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Appeal Or Request For Increase Avn Hips


Elperro
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Hello,

I have been diagnosed with avascular necrosis of my right and left Hip. I completed a claim indicating that the avascular necrosis of my hips was secondary due to chondromalacia of my right and left knee with instability (40%). Went to the C&P exam, was examined and had x-rays taken. I recently received my award letter and won an award for chronic ligamentous capsulitis bursitis, avascualr necrosis of my left femoral head (10%). However, I feel I have been misdiagnosed by the C&P medical examiner due to the fact that I did not receive an award for avascular necrosis of my right hip. The award that was won regarding my right hip is chronic ligamentous capsulitis bursitis degenerative cyst (10%). Since then I have had two surgeries and have a prosthesis on my right and left femoral head.

My question is what do I do? Request an increase or appeal the decision of the award that I received. Any input would be greatly appreciated.

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Welcome to hadit!

You said that since then you have had two surgeries. So I am assuming the decision was not recent. Can I ask how long ago the decision was made? Also, do you have a copy of the C&P report?

If I am getting this correct, they granted both the right and left hip, (both with chronic ligamentous capsulitis bursitis) but with a degenerative cyst with the right hip and avascular necrosis of the left hip?

Would the rating be much different?

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Elperro: If this is recent award without a large Retro due, file new claim for increase. You still have the 12 month NOD window and you could always file the NOD at any time up to 364 days from the date of your original awards letter. If your recent surgery would be considered New & Material evidence in support of both your original claim and a new claim for increase, you might win either way. Can't hurt and if you file a "solid" FDC claim you could have an award in as little as 5 or so months, that was my 2014 FDC experience. The NOD appeal route could take 21/2+ years just to get to a DRO Hearing.

Happy Thanksgiving

Semper Fi

Gastone

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Thanks for all the info,

Well my C&P exam was approximately in March/April and I received the award letter in September after my surgeries. I know that I can request 100% disability rating for my left hip and per the rating schedule after my one year is over I receive a minimum rating of 30%. However since I was misdiagnosed I don't know if my right hip were to be covered since the VA does not recognize that I have avascular necrosis. Now my second question is when the VA does recognize that I have avascular necrosis of the right hip would I receive a minimum rating of 30% per hip?

Note: The 100 pct rating for 1 year following implantation of prosthesis will commence after initial grant of the 1-month total rating assigned under §4.30 following hospital discharge. 5054 Hip replacement (prosthesis). Prosthetic replacement of the head of the femur or of the acetabulum: For 1 year following implantation of prosthesis 100 Following implantation of prosthesis with painful motion or weakness such as to require the use of crutches 190 Markedly severe residual weakness, pain or limitation of motion following implantation of prosthesis 70 Moderately severe residuals of weakness, pain or limitation of motion 50 Minimum rating 30

I believe the route I will take is to file for an increase since I have documentation that indicates I have had surgery and have prosthesis on both hips. I am just afraid of being denied and having the VA give me a lower rating, although I have the surgeons report with the proper facts. Also does anyone believe I should get an IMO.

Thanks, Happy Thanksgiving!

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Question I have Avascular Necrosis in both hips. I had a total left hip replacement and have to wait till the right gets a little worse before I can have surgery on it. I'm currently receiving 100 percent for one year and it will drop to 30 percent. I'm still having pain from scar tissue from the surgery in my hip. Also I thought my hip would be a little stronger after surgery but its not. Should I for an increase before the year is up.

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