Goniometer Required For Rom C&p Exam?

[SSGmajik]

I forgot to ask in a different post, but is a goniometer required for a ROM C&P exam? If so, does anyone know where to find the VA regulation on it?

[USMC5811]

38 C.F.R.4.46 -

§ 4.46 Accurate measurement.

Accurate measurement of the length of stumps, excursion of joints, dimensions and location of scars with respect to landmarks, should be insisted on. The use of a goniometer in the measurement of limitation of motion is indispensable in examinations conducted within the Department of Veterans Affairs. Muscle atrophy must also be accurately measured and reported.

On DBQ's (VA FORM 21-0960M-14) it states the following for Measuring Range of Motions:

NOTE: Measure ROM with a goniometer, rounding each measurement to the nearest 5 degrees. During the measurements, document the point at which painful motion begins, evidenced by visible behavior such as facial expression, wincing, etc. Report initial measurements below.

Following the initial assessment of ROM, perform repetitive use testing. For VA purposes, repetitive use testing must be included in all joint exams. The VA has determined that 3 repetitions of ROM (at a minimum) can serve as a representative test of the effect of repetitive use. After the initial measurement, reassess ROM after 3 repetitions. Report post-test measurements in Section 5.

C&P Service Clinicians Guide.htm

17. Musculoskeletal

:

a. For all joint or muscle disorders, state each muscle and joint affected.

b. Separately examine and describe in detail each affected joint.

Measure active and passive range of motion in degrees using a goniometer.

In addition, provide an assessment of the effect on range of motion and joint function of pain, weakness, fatigue, or incoordination following repetitive use or during flare-ups. (See the appropriate musculoskeletal worksheet for more detail.) NOTE: The diagnosis of

degenerative or traumatic arthritis of any joint requires X-ray confirmation

, but once confirmed by X-ray, either in service or after service, no further X-rays of that joint are required for disability evaluation purposes.

Edited July 27, 2012 by USMC5811

[manning01]

I know it's in the new DBQ's stating:

MEASURE ROM WITH A GONIOMETER, ROUNDING EACH MEASUREMENT TO THE NEAREST 5 DEGREES. DURING THE MEASUREMENTS, OBSERVE THE POINT AT WHICH PAINFUL MOTION BEGINS, EVIDENCED BY VISIBLE BEHAVIOR SUCH AS FACIAL EXPRESSION, WINCING, ETC. REPORT INITIAL MEASUREMENTS BELOW.

This is copied right out of the lower back DBQ they use. The Phoenix VARO noticed when they were finally deciding my claim from 2010 that the C&P PA that did my exam in Wilkes-Barre PA did not use a Goniometer. So last month they had come back in to redo the exam due to it being done incorrectly citing they did not use that device. So if they didn't use it they didn't follow the DBQ and your exam should not be valid. Pull the DBQ for the condition your claiming I bet that statement is there. Sorry don't know the regualtion but I bet the experts on here will know. Just my 2 cents worth.

[SSGmajik]

I know it's in the new DBQ's stating:

MEASURE ROM WITH A GONIOMETER, ROUNDING EACH MEASUREMENT TO THE NEAREST 5 DEGREES. DURING THE MEASUREMENTS, OBSERVE THE POINT AT WHICH PAINFUL MOTION BEGINS, EVIDENCED BY VISIBLE BEHAVIOR SUCH AS FACIAL EXPRESSION, WINCING, ETC. REPORT INITIAL MEASUREMENTS BELOW.

This is copied right out of the lower back DBQ they use. The Phoenix VARO noticed when they were finally deciding my claim from 2010 that the C&P PA that did my exam in Wilkes-Barre PA did not use a Goniometer. So last month they had come back in to redo the exam due to it being done incorrectly citing they did not use that device. So if they didn't use it they didn't follow the DBQ and your exam should not be valid. Pull the DBQ for the condition your claiming I bet that statement is there. Sorry don't know the regualtion but I bet the experts on here will know. Just my 2 cents worth.

Thank you for the info! I'll look the DBQ up and use that for reference on my NOD letter. I'm just trying to use as many facts in my NOD letter to have my C&P from 11/2010 thrown out. C&P examiner did not do the required "repetitive-use testing" or goniometer. He honestly didn't even do a ROM exam, but since he stated he did, it's my word versus his, so I'm using 2 other ROM tests that were done in 03/2010 & just last week and it obviously shows that his measurements were incorrect. Thanks again for the info!

[SSGmajik]

38 C.F.R.4.46 -

§ 4.46 Accurate measurement.

Accurate measurement of the length of stumps, excursion of joints, dimensions and location of scars with respect to landmarks, should be insisted on. The use of a goniometer in the measurement of limitation of motion is indispensable in examinations conducted within the Department of Veterans Affairs. Muscle atrophy must also be accurately measured and reported.

On DBQ's (VA FORM 21-0960M-14) it states the following for Measuring Range of Motions:

NOTE: Measure ROM with a goniometer, rounding each measurement to the nearest 5 degrees. During the measurements, document the point at which painful motion begins, evidenced by visible behavior such as facial expression, wincing, etc. Report initial measurements below.

Following the initial assessment of ROM, perform repetitive use testing. For VA purposes, repetitive use testing must be included in all joint exams. The VA has determined that 3 repetitions of ROM (at a minimum) can serve as a representative test of the effect of repetitive use. After the initial measurement, reassess ROM after 3 repetitions. Report post-test measurements in Section 5.

C&P Service Clinicians Guide.htm

17. Musculoskeletal

:

a. For all joint or muscle disorders, state each muscle and joint affected.

b. Separately examine and describe in detail each affected joint.

Measure active and passive range of motion in degrees using a goniometer.

In addition, provide an assessment of the effect on range of motion and joint function of pain, weakness, fatigue, or incoordination following repetitive use or during flare-ups. (See the appropriate musculoskeletal worksheet for more detail.) NOTE: The diagnosis of

degenerative or traumatic arthritis of any joint requires X-ray confirmation

, but once confirmed by X-ray, either in service or after service, no further X-rays of that joint are required for disability evaluation purposes.

This is awesome! Thank you USMC5811, it's much appreciated!

[Carl the Engineer]

My last exam for ROM, the examiner used one and did three measurements each time. I do not have a copy of the exam yet, so I am not sure how it will be anotated. I believed the examiner (different person) used one at the first C & P, however, she only measured once each joint, etc.

Hamslice

[SSGmajik]

My last exam for ROM, the examiner used one and did three measurements each time. I do not have a copy of the exam yet, so I am not sure how it will be anotated. I believed the examiner (different person) used one at the first C & P, however, she only measured once each joint, etc.

Hamslice

I don't know if you know or not, but you can go to your VAMC and go to release of information/records and get a copy of your C&P exam, if it was done there.