tdiu Tdiu Doctor's Opinion - Would This Work

[Charleese]

Hi All,

The vet I am helping orthropediac doctor wrote under History that: The patient is a 73-year old male who comes in primarily for pain in both knees and lower back. The patient had previous left knee surgery in 1954 service connected where he was injured. He has had progressive knee pain over the past years, which because of the way he has been walking has started to affect his other knee as well as his lower back. Physical Exam doctor states in part: Both knees have crepitus. The right knee has more crepitus and pain in the medial side. Varus knee deformity on the right is noted. Sensory examination is intact. Reflexes are trace gilaterally. Dorsalis pedis pulse is 2+. X-rays taken today shows severe patelloofemoral arthritis and milder femororotibial arthritis. He has also patellofemoral arthritis on the right knee and primarily medial joint arthritis on the right knee. Impression: The patient's pain is more severe in the left knee than the right. Treatment Plan: Is is felt that the patient has severe osteoarthritis, posttraumatically induced. I feel the right knee is probably within a reasonable degree of medical certainity related to the fact that he has been limping for the past 20 years and favoring the left side has caused an effect of producing arthritis on the right knee. The treatment options were discussed with him. At the present time, the patient is probably unemployable since ambulation for any long periods of time bother him and he cannot stand for a long period of time, anything longer than 20 minutes of the time and also, when he sits in one position for a while, his legs start to cramp up and bother him as well as pain in the lower back, so he has got to get up and move. We will see the patient back in the office as needed.

Questions: (1) Do you think these medical opinions by the doctor will get him secondary service connected for his rigt knee and lower back to his service connected left knee.

(2) Doctor stating: "At the present time, the patient is probably unemployable", get him TDIU.

Thanks in advance for your replies.

[carlie]

The word Probably means: insofar as seems reasonably true, factual, or to be expected without much doubt.

Charleese,

This maybe a definition from a dictionary - but in regards to VBA disability claims adjudication

the word "probably" means nothing - "probably" is like a guess grasping at straws, as Berta posted

"probably" is viewed by VBA as mere "speculation".

An opinion by a doctor that something is "probably" connected to active duty or as a secondary

condition, is not even strong enough to put the the medical evidence into a state of relative equipoise,

thus bringing in the Benefit of the Doubt for application, with the tie going to the veteran.

Probably - is not sufficient for there to be a tie.

Keep in mind, whatever a doctor writes must be supported by the medical evidence of record

and full medical rationale.

jmho

[Charleese]

Carlie I'm sorry I over looked ROM measurement that was stated in Note. Note states range of motion of the knee is about 10 degrees to about 80 degrees.

Berta thank you for the link. I printed it out and gave it to him to take to his orthopedic doctor and told him to ask doctor to redo his note using at least as likely as not, and stating he is unemployable.

Panamavet I suggest you read my other topics on this matter and you will see why this man is unemployable.

[carlie]

Carlie I'm sorry I over looked ROM measurement that was stated in Note.

Note states range of motion of the knee is about 10 degrees to about 80 degrees.

Charleese,

ROM of knee IS ABOUT ....etc.....

About - is not a measurement for VA Disability purposes.

jmho

[Charleese]

I know that is why I gave him a copy of Getting An Independent Medical Opinion to give to doctor so he could redo his note.