteran retired in 1995 and he does not work, so occupation does impact his service-connection. My husband did work but it was part time she is speaking of when he last worked full time. She did not use ther word unemployable in her exam report, even though she stated "occupation does impact his servife-connection"..My husband was working part-time when his left knee gave and he lost his balance on the pavement. He never filed a claim with VA for this. He used his job insurance that he paid for himself to pay for hospital and doctors bills. He is still under doctors care for this fall and goes to therapy 2 times a week for it. His doctor has said he cannot go back to that job anymore stating that he is Totally Permanent and Disable to do that job.

My question: Should we claim this with VA or not, since C&P doctor said that his fall is as least as likely as not the result of his left knee disorder? Will the fact that he was working and used his insurance to pay for operation, etc. hurt him. If he claims this will it increase his rating or would they said this is just part of left knee injury 30%.

My question: Should we file for TDIU now, since he is 60% and attach C&P exam stating that left knee is cause of him falling,as well as Letter from doctor stating he can no longer work his job because of fall.

Please, please answer the questions thats outlined in this topic.

Thanks!

Edited March 30, 2009 by Charleese

[carlie]

Chances are that a knee condition alone would not make

one unemployable by VA or SSA regulations.

jmho,

carlie

[Charleese]

Carlie,

He has more going on besides knee condition. Diabetes, Hypertension, bilateral carpal tunnel, Hypertensive heart disease, gout, right knee condition, etc.

He asked for an increase on these items, but was denied. We intend to appeal.

[Philip Rogers]

Charleese, just guessing but I estimate your husbands age at around 72yo and I can see the VA fighting this, just based on age. Not that they should. jmo

pr

[Berta]

"My question: Should we file for TDIU now, since he is 60% and attach C&P exam stating that left knee is cause of him falling,as well as Letter from doctor stating he can no longer work his job because of fall."

Yes-if he is still not employed due to the SC knee -apply for TDIU.