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Cobra4v

Exams during flare up?

Question

A friend of mine who is a fellow Vet were talking about the C&P process. Like me he has a lot of inflammation issues in his shoulders. I told him how the examiner asked me if I was having a flare up when she examined my knee. We both became curious if that has any effect on a rating.

 

So if a veteran is experiencing a flare up during a C&P exam. Does the assigned rater take that into consideration and rate it at less of a percentage based on the restriction of movement due to a flare up? Or do they rate it as scheduled no matter what?

 

 

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It must be considered as part of the claim, as it could effect the rating percentage, but rarely is this done in the first examination.

At least from 6 exams I have had.

You usually have to fight for the secondary issues caused by a service connected injury.  

JMO.

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So they would most likely assign the minimum rating for pain? And not assign a rating for range of motion effected by the flare up? 

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Yes that is a possibility, there is no sense worrying about it though.  The foremost concern is getting the injury service connected, once that is done then you can appeal the rest that you may be entitled to with medical evidence,IME/IMO, ect....

This sounds cold, however, no sense worrying about it until you receive the decision, from there you can decide which avenue you will pursue as well what attack to utilize.

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Okay, I'm reviewing my C&P exam now. Noted is a significant loss of motion. Here are my results. This was done during a "flare up" apparently. Even though I have had this "flare up" for 3 weeks. My previous initial C&P exam 3 years ago noted loss of motion ass well this time however is much worse. Im not sure if this should be noted as a flare up or the worsening of the cartilage decay in my knee cap.

Left Knee --------- [ ] All normal [X] Abnormal or outside of normal range [ ] Unable to test (please explain) [ ] Not indicated (please explain)

Flexion (0 to 140): 40 to 55 degrees Extension

(140 to 0): 55 to 40 degrees

If abnormal, does the range of motion itself contribute to functional loss? [X] Yes (please explain) [ ] No If yes, please explain: sigificanly reduced ROM would impede kneeling/squatting.

Description of pain (select best response): Pain noted on exam and causes functional loss If noted on exam, which ROM exhibited pain (select all that apply)? Flexion, Extension Is there evidence of pain with weight bearing? [X] Yes [ ] No

Is there objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue? [X] Yes [ ] No If yes, describe including location, severity and relationship to condition(s):

lateral patellar Is there objective evidence of crepitus? [ ] Yes [X] No b. Observed repetitive use

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To me it reads like your in line for an increase, however, I am not a rater and it is purely JMO. I started with 0 on both knees and appealed to get to 10% bilateral, I am still in appeals to go for a 20% on the right knee because of the laxity and crepitus of that joint.  I am going for this rating because I have an independent medical opinion to substantiate such rating.  Without an objective medical examination it will be difficult to go much higher.  Read the ratings criteria in the eCFRs under the knee joint and you will have a clearer picture of what is needed.  I stress you must have the medical evidence to warrant the higher rating.

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