Total Knee Replacement

[mrueckert]

So in 2012 i had a partial knee replacement i was already rated at 20% for my right knee. Fast forward to August 2014 i had been having difficulty with the knee never seemed to be right after the surgery but i went on with living with pain till it go to be to much, went to see my DR did x-rays and then exploratory surgery to find a torn ACL. My options were to fix it rehab it or just get the knee replaced i opted to have Knee replaced. Since i was already 20% disabled for this knee i figured it would be covered at 100%, filed my claim they sent it to an VA evaluator and his opinion said my disability had nothing to do with my original claim when i was diagnosed not once but twice by VA dr's. I have not gotten a decision yet but i am starting to worry after reading the evaluators opinion should i be or am i putting to much stock into it. I would not worry so much but i have been out of work since the surgery 3 months now so just kind of freaking out a little thanks for letting me rant. Any advice or comments would really help.

[Pete53]

Seems like if you need it you should get it.

[saints13]

I had a total reconstruction of right knee back in 08 by a private Dr. After surgery I submitted my hospital discharge paperwork and the doctor recommendation of 9-12 months recovery. VA paid me convalescent leave at 100% during that time. After recovery they re evaluated me and got an increase on both knees.

Think VA convalescent time is 1 year TKR at 100%. Then a differnt percent post TKR after that year. It is in the 38 CFR part 4. Think it is 50% post TKR.

I Just had another reconstruction on both knees. Doctors won't do TKR until I'm over 50 years old. Said I would wear them out if did it now and they don't want to do it again if or when I did wear them out.

Also you should have two different ratings for knees.

One is for ROM (which is pain, the amount you can move it)

Second is instability/sublaxtion

Did you submit your hospital discharge notes and a note from doctor on the expected recovery time? You should be getting convalescenct leave @ 100% until recover. Then re evaluated sometime after the recovery.

[TiredCoastie]

Sounds like a nexus problem is at the root of your concern. The C&P is saying that your disability was caused by something other than military service.

Who did the surgery, Mrueckert? Was it the VA or an outside doctor? If it was an outside doc, you might want to get with him ASAP and get him to put a nexus in writing - basically stating that the torn ACL either happened while you were on active duty or is the result of the partial knee replacement you had done in 2012. If the C&P doc is saying that it's due to something else, you'll need the orthopedic surgeon to say that it's service connected. Otherwise, if you have medical records which point to your ACL tear as being caused either a directly or secondarly to military service (like a result of your partial replacement), you'll want to ensure the RO has those ASAP if they don't have them already. What kind of doctor was the C&P examiner? If he was not an orthopedic doc, and you have one that says that your current status is service connected, you have enough already to successfully fight if it comes to an appeal.

If the VA did the surgery, at some point you'll want to get a consult with an outside doctor to review your SMRs, your post-miliary records on your knee, and get you a written nexus letter. The question in this case is whether you wait until after you get the decision or not. If you have outside insurance, this is the time to use it.

Then, as Saints13 aptly stated, it's all about ROM and stability. Take a look at 38 CFR part 4 to get an idea of what's what:

http://www.ecfr.gov/cgi-bin/text-idx?rgn=div5;node=38:1.0.1.1.5#sg38.1.4.b.sg0

Edited April 13, 2015 by TiredCoastie

[mrueckert]

The surgery was done at the VA. I have been out of the service for quite some time i believe the torn ACL was a result of the partial knee replacement, my VA DR said he did not see the torn ACL but was not looking for it either so it could have been there all along. When i complained about more pain in my knee they did an X-Ray and could not see it they had to actually go in there surgically to find out what the problem was. From the time i have my PKR i have had nothing but problems should have made them do the full it was my choice and i took the DR's advice bad move. I have know idea what kind of DR the C&P examiner was, do they always send it to a C&P examiner when you file a claim? I have been on disability for about 8 years now and i am already at 20% prior to both surgeries. I just think it's the VA way of trying to screw us vets over.

[TiredCoastie]

From what I've experienced with my knee, the ACL would have been found with an MRI which can see soft tissue like ligaments unlike x-rays. If no one has done an MRI and you had a PKR then a TKR, someone has really screwed up. That's like the second thing they do after x-rays and ROM tests. Is there some reason you can't have an MRI? Unless there's a very good reason, there is absolutely no excuse, IMHO, for you to have suffered exploratory surgery to find a torn ACL.

We're getting outside the areas where I have experience, but this is beginning to sound like an 1151 claim to me. Either they screwed up royally in failing to propertly diagnose you using modern diagnostic techniques or the PKR caused damage to your ACL, which could well be from bad doctoring.

Meanwhile, it sounds like you have one of those benefit of the doubt situations in which there is no proof either way that you had or didn't have a torn ACL at the time you left the service.

What was the original condition that caused you to have a PKR?

[mrueckert]

The reason i had a PKR was due to the knee deteriorating cartilage was gone on one side of my knee which happened from a injury i suffered while serving in desert storm. I had already had multiple arthroscopy surgeries plus cortisone shots and nothing help it only got worse till the DR decided to due a PKR. I believe the torn acl was a result of the PKR because my knee was never right i just dealt with it till it became to much to handle. They told me the could not due a MRI due the fact i had a PKR and the chances of being able to see it would be slim to none, so i took them at there word they are the experts.