hypertension Smc Overload

[USNDW]

I have been reading posts, asking questions, reading USC codes and Title 38 and I am more confused now than I ever was.

For SMC. If I have a rating that is 60%, Service connected right knee with chronic resiudals following TKR. Can that rating be established as could or would be able to grant me TDIU??

If it was established that that single service connected condition at 60% could grant me IU, then would I be able to combine my other ratings to meet the 60% criteria for SMC S???

I have seen a lot of posts that state the rating for IU must be 70% to be considered total for the purpose of SMC S, is that true?

Are Bi-lateral conditions considered when computing the rating % necessary to qualify for IU and then SMC S?

I have the following ratings

60% Right knee, failed knee replacement x2 (and just recently diagnosed with Complex Regional Pain syndrome in that knee as well. Can that 60% be increased due to CRPS)

10% Left knee

30% Adjustment disorder

30% sleep apnea

30% cervical

20% lumbar

10% For bothe right & left lower limbs, radiculopathy

10% left shoulder radiculopathy

10% Bi-lateral Plantar Fasciitis

10% Left hand arthritis

10% Tinnitus

10% Hypertension

and a bunch of service connected 0%

My inital rating provided me TDIU and a 90% schedular. I filed a NOD and was granted the 60% for the right knee vice the 30% the rater initially awarded. Added the hypertension and left shoulder since then as well. Currently have a NOD for

seronegative RA, increase for left knee following a menisectomy & prescribed full length leg brace. Active claim for automobile allowance.

[Berta]

Is the 10% left knee secondary to or a bilateral percent solely due to the SC right knee?

"Currently have a NOD for

seronegative RA, increase for left knee following a menisectomy & prescribed full length leg brace"

and "10% Bi-lateral Plantar Fasciitis" which sure must be aggravating the other stuff.

Have you compared the medical evidence that they used for the 60% to the Schedule of Ratings?

Have that specific disability gotten worse since they awarded?

Have you claimed it (the 60% disability) has been aggravated by the left leg disability -which sure has gotten worse- and warrants a higher rating that way?

"I filed a NOD and was granted the 60% for the right knee vice the 30% the rater initially awarded"

Did you formally appeal the 60%?

"I have seen a lot of posts that state the rating for IU must be 70% to be considered total for the purpose of SMC S, is that true?"

Can you refer me to one of those posts?

[Berta]

forgot to ask:

"My inital rating provided me TDIU and a 90% schedular."

How did VA consider and deny SMC at that time? what was the date of that decision?

[Berta]

sorry-I should have focused on your first question first-

60% Right knee, failed knee replacement x2 (and just recently diagnosed with Complex Regional Pain syndrome in that knee as well. Can that 60% be increased due to CRPS)

Yes.

The BVA would not have remanded this claim if CRPS was not a ratable disability:

http://www.va.gov/vetapp10/files4/1034802.txt

Did the diagnoser of the CRPS document in your med recs that the CRPS was a direct result of the SC knee?

Can you tell me the diagnostic codes they used for each of your ratings pertaining to both knees?

[WAC-Vet75]

If, you receive TDIU for one service connected disability rated at 60% or more, and have additional disabilities rated at 60% or more, separate and distinct from the disability that afforded you the TDIU, AND involves different anatomical segments or bodily system(s), then you would be eligible for SMC s. You would have to have medical evidence that you can not obtain, or maintain employment due to your knee condition, and apply for TDIU for it. I would venture to say that the VA would then schedule a C&P. I did not have to have a C&P for my TDIU, as my medical evidence, provided by VA Physicians, my employment record, and my statement was sufficient to establish TDIU.

[USNDW]

Well, the Fast letter says a single condition that was the reason for IU, OR could be considered for IU. My right knee condition is the main reason I was medically retired, and I was approved for SSDI, while on active duty, and the date SSDI found I could no longer work was January of 2007, prior to the left knee being injured, and the daignosis of the multiple orthopedic conditions, inflammatroy arthritis, sleep apnea, hypertension, and adjustment disorder. So I would have to think the right knee at 60% which is the maximum rating even with amputation was, or is able to be a single disability rated at 60% that would keep me from seeking gainful employment.

The Fast Letter does not specifically state that a condition that would qualify the Veteran for SMC S has to have been determined to cause the Veteran IU, or that IU has been awarded for that single SC condition. That is why I am confused. If the qualification now states that the condition "could be" the sole reason for IU, then the VA can grant SMC S.

The CRPS was just diagnosed, and it was consistent with the right knee surgeries and treatment causing the CRPS. The doctor didn't comment on CRPS in any other joint than the right knee. But I don't know if the VA can rate 60% due to chronic residuals of knee replacement, 5055, and rate the right knee with CRPS, or Neuralgia. If 60% is the maximum rating for a leg, can they rate another condition that is present??