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

[broncovet]

I hope you didnt miss James Breckenridge's Post...I will post it again, because I think that many of us are unaware of this:

"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."

[JHawks]

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.

Thank you for your input and the information. I am curious as to what you mean by "ignoring bilateral factors" and what impact that would have on a rating? Is that good or bad?

[JamesBreckenridge]

Thank you for your input and the information. I am curious as to what you mean by "ignoring bilateral factors" and what impact that would have on a rating? Is that good or bad?

There's a few extra percentage points that are assigned when you've got disabilities in both arms or both legs. Sometimes, it's just enough to make your combined evaluation to round up to the next higher level. Examples:

Vet A is 56 percent disabled, but bilateral factors push that up to 58 percent disabled. The bilateral factors that are added don't really do anything, because we were gonna round him up to 60 percent anyway.

Vet B is 64 percent disabled, and the bilateral factors push him up to 66 percent disabled. We would have rounded down to 60 percent, but now we get to round up to 70 percent.

[JHawks]

There's a few extra percentage points that are assigned when you've got disabilities in both arms or both legs. Sometimes, it's just enough to make your combined evaluation to round up to the next higher level. Examples:

Vet A is 56 percent disabled, but bilateral factors push that up to 58 percent disabled. The bilateral factors that are added don't really do anything, because we were gonna round him up to 60 percent anyway.

Vet B is 64 percent disabled, and the bilateral factors push him up to 66 percent disabled. We would have rounded down to 60 percent, but now we get to round up to 70 percent.

Thanks for explaining that to me. I had read many posts about bilateral factors but never completely understood it. I just hope the rater is awake and follows your thoughts. I would be more than happy with an overall rating of 60%.

[JHawks]

Today I looked on the E benefits Site and was SHOCKED to see my claim is already in Decision Phase. That's only 29 days after my C&P. That makes me NERVOUS considering the C&P results I posted here. My experience has been a BIG DENIAL when things move this fast. I hope I am wrong.

[ruby]

What is e benefits site and how do you know where your claim is.