Appeal Video Conference, S/c Back Secondary To S/c Knees

[USAFvet13]

Hello all, unfortuantely my first post must be one asking for help as I do not know what to do from here.

I have service connections for the following:

Right knee degen joint disease w/ slight subluxation 10%

Right knee patellofemoral syndrome with chondromalacia 10%

Left knee patellofemoral syndrome with chondromalacia 10%

My knee symptoms and pain started during my service in the USAF. I have a lot of medical records to prove this so getting s/c for my knees wasn't extremely difficult. My knee s/c disablities began in 2004. I had surgery on my right knee with a private doctor in 2005 and since then I have had back pain and problems. I have continuous medical records from different chiropractors to show my back problems.

Problem is I never had any of them connect my knee problems to developing a back problem until I decided to try to get s/c back secondary to knees. I was able to get an IMO recently from one chiro saying "........ I have reviewed xxxx SMR's and it is my professional opinion that his altered gait due to his bilateral knee complaints has contributed to his low-back pain."

Here is where the difficulty began. I failed to get all my chiro records and this letter to the VA before they made a decision on back secondary to my knees. So I was denied. I filed a NOD and during this time my chiro records and my IMO made it to the VA. Well, they denied me again. This time they are saying there is significant documentation in support of a back problem, but I am lacking evidence of an altered gait with the exception of one VA note, and the IMO I submitted. So I have now requested a board of vet appeal video conference hearing.

I just today came from an appointment with the physical therapy / rehab doc at the VA in hopes that she would back up the altered gait developing a back problem, but she wouldn't write me an IMO and didn't agree with me that its a possiblity my knee conditions contributed to my back condition... WTF? She said she has plenty of patients with knee/ankle problems that do not develope back conditions...

So now I'm not sure what to do. The DAV is helping me, and he even said it's common medical knowledge that if you ankle or knee get messed up it will have a chain reaction and eventually mess up your back.

Sorry for the long rant, I look forward to hearing some advice on what to do. Hopefully I have enough time to figure something out before my appeal.

[Berta]

"This time they are saying there is significant documentation in support of a back problem, but I am lacking evidence of an altered gait with the exception of one VA note, and the IMO I submitted."

You mean they acknowledged the IMO but rejected it?

What was the rationale they stated for denial with reference to the MO?

Did the IMO fully comply with the IMO criteria here at hadit under the IMO forum?

Did they list the IMO as evidence in the denial?

Then did they fully refer to it in the denial? Can you scan the decision (cover personal stuff) and attached it here?

[USAFvet13]

I'll scan what I have and post it here this evening.

The IMO was listed as evidence.

I don't have it in front of me now, but I think it was said although my Chiro's IMO stated my back condition is due to my altered gait from my s/c knees it also stated that other than this one time my chiro never said anything about an altered gait during all my chiro visits I submitted.

I'm pretty sure he followed the format, he said that he reviewed my SMRs and he said my back condition "is due to" my altered gait from my s/c knees.

[1lonewolf]

I know what you are going through. I got hurt while serving during the Gulf War. They performed reconstructive surgery on both of my Feet(screwed them Together) This has caused me allot of pain and an abnormal gait for all these years. Now I have misalignement and degenerative arthritis in both hips which also catch and pop out every so often. I also have Degenerative Disc Disease, Degenerative Arthritis, 5 bulging discs, a pinch sciatic nerve, and facet syndrome in my lower back. I never went to the VA for treatment for over 19 years other than in 1997 when one of my feet broke and they had to redo it. When My hips and back finally got so bad I could not manage it anymore with over the counter Motrin (Which also caused me to have Barrett's Espophagus). I started going to the VA again. All of my doctors from Podiatry to Ortho said the same thing. That my hips and my back were in the shape they are because of my abnormal gait all these years because I walk on my heels and the sides of my feet for obvious reasons. I am in constant pain and they have prescribed my morphine 60 mg a day and hyrdrocodone 10s 4 times a day. I also take sleeping pills prescribed by them. I was told by all my doctors that this would only get worse with age and I am only 40 and can barely move now. There was however one very brash and rude older female doctor in Ortho who has always had an overall demeanor with me that my conditions are not related to walking on my heels and my abnormal gate. This is the same doctor who pushed bruised on me and sent my to Physical Therapy before she even knew what was wrong with my back or hips. She is also the Doctor who showed up to perform my C and P examination btw! I knew when I saw her that This was a waiste of my time and what she would do for my claim. Keep in mind that I was granted 10 percent for my right hip last Jan for Degenerative Arthritis and popping. This C and P exam was done by another Honest Doctor who followed procedure and code 38 regs. So here I am with the Doctor who treats all Vets like animals about to do a C and P exam on my back and left hip. She pulled the muscles in my right ribs during trunk rotation by grabbing my arm and extending me and she forced me to squat when I cannot and I cound not back up. Needless to say when I left I was hurting so bad I had to go home and take some med and lay down for a few hours. I hurt for over a week! I just got my claim back today and Not only was it denied but they took the 10 % away for my right hip. She wrote that my conditions were not related to abnormal gate. Not only that she answered the questions using her own opinion and not medical facts and did not even perform all the tests she was supposed to in accordance with the 38 references. They can do and put whatever they want and put your life on hold. Now I have to appeal. Gait causes all kinds of problems! You can find evidence to the contrary as she has but there is plenty of information all over the internet to prove that. It is common sense. Now here I am in the same boat with you appealing the same argument because of one doctor who should not even have a job treating Vets in Ortho they way she is. I feel you pain and wear ankle braces and walk on a cane to boot! The letter I got today should have been and would have been 100% if it had not been for her and her plight to disprove and mistreat all Vets she treats or examins! Now my life continues to be on hold thanks to her and I have lost everything and can barely walk. I will keep you posted as I attack my appeal through the proper channels and you keep me posted. The information we have and/or gain on Gait will most certainly help in both cases! I am writing my appeal letter now! I did not get this way by myself nor did you and I will not lose my life and my 6 digit income and everything I have and owned previously to be denied by a broken system and a bad Dr/employee at the VA. I am mad as hell as you can see and so are you. Let's keep communicating!

[1lonewolf]

F.Y.I my eval used Knee problems and abnormal gait as an example and went on to say the Knee issues and abnormal gait does not cause back problems! My issues are with my feet?? Anyway I have put a link below for your reference. Let me know how your case is going and I will keep you posted on mine as well! Secondary SC back condition due to Knee problems awarded based on IMO. http://www4.va.gov/vetapp05/files2/0508095.txt

[1lonewolf]

F.Y.I my eval used Knee problems and abnormal gait as an example and went on to say the Knee issues and abnormal gait does not cause back problems! My issues are with my feet?? Anyway I have put a link below for your reference. Let me know how your case is going and I will keep you posted on mine as well! Secondary SC back condition due to Knee problems awarded based on IMO. http://www4.va.gov/vetapp05/files2/0508095.txt

[USAFvet13]

Quick update to my appeal, I had a CP exam scheduled this month but the doctor became sick and cancled on me so it's been rescheduled for Sept 20th. I had a second chiropractor write me another IMO and he also said it was as least likely as not my SC knees were the cause of my back problems. This Chiro also stated a few facts about how an altered gait will eventually lead to compensation of other muscles and eventually lead to muscle imbalances and pain / problems in other areas of the body. He also attached two sheets of all his medical training.

After reading over my previous denial for back secondary to knees, it seems the probelm is the lack of documentaion of an altered gait. But I have seen a muscle activation therapist for a few months in hope of getting my knees to work a little better so this therapist is supposed to be writing me another IMO stating he saw me for an altered gait. Hopefully with all this my appeal will go through in my favor.