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Confused About C & P Of Right Knee And Other Questions


kkp

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Two questions:

1) Had C & P exam on SC right knee. Got a copy of it today. There was significant damage to the right knee including -30 degrees range of motion on extension which I think is significant. I only requested an exam on my right knee but the VA form that the examiner filled out has a question about other knee abnormality: mild collateral lig-laxity, also a ROM of -30 degrees. I am wondering if this is will automatically be considered bi-lateral or if I will have to file another claim for the left knee?

2) The RO returned the report to the examiner for corrections. Can anyone interpret this opinion for me? Is it service-connected or not? :(

Medical Opinion Summary:

Restatement of Requested Opinion: Whether or not the currently diagnosed degenerative joint disease is at least as likely as not related to right knee injury in service.

Medical Opinion: This veteran's is less likely as not (less than 50/50 probability) caused by or a result of right knee injury.

Other Medical Opinion or Comments: Whether or not, the currently diagnosed degenerative joint disease is at least as likely as not related to right knee injury in service.

I have been on SSDI since 1985 due to a back injury.

P.S. I am 50% PTSD, and on appeal for 70% to 100%.

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  • HadIt.com Elder

Not service connected is what they are saying I think. Less likely than not means not.

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  • HadIt.com Elder

Typical VA BS, start preparing for your NOD now ........If you can, go get a IMO to counter the C&P.

It is well known in the Ortho comunity that one bad knee will ultamitly lead to 2 bad knees , and then the hips start to give. Since you have a SC for your back, that itself could be a contributing factor.

Push this to the end and you will prevail, but you must be ready to counter the VA.

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  • HadIt.com Elder

KKP,

The reason why the VA returned to the C&P exam to the examiner is due to the fact the doctor examined and made comments about your left knee, which was not a claimed condition. The VA wants to know if the reason why the doctor examined the left knee was because he/she thought it was related to your right knee. That's why the VA is asking whether or not it is "at least as likely as not." It looks like the VA is trying to do you a favor and establish service-connection for your left knee also!

John,

"at least as likely as not" means equal to greater than 50%. Therefore, allowing the VA to envoke reasonable doubt in the veterans favor.

JR,

This isn't "typical VA BS!" It may be well known throught out the medical community that one bad knee can cause a change in the patient's gait, therefore, causing injury to the other. The RVSR's even know this, but the VA needs to hear from a medical professional that YOUR right knee has caused YOUR left knee to be damaged. This is a medical determination and only a medical professional can state this. A RVSR is not allowed, by law, to make medical detreminations. I hear alot of veterans will submit genreal articles as evidence that state such a conditions causes other conditions. The RVSR's know all of this already, but they need to hear from a doctor that YOUR condition has caused YOUR OTHER condition. Generic artcles just clutter up the c-file and don't do the veteran any good. By law, the VA cannot grant service connection in theses case unless a doctors opines to what I have stated above.

Vike 17

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"Other Medical Opinion or Comments: Whether or not, the currently diagnosed degenerative joint disease is at least as likely as not related to right knee injury in service. "

Is this right knee injury in service fully documented?

I could not determine this from your message to me-

Do you have a claim in specifically for a rating on the right knee?

What was their decision on that?

WHat I see here is that they are stating there was in injury in service which might be just a repeat of what you claimed.

Has this right knee disability been completely recognized and established by the VA yet?

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  • HadIt.com Elder

Vike

I think the VA said the condition was "less likely than not" which means less than 50/50. That would indicate they are rejecting service connection. "As likely as not" means more than 50/50 chance of being SC. This is what I read from the vet's post.

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While they are saying that it is less likely than not, you may still have a chance at a bilateral rating depending on the cause and condition of the other knee. If you have been guarding the right knee putting more weight on the left because of pain from the right knee) it would cause undo strain on the left and cause it to wear prematurely. If you cannot find anything in your service medical record or other treatment records from other source(s) that are within 12 months of you getting out you'll have a hard time getting it service connected.

In this case, you may wish to send the va a Notice of Disagreement. Claim that this is a bilateral condition, as the left knee condition is a "secondary cause condition due to a service connected injury".

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  • HadIt.com Elder

Vike,

I agree with John.

That is exactly how I read the post, and further it seems the C&P examiner opened pandoras box by refering to the other knee, I mention no use of any articles from anywhere, and only refered the Vet for a IMO to counter the C&P, this would not come from any article, it would come from a Orto doctor as you suggest.

BTW... It realy is typical VA BS, what is being done here by the RO is they are trying to cover for what seems to be a mistake by the C&P doc as he mentioned the other knee in conection with the claimed one, which opened up a whole new can of worms for this Vet as it is now a new claim secondary to the SC condition or proposed condition.

Edited by JR Reihs
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  • HadIt.com Elder

John,

Under "Restatement of Requested Opinion," It states Whether or not the currently diagnosed degenerative joint disease is at least as likely as not related to right knee injury in service.

Then it states under "Medical Opinion," This veteran's is less likely as not (less than 50/50 probability) caused by or a result of right knee injury.

Lastly, it states under "Other Medical Opinion or Comments" Whether or not, the currently diagnosed degenerative joint disease is at least as likely as not related to right knee injury in service

This means the VA wants to know if the C&P examiner, in his medical opinion, thinks his right knee has caused his left knee condition or not.

JR,

It wasn't a mistake for the C&P examiner to reference the right knee during the exam. And since he did, the VA simply wants to know whether the right knee condition was caused by the left knee, so they can grant secondary service-connection even though the veteran never claimed it. I don't think that is any VA BS! I looks like the VA is trying to do the veteran a favor by trying to see if they can grant a secondary condition.

The reference to the article was not directed at you, just an observation in general after seeing many veterans submit stuff like that and then get denied. Then after the veteran obtaines an actual IMO as previously stated in my other posts, the claim was granted rather quickly!

Vike 17

Edited by Vike17
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Two questions:

1) Had C & P exam on SC right knee. Got a copy of it today. There was significant damage to the right knee including -30 degrees range of motion on extension which I think is significant. I only requested an exam on my right knee but the VA form that the examiner filled out has a question about other knee abnormality: mild collateral lig-laxity, also a ROM of -30 degrees. I am wondering if this is will automatically be considered bi-lateral or if I will have to file another claim for the left knee?

2) The RO returned the report to the examiner for corrections. Can anyone interpret this opinion for me? Is it service-connected or not? :(

Medical Opinion Summary:

Restatement of Requested Opinion: Whether or not the currently diagnosed degenerative joint disease is at least as likely as not related to right knee injury in service.

Medical Opinion: This veteran's is less likely as not (less than 50/50 probability) caused by or a result of right knee injury.

Other Medical Opinion or Comments: Whether or not, the currently diagnosed degenerative joint disease is at least as likely as not related to right knee injury in service.

I have been on SSDI since 1985 due to a back injury.

P.S. I am 50% PTSD, and on appeal for 70% to 100%.

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  • HadIt.com Elder

JR

I think they call it a Red Herring or a Straw Man. The VA ceates a false issue and then rejects a claim based on something the vet is not even claiming.

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"Other Medical Opinion or Comments: Whether or not, the currently diagnosed degenerative joint disease is at least as likely as not related to right knee injury in service. "

Is this right knee injury in service fully documented?

I could not determine this from your message to me-

Do you have a claim in specifically for a rating on the right knee?

What was their decision on that?

WHat I see here is that they are stating there was in injury in service which might be just a repeat of what you claimed.

Has this right knee disability been completely recognized and established by the VA yet?

Yes the right knee injury is fully documented.

I filed a claim in 7/7/05. I had a c&p exam on 6/7/06. On the 14th of June I went to records to get a copy of the report. The clerk told me to go to compensation and pension. I did and the lady called the examiner and asked where the report was. He said he sent his report to the ro,and they sent back to him for clarification and he had mailed it back to the ro that day. The va finally sent me a copy of the c&p on 7/11/06. I am quite sure the va has recongnized the right knee as sc.

This is a great forum and I want to thank everyone who has taken the time to respond. The post by you vike, john, jr and all the others has been very helpful, after reading the posts I reread the report and agree it's the left knee they wanted (other medical opinion on)

I also have an appeal on my (ptsd&major depression) I am currently rated 50%. My vfw rep. asked for an increase of 70% to 100%(dont ask me why)but that's the way he worded it. I had enough evidence for 70% on my first claim but he only asked for 50%. I had a gaf of 40 to start with but still sent much more evidence.

For all it's worth I talked to a lady from the ro 7/2/06.She was very nice.She said every thing they had requested was including my ssdi records, She also said a decision would probably be made in the next 30 days.????

I am drawing SSDI for a back injury that is not SC.

I would enjoy any input you guys have to offer. thanks.

kkp

P.S. Do you guys think there is a chance for P & T on my claim?

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  • HadIt.com Elder

John,

I agree, years ago when I got out of the Navy i was sent to the VA to let them fit my knee for a brace, I knew I was in trouble when the Doc marked on my knees L&R and he got them backwards.

AS far as KKP issue goes, I will stand by what I posted, as his issue became both knees when mentioned in the C&P report, mistake or not, and should be persued as a secondary issue due to his SC condition of the right knee, so a IMO is in order to counter the "less likley than not" opinion of the C&P examiner.

Vike,

After fighting with the VA for over 7 years, with the same exact information in my C-file, and finding out it was the RO that had my claim and sat on it for these years only to find out the rating official did not like my VSO, I was told to move my claim , which I did, and it was approved in 9 months, T&P, game over.

So when i say it is typical VA BS, to me it is, and to so many others who have had to deal with misguided VA BS when we shouldn't have had to, I do get a lil PO'ed, I just have never seen a RO go out of there way to help a Vet without being forced to when it comes adjudication time,and I do not think KKP will find the VA on his side as to the secondary condition.

BTW, I bet the C&P examiner gets his collective Butt ripped for this.

Edited by JR Reihs
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  • HadIt.com Elder

JR,

KKP's issues haven't turned into both knees. Even if the C&P doctor stated it was "less likely than not" that his right knee caused the left knee condition, it would not have an effect on the determination of service-connection for the right knee. Also, if the C&P examiner did state "less likely than not" KKP could/should, as we have both stated, get an IMO opining otherwise. This would sway the Benefit of the Doubt in favor of the veteran for the RO to grant secondary service-connection of his left knee. Actually, when you take a look at this situation, yes, the VA opened "pandora's box," but in favor of the veteran, as KKP never claimed the right knee as a secondary condition.

Now, if the RO wanted to know the exact opposite (left knee condition causing the right knee condition), and there wasn't any medical documentaion in the veteran's SMR's about the right knee, then, yes, KKP could have a problem. However, as the veteran stated, there is "full" documentaion of the right knee in service, which would then make any issue of the left knee causing any condition to the right a moot piont.

I can understand your frustration towards the VA. Hell, if I had a claim that went on for 7 years, I would be a little irretated too. But the vast majority of claims with VA are handled correctly. As I have said in previous post, 'does the VA make mistakes?' Yes, they do, just like any other large agency does (take a look at Social Security). Is there that occasional RVSR that thinks he/she is personnaly writing the comensation checks, and is a really a$$? Yes, there is. But I think this is the exception, not the norm. I have helps numerous veterans with their claims and have actually had the VA screw up one time. Also, the veterans I have helped were not with just one RO. I think I have delt with 6-7 different Regional Offices, and I have had all of them grant claims that weren't actually claimed by the veteran i.e secondary conditions or condition noted in the veterans SMR's that they never claimed ect... The VA isn't so advesarial as one thinks.

Vike 17

Edited by Vike17
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I disagree-

A May 2005 Inspector General survey of VARO raters and DROs revealed that

"65 percent of raters and Decision Review Officers surveyed by the IG,in conjunction with its May 2005 report,admitted that they did not have enough time to provide timely and quality decisions. In fact ,57 percent indicated that they had difficult meeting production standards if they took time to adequately develop claims and thoroughly review the evidence before making the decision."

But I too have worked on many claims that have succeed at VARO levels.

I recently wrote to the Buffalo RO director asking for someone within the 39 % of VARO employees ,based on the IG survey, who actually can do their job there, to begin to address my evidence.

Has the right knee disability been established as service connection?

WHat I mean is not what the C & P double talk says but has the veteran here been awarded SC for the right knee?

This is the key to getting the DJD and left knee secondarily service connected if the medical evidence supports that.

While it appears that the C & P is recognising the right knee as SC-

and this should generate an award- the examiner has set the stage for the left knee- regardless of negative statements, as this is what a good IMO can combat.

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