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Tkr Postop Pain


cooter
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Im rated 60% on right knee due to postop occuring pain and buckleing,ect. in 2009. I was forced to take a disability retirement in June 2008 due to my sc knee injury which is noted by my last employer. This was all due to a tragic parachute fall while attending airbourne school at ft. benning,ga. in 1976. I didn't apply for compensation with the VA untill 2004 bcause believe or not I didn't know I could!!! I was out of the service for 30 years before I joined the American Legion post in arizona and thats when I found out I could apply. I guess I don't get around much.ha. I filed a claim for IU due to symptoms stated above. They denied my claim stating the VA med examiner said I could be employed with a job sitting down. I filed a reconcider letter 2 weeks ago. I also sent a letter from my civ. Dr. saying I can not sit for more than 15 minutes at a time. By the way my civ doc is not an ortho but a pain management dr. I understand I hve 60 days to send the VA any evidence that will support my claim. I lost my job of 22 years and havn't worked since june 2008. Any help from the Hadit family or anyone thats been thru or seen this type of claim would surely be appreciated. I'm also new here, and not sure where to find your answers or ideas. help again

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cooter,

Welcome,

I've moved your topic to Claims/Benefits Research.

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  • HadIt.com Elder

Im rated 60% on right knee due to postop occuring pain and buckleing,ect. in 2009. I was forced to take a disability retirement in June 2008 due to my sc knee injury which is noted by my last employer. This was all due to a tragic parachute fall while attending airbourne school at ft. benning,ga. in 1976. I didn't apply for compensation with the VA untill 2004 bcause believe or not I didn't know I could!!! I was out of the service for 30 years before I joined the American Legion post in arizona and thats when I found out I could apply. I guess I don't get around much.ha. I filed a claim for IU due to symptoms stated above. They denied my claim stating the VA med examiner said I could be employed with a job sitting down. I filed a reconcider letter 2 weeks ago. I also sent a letter from my civ. Dr. saying I can not sit for more than 15 minutes at a time. By the way my civ doc is not an ortho but a pain management dr. I understand I hve 60 days to send the VA any evidence that will support my claim. I lost my job of 22 years and havn't worked since june 2008. Any help from the Hadit family or anyone thats been thru or seen this type of claim would surely be appreciated. I'm also new here, and not sure where to find your answers or ideas. help again

Welcome aboard 'cooter'.

What do you mean, you filed a "reconsider" letter 2 weeks ago??? With who?

Have you filed a notice of Disagreement (NOD) yet? You have one year after the denial letter to file a NOD...

Edited by Commander Bob
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Did your doctor use the IMO format here in our IMO forum?

Do you have a copy of the actual C & P exam results and did your private doc have it?

Was that the sole reason they denied TDIU?

Do I understand this right-

you get comp at 60% now for the right knee. Does this condition affect your back, hips, or feet?

Did you tell VA on the TDIU form of any side affects of any meds you take that would hinder or prevent employment?

Did the pain management doctor have any X rays or MRI results to show that this disabilty has affected your ability to sit for long periods? Does this doctor have the expertise to opine on those findings?

That is medically possible but I think you might need to consider getting an IMO from an ortho specialist that follows the IMO criteria here with a full medical rationale as to how this disabilty prevents you from any type of employment.

Did the VA consider any higher rating than the 60 in this decision? It might be the highest percent they could award at this point.

Then if there are secondary conditions you have claimed that are directly due to the knee injury, they would have to rate them as well and an IMO ortho doc could also support the secondary conditions.Do you have any documented nerve impingement?

DID VA give any other reason for denial of TDIU?

Did your job depend on sitting down for long periods and is this why you are on disablity from the employer?Because you could not sit longer than 15 minutes.

Does the VA have those employee records and any employer disability findings?

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  • HadIt.com Elder

You should probably file for chronic pain disorder as well. Have you ever seen a psychiatrist at the VA? If your knee is that bad that you can't sit for more than 15 minutes you must have pretty severe pain. What kind of pain meds do you take? Your medications affect your ability to work if you are doped out. Why did you lose your job? I would get a letter from my pain doctor to say that due to severity of pain and pain meds you can't concentrate enough to hold a job. As Berta says you may have other secondary disabilites due to that knee. Do you see a real orthopedists that could help you? If you want to win a TDIU claim you have to take it to them. Do you get SSD for your knee? How have you lived the last two years with no job? Your disability retirement should help your TDIU claim. Are you saying your former employer could find no accommodation for you? What you need to show the VA is that soley because of your SC conditions you cannot maintain employment.

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Welcome aboard 'cooter'.

What do you mean, you filed a "reconsider" letter 2 weeks ago??? With who?

Have you filed a notice of Disagreement (NOD) yet? You have one year after the denial letter to file a NOD...

( Instead of filing an NOD I was told by my VR at DAV to file a reconsider letter instead to the VA Regional Office claims Dept. DAV said I would get a faster reply. If it's denied again then I need to file an NOD. Does this proto sound resonable or shall I try another route?) !!!BROKEN ARROW!!!

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Did your doctor use the IMO format here in our IMO forum?

Do you have a copy of the actual C & P exam results and did your private doc have it?

Was that the sole reason they denied TDIU?

Do I understand this right-

you get comp at 60% now for the right knee. Does this condition affect your back, hips, or feet?

Did you tell VA on the TDIU form of any side affects of any meds you take that would hinder or prevent employment?

Did the pain management doctor have any X rays or MRI results to show that this disabilty has affected your ability to sit for long periods? Does this doctor have the expertise to opine on those findings?

That is medically possible but I think you might need to consider getting an IMO from an ortho specialist that follows the IMO criteria here with a full medical rationale as to how this disabilty prevents you from any type of employment.

Did the VA consider any higher rating than the 60 in this decision? It might be the highest percent they could award at this point.

Then if there are secondary conditions you have claimed that are directly due to the knee injury, they would have to rate them as well and an IMO ortho doc could also support the secondary conditions.Do you have any documented nerve impingement?

DID VA give any other reason for denial of TDIU?

Did your job depend on sitting down for long periods and is this why you are on disablity from the employer?Because you could not sit longer than 15 minutes.

Does the VA have those employee records and any employer disability findings?

1. No not yet but I will copy the IMO and have him fill it out. I havn't checked it out yet. I'll be seeing a new ortho and maybe he'll fill it out before the deadline.

2. No I didn't even think about that. I'll be going to the VA this week and get a copy of the C&P exam and show it to him.

3. The sole reason they denied it was and I quote; The evidence does not show that I am unable to ( i'll make it short) work. then it goes on saying they received VA

Form 21-4192 October 6, 2009, and I stated that I last worked June 27, 2008, and indicates retirement. ( they failed to mention Disibility Retirement). The VA

medical examiner stated that I cannot do prolonged standing and walking, but vocational rehabilitation should be considered for more sedentary-type work. The

examiner has provided the opinion that I am able to engage in substantially gainful employment. Therefore, denied.

4. Yes you are right, I am now receiving 60% for the right knee. NOW comes the kicker! You asked if this condition effects my back, hips, or feet. I guess I'll start this

off with the day in 1976 when I experienced a bad parachute fall and medivaced to the base hospital at Ft Benning, Ga. I can't remember anything about the trip

nor the stay at the hospital cause I was in so much pain. But I ended up wearing a full leg cask for the next 4 to 5 weeks. I ended up unexpectedly seperating from

the army 3 months later on a hardship discharge due to family problems. During my postservice years to now I've had back, legs, feet, and neck problems. My

last MRI in 2005 showed sever spinal cord stenosis in lowerback and neck. and some DDD problems, sciatic nerve problems in legs and feet. I also have

anxiety/panic attacks which started the month I seperated from the army. At my seperation exam I mentioned that I have swollen and painful joints, and possible

athoritis which he noted, but when I mention my episode of anxiety he noted on the psychiatric box abnormal but scratched it and put normal and said it was

more likely seperation anxiety but if I have anymore I should have it checked. Well I didn't ad now I'm paying for it. By the way, when I received copies of my SMR's

none of my hospital records where in it. I know most if not all of my injuries were caused by the parachute jump. But trying to tie it all in has been hard because

the VA say's there's no record of such in my SMR's.

5. VA sent me a new TDIU form to fill out and I will mention my meds and how they hinder me.

6. I am scheduled for another MRI coming up and hopefully it'll show something.

7. 60% is the highest I can go for the knee

8. No other reason was given for denial just what was mentioned in no.3

9. Not sure exactly what my former employer sent them except VA form 21-4192. I do know that my disibility retirement papers state that there was no other job

that they could place me in. I do know I have to go to the VA and review my c;files.

Thank you very much for the guidence you have presented me. I hope I answered your questions enough to touch bases. !!!BROKEN ARROW!!!

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"During my postservice years to now I've had back, legs, feet, and neck problems. My

last MRI in 2005 showed sever spinal cord stenosis in lowerback and neck. and some DDD problems, sciatic nerve problems in legs and feet"

A good IMO could potentially connect all of the dots here and would reveal how the initial disability has profoundly disabled you to the point of not being able to work.

Unless there is some other post service etiology, these could definitely be secondary conditions to the the inservice injury.They have to be formally claimed as secondary to the Original SC.Stress on any major joint can certainly affect other joints ,the back, neck,etc.

Hopefully they will read and address the reconsideration request but still you have to watch the NOD clock because a reconsideration request cannot replace a formal NOD.

You need to go over the evidence list carefully and the narrative, to see what they used, what they parsed or manipulated, and what they had bit ignored -send it in again as new evidence.

See if the actual C & P doc considered the 2005 MRI:

"last MRI in 2005 showed sever spinal cord stenosis in lowerback and neck. and some DDD problems, sciatic nerve problems in legs and feet. I also have

anxiety/panic"

Did you also request your 201 file from NARA along with the SMRs?

Did your copy of your SMrs come from the VA or from NARA?

When VA says something isnt in Military records or SMRs , I never believe them.I even have copies here of SMRs from vets I know that were "destroyed in the St Louis Fire" per the VA.

Also I have SMRs that helped some local vets get SC because No one , no vet rep, not the VA itself, actually read the SMRs carefully.

One vet had 2 lawyers, went to BVA twice and to CAVC twice and within minutes of seeing his BVA decision where one reference was made to something in his SMRs I knew he had a winner.

SMCs are not easy to decifer sometimes but need to be read carefully.By the vet and by the VA.

If there is any other possible etiology for these problems in the SMRs raise that issue to the VA too.

I hope the DAV supports the reconsideration request and they were right to suggest it.

Edited by Berta
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"During my postservice years to now I've had back, legs, feet, and neck problems. My

last MRI in 2005 showed sever spinal cord stenosis in lowerback and neck. and some DDD problems, sciatic nerve problems in legs and feet"

A good IMO could potentially connect all of the dots here and would reveal how the initial disability has profoundly disabled you to the point of not being able to work.

Unless there is some other post service etiology, these could definitely be secondary conditions to the the inservice injury.They have to be formally claimed as secondary to the Original SC.Stress on any major joint can certainly affect other joints ,the back, neck,etc.

Hopefully they will read and address the reconsideration request but still you have to watch the NOD clock because a reconsideration request cannot replace a formal NOD.

You need to go over the evidence list carefully and the narrative, to see what they used, what they parsed or manipulated, and what they had bit ignored -send it in again as new evidence.

See if the actual C & P doc considered the 2005 MRI:

"last MRI in 2005 showed sever spinal cord stenosis in lowerback and neck. and some DDD problems, sciatic nerve problems in legs and feet. I also have

anxiety/panic"

Did you also request your 201 file from NARA along with the SMRs?

Did your copy of your SMrs come from the VA or from NARA?

When VA says something isnt in Military records or SMRs , I never believe them.I even have copies here of SMRs from vets I know that were "destroyed in the St Louis Fire" per the VA.

Also I have SMRs that helped some local vets get SC because No one , no vet rep, not the VA itself, actually read the SMRs carefully.

One vet had 2 lawyers, went to BVA twice and to CAVC twice and within minutes of seeing his BVA decision where one reference was made to something in his SMRs I knew he had a winner.

SMCs are not easy to decifer sometimes but need to be read carefully.By the vet and by the VA.

If there is any other possible etiology for these problems in the SMRs raise that issue to the VA too.

I hope the DAV supports the reconsideration request and they were right to suggest it.

Good morning Berta. Ok I'm thinking what your saying is to send in the results of the MRI along with the current claim I have pending for TDIU, and file this as secondary to my knee, and file this as new evidence correct?

What is a 201 file? When I requested copies of my SMR's from NARA they sent me a letter stating my records had been lent to the VA. So I requested copies from

the VA and received them from my claim file.

There is one other factor in my SMR besides the parachute fall. I hurt my neck playing football while in service oversea's and went to the clinic and complained of

neck pain and popping of neck. They x-rayed and came out negitive. !!!BROKEN ARROW!!!

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You should probably file for chronic pain disorder as well. Have you ever seen a psychiatrist at the VA? If your knee is that bad that you can't sit for more than 15 minutes you must have pretty severe pain. What kind of pain meds do you take? Your medications affect your ability to work if you are doped out. Why did you lose your job? I would get a letter from my pain doctor to say that due to severity of pain and pain meds you can't concentrate enough to hold a job. As Berta says you may have other secondary disabilites due to that knee. Do you see a real orthopedists that could help you? If you want to win a TDIU claim you have to take it to them. Do you get SSD for your knee? How have you lived the last two years with no job? Your disability retirement should help your TDIU claim. Are you saying your former employer could find no accommodation for you? What you need to show the VA is that soley because of your SC conditions you cannot maintain employment.

Good morning John999! Sorry I couldn't reply to you earlier, I had an appointment with the doc yesteday and it takes a full day to get there and back since I live in a little city in the mountains I have to go to a bigger city to get better results,if you get my drift.

Your right I should file for chronic pain disorder and I will. My meds right now are Oxycodone 10-mgs, xanax for my anxiety/panic disorder, flexeril for muscle spasms.

and Lidocaine patches. He wanted to put me on Oxycotin but I refused. I have an anger problem as it is and don't want to add fuel to the fire. My wife is on it and I havn't

been out of the doghouse since,lol.

No I havn't seen a psychiatrist yet. Is it better to see one at the VA verses a civ one? My head is on cloud nine when on my meds, which is all the time, and blurred

vision.

When I was working my occupation was an electrical lineman. I had arthoscopy on my right knee in 2007, took a year off work due to complications of knee and was

forced to retire on disibility since I could't climb and perform my duties as a lineman. I had to perform a 4 year apprentice program just to get this job. which is the only

qualifications I have (as to occuptional purpaces).

I havn't filed for SSD yet, as I'm still waiting for more evidense. Shouldn't be long now.

My former employer could not accomodate me with another job as I was not trained for other placements. Whic they noted on my disibility papers.

How can my disibility retirement help me? What true value does this have with the VA? The wife and I are surviving on her SSD and my retirement, which has caused a fianancial hardship due to the earnings we were bringing home. !!!BROKEN ARROW!!!

hav

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