lumbosacral Question About Rating For Back,knees,feet

[Mont36]

Good day to you all. I was rated 40% for back condition( chronic lumbosacral strain), 10% for left and right knee patellofemoral syndrome all due to flat feet. 50% for bilateral feet pes planus with plantar fasciitis which was increased from 20%. My question is I have a future exam for feet and back but not knees, so how can someone's feet and back get better when you walk on your feet everyday and put pressure on knees and back due to flat feet. They totally skipped the knees as far as future exam. Any ideas or insight on how this is possible since on my exam, they said condition not improved by shoes and all the criteria for 50% and this is maxed out as far as rating for feet. Any way please give me some insights on this. Thank you.

[Berta]

Does this condition make you unable to work?

90% isnt far from TDIU, if your service connected conditions prevent substabntial gainful employment.

"My question is I have a future exam for feet and back but not knees, so how can someone's feet and back get better when you walk on your feet everyday and put pressure on knees and back due to flat feet."

Sure beats me......I think the VA overlooked the knee copndition to possibly save some cash.....

This past thread here might help you:


Knee conditions can get worse in time and maybe you should request an increase in the 10% for left and right knee patellofemoral syndrome, if by now, there is arthritic or osteoporosis involvement.

This BVA decision is for a higher rating of the veteran's patellofemoral syndrome:


:"The standardized range of motion for the knee is flexion to
140 degrees and extension to zero degrees. 38 C.F.R. § 4.71,
Plate II. A noncompensable (0 percent) rating is warranted
under DC 5260 when flexion of the leg is limited to 60
degrees. A 10 percent rating is warranted when flexion is
limited to 45 degrees, and a 20 percent rating is warranted
when flexion is limited to 30 degrees. 38 C.F.R.
§ 4.71a, DC 5260. A noncompensable rating under DC 5261 is
warranted when there is limitation of extension of the leg to
5 degrees. A 10 percent rating is warranted when extension
is limited to 10 degrees, and a 20 percent rating is
warranted when extension is limited to 15 degrees. 38 C.F.R.
§ 4.71a, DC 5261. "

http://www.va.gov/vetapp08/files1/0807704.txt

This veteran did not succeed in getting a compensable rating but BVA denials are as good as awards sometyimes to understand the VA's way of application of the rating percentages.

Also you might want to read VA OGC Pres Op 23-97 as to multiple ratings for knee disabilities:

http://www.va.gov/ogc/opinions/1997precedentopinions.asp

The BVA had to remand this case so that a proper C & P exam in compliance with the OGC Pres Op could be done:

"The veteran's representative has suggested in a written
correspondence, dated September 2002, that the veteran's knee
disabilities be additionally evaluated under Diagnostic Code
5257 due to instability. In further adjudicating the
veteran's claim, the RO should take into consideration 38
C.F.R. §§ 4.14, 4.40, 4.45, 4.59, and the holdings in DeLuca
v. Brown, 8 Vet. App. 202, 204-7 (1995) and VAOPGCPREC 23-97
(hereinafter G.C. Prec. Op. 23-97) and VAOPGCPREC 9-98
(hereinafter G.C. Prec. Op. 9-98). In G.C. Prec. Op. 23-97,
General Counsel stated that when a knee disorder is rated
under Diagnostic Code 5257 and a veteran also has limitation
of knee motion which at least meets the criteria for a zero
percent evaluation under Diagnostic Code 5260 or 5261,
separate evaluations may be assigned. In G.C. Prec. Op. 9-
98, General Counsel stated if a veteran has a disability
rating under Diagnostic Code 5257 for instability of the
knee, and there is also X-ray evidence of arthritis, a
separate rating for arthritis could also be based on painful
motion under 38 C.F.R. § 4.59. "

http://www.va.gov/vetapp04/files/0404109.txt

I am surprised the VA didnt set up a C & P for your knee condition.

If I were you I would go to the VA Schedule of Ratings here under knee conditions and see if your medical evidence warrants higher ratings for the knees by now.

And I mentioned possible TDIU potential too.

[john999]

Get an IME doctor to write you a report in which he connects all the dots to the feet, knees and back. The way to fight the VA's inadequate medical exams is to get your own medical evidence. If you depend on the VA for a fair exam they can screw you over for the next 30 years. You need to get your own evidence to fight their evidence.

[Mont36]

Here is the rating for the knees:

Service connection for right knee patellofemoral syndrome has been established as related to the service-connected disability of bilateral pes planus with plantar fasciitis.

An evaluation of 10 percent is assigned from January 6, 2014, the date of receipt of your successfully reopened claim.

We have assigned a 10 percent evaluation for your bilateral knee condition (claimed as tendonitis of the knees) based on:

• Painful motion of the knee (38 CFR §4.59 allows consideration of functional loss due to painful motion to be rated to at least the minimum compensable rating for a particular joint. Since you demonstrate painful motion of the knee, the minimum compensable evaluation of 10 percent is assigned)

The provisions of 38 CFR §§4.40 and 4.45 concerning functional loss due to pain, fatigue, weakness, or lack of endurance, incoordination, and flare-ups, as cited in DeLuca v. Brown and Mitchell v. Shinseki, have been considered and applied under 38 CFR §4.59.

A higher evaluation of 20 percent is not warranted unless the evidence show limitation 16-30 degrees.

What gets me is that I have never been rated for the knees but put in for them back in 2003 and tried to tell them it was due to service but they denied it. Of course I didn't continue it until this year which I went a different route of connecting to my feet. It is a shame that my back and feet have futures exam but I walk on my feet everyday along with knees and back they are always in pain every single day. I have knee braces,back brace and orthotic insoles and shoes which don't give me no relief which I have expressed to the doctor over and over. I need to find a way to get these issues permanent which I feel I can but am lost on how to do this. Any suggestions?