Got My C&p Results. Looking For Opinion

[JHawks]

I am already SC for malunion of my tib-fib with arthritis for my left ankle. I wear a prescribed brace on it and walk with a cane. Here is what was said in my C&P exam of June 10th. I will skip all the generic stuff.

Impression:

1. Right Knee Chondromalacia patellae - 5/5 motor strength / extension to 10 degrees with pain / flexation 125. Knee swells, locks, buckles, pops and grinds.-

2. Left Knee Chomdromalacia patellae - 5/5 motor strength / extension to 15 degrees with pain / flexation 115. Knee swells, locks, buckles, pops and grinds.

3. Right Ankle Achliiles tendonitis, calcaneal spur and planter faciitis. 5/5 motor strength / Dorsiflexion 0-20, planter flexation 0-25 with inversion, eversion pain on all ranges of motion.

4. Left Ankle Bimalleolar fracture with distal tibial deformity and cancaneal spur and posterior tibial nerve neuritis. 4+/5 motor strength / Dorsiflexion 0-10 / planter flexation 0-15 with essentially no inversion or eversion.It is further my (C&P Dr.) impression that problems 1, 2 and 3 are all more likely than not secondary to problem #4 considering that he has been ambulating with a limp and a cane and leg length discrepancy for many years.

What could I possibly expect from all of this? I am a complete novice in medical blah blah. Any off the cuff opinion would be helpful and appreciated.

Edited July 8, 2010 by JHawks

[Berta]

Did the doctor link this to your established SC disability?

This info would help rate the disabilities but what did he say as to the inservcice nexus or cause of these disabilities?

[JHawks]

all he wrote in the C&P was the following:

It is further my (C&P Dr.) impression that problems 1, 2 and 3 are all more likely than not secondary to problem #4 considering that he has been ambulating with a limp and a cane and leg length discrepancy for many years.

[LarryJ]

He's already SC'd for his left ankle, Berta. So, if the rater is awake then just maybe this will fly. Maybe.

1. 10%

2. 10%

3. 20%

4. Maybe 0%, if they consider this the same as what he is already rated for (don't know what percentage he is now getting for the lft ankle), maybe an increase, if so, no more than 10% above what he has now.

But, then, heck, take that OPINION and a $5.00 bill and buy a Starbucks.

[JHawks]

I forgot to include I am currently rated 30% for my SC left ankle, 2 scars 10% each. VA Math combined 40%.

[john999]

I think the VA will SC the first three conditions as secondary to number 4. No idea about percentages.

[JamesBreckenridge]

I don't have your file in front of me, so I'm having to make a wild-ass-guess based on certain assumptions.

Assuming the following...

You are already service connected for DC 5262 malunion of tibia and fibula on your left leg evaluated at 30 percent for marked knee or ankle disability. This is probably the left ankle bimalleolar fracture with distal tibai deformity. This is what makes your left leg shorter than your right. If this requires a brace (as opposed to a knee brace), then that satisfies the criteria for a 40 percent.

Are you sure that you're not 40 percent for the malunion of tibia and fibula, and 0 percent for the scars? In my experience, scars are rarely ever compensable. They generally have to painful, unstable, disfiguring, or actually limit the motion of an arm or leg or something before they become compensable.

In any case, due to the Amputation Rule 38 CFR 4.68, 40 percent is the maximum you can get for ALL conditions, no matter what, that are located below the knee. This makes sense, because a below the knee amputation is 40 percent. So, we can probably ignore whether it's 30 and two 10s, or a 40 and two 0s.

Both knees have limitation of motion secondary to the bimalleolar fracture, according to the doctor. Presto, they are now service connected on a secondary basis. What would the likely evaluation be? Because there is some limitation of motion in each knee, there's going to be at least 10 percent for each knee. But look at DC 5261. If extension of the left knee is limited to 15 degrees (normal is 0 degrees, which is a straight leg) it warrants a 20 percent. Also, the right ankle gets 10 percent for limited motion.

So, all up, we have 20 percent for the left knee due to extension being limited to 15 degrees, 40 degrees for what's below the knee, 10 percent for the right ankle, and 10 percent for the right knee. 40-20-10-10 should be about 60 percent, ignoring bilateral factors.

Fun fact: since all of the conditions share a common etiology/body system, they count as a single 60 percent disability, which meets the baseline criteria for individual unemployability. A doctor would still have to opine upon whether it actually stops you from working.

Edited July 9, 2010 by JamesBreckenridge