The Experience: Just had my first C&P on Monday and was able to read the report yesterday. The doctor was polite and seemed genuinely compassionate, but the exam felt hurried. In fact, I was called on my mobile phone fifteen minutes after the exam, by the doctor himself, to come back because he forgot to perform an important part of it. I'm grateful he called me back in rather than scheduling or just using his imagination to conjure something up. There are many errors and oversights, though some are in my favor, most are unfavorable. The report is more inaccurate than it is accurate. Although I was prepared for this by HadIt (Thank You!) and my other research, it's nonetheless frustrating. I have already prepared my rebuttal to perceived mistakes so my account of the exam is freshly documented. I am also considering a call to the Patient Advocate office per the advice of my VSO--but, I'm on the fence about it. I just can't help but ask myself, jokingly, if I am completely delusional, because it certainly would be the case if I believed what's on the report actually took place.
Medical History & The DBQ: I have substantial pain in both of my knees, it's why I was discharged. Historical and continuous chondromalacia/patellafemoral and IT band syndrome diagnoses. During range of motion testing, the doctor was able to lift both legs to full extension. It was obviously painful and he apologized for causing the pain. In active range of motion, there's no question that I lacked full extension and suffered even greater pain. However, his report contrarily indicates full range in every motion and "no pain" on each measurement. (Side note: He actually used a goniometer, unlike many of the stories I've read here). He also indicated no scars, which is false. How could he know if my legs were clothed the entire exam?
Question: My question is regarding the knee range of motion testing. Never mind that he wrongly indicated no pain despite having apologized for such, I'm looking for clarification on painful vs actual range of motion for both passive and active. Is painful ROM to be considered in the actual measurement, in degrees, of passive range of motion? What about active range of motion? I ask because I read in another post here, if I understood it correctly, that for DC 5260 and DC 5261 (knee range of motion), the Mitchell criteria is that painful ROM is disregarded in measurement. This conflicts with everything I had read previously, and also with my own sensibilities, but nevertheless could be true. Just looking for clarification.
Thank you to everyone here in the HadIt community. Your posts have guided me to a great deal of information and greater understanding of the VA claims process.
* EDIT: I found a few unofficial documents that seem to state any reduction in ROM due to pain should be described by the examiner, if feasible. However, if pain in motion exists where ROM is not deemed as limited, then 10% is justified. Does that sound accurate? If so, does anyone know if the below indications from the doctor tie into the rating based on pain (10%), rather than ROM? I'm of course still confused how in one part the examiner can say there's no pain but in the other say that there is.
c. If the Veteran has functional loss, functional impairment or additional
limitation of ROM of the knee and lower leg after repetitive use,
indicate
the contributing factors of disability below (check all that apply and
indicate side affected):
[X] Pain on movement [ ] Right [ ] Left [X] Both
[X] Disturbance of locomotion [ ] Right [ ] Left [X] Both
Question
K_C
The Experience: Just had my first C&P on Monday and was able to read the report yesterday. The doctor was polite and seemed genuinely compassionate, but the exam felt hurried. In fact, I was called on my mobile phone fifteen minutes after the exam, by the doctor himself, to come back because he forgot to perform an important part of it. I'm grateful he called me back in rather than scheduling or just using his imagination to conjure something up. There are many errors and oversights, though some are in my favor, most are unfavorable. The report is more inaccurate than it is accurate. Although I was prepared for this by HadIt (Thank You!) and my other research, it's nonetheless frustrating. I have already prepared my rebuttal to perceived mistakes so my account of the exam is freshly documented. I am also considering a call to the Patient Advocate office per the advice of my VSO--but, I'm on the fence about it. I just can't help but ask myself, jokingly, if I am completely delusional, because it certainly would be the case if I believed what's on the report actually took place.
Medical History & The DBQ: I have substantial pain in both of my knees, it's why I was discharged. Historical and continuous chondromalacia/patellafemoral and IT band syndrome diagnoses. During range of motion testing, the doctor was able to lift both legs to full extension. It was obviously painful and he apologized for causing the pain. In active range of motion, there's no question that I lacked full extension and suffered even greater pain. However, his report contrarily indicates full range in every motion and "no pain" on each measurement. (Side note: He actually used a goniometer, unlike many of the stories I've read here). He also indicated no scars, which is false. How could he know if my legs were clothed the entire exam?
Question: My question is regarding the knee range of motion testing. Never mind that he wrongly indicated no pain despite having apologized for such, I'm looking for clarification on painful vs actual range of motion for both passive and active. Is painful ROM to be considered in the actual measurement, in degrees, of passive range of motion? What about active range of motion? I ask because I read in another post here, if I understood it correctly, that for DC 5260 and DC 5261 (knee range of motion), the Mitchell criteria is that painful ROM is disregarded in measurement. This conflicts with everything I had read previously, and also with my own sensibilities, but nevertheless could be true. Just looking for clarification.
Thank you to everyone here in the HadIt community. Your posts have guided me to a great deal of information and greater understanding of the VA claims process.
* EDIT: I found a few unofficial documents that seem to state any reduction in ROM due to pain should be described by the examiner, if feasible. However, if pain in motion exists where ROM is not deemed as limited, then 10% is justified. Does that sound accurate? If so, does anyone know if the below indications from the doctor tie into the rating based on pain (10%), rather than ROM? I'm of course still confused how in one part the examiner can say there's no pain but in the other say that there is.
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