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Knees and Back C&P


Hello brothers and sister!

I went today for an increase on L Knee (currently 0%), R Knee and Back condition secondary to L knee. The left knee received a 0% rating at first because of the doc not doing the range of motion testing. This time the doc used the "at least as likely as not" and agreed that my Back and R Knee is because of my service connected L Knee. I cant get the C&P notes to transfer so ill type up the important parts on here and please ask questions. What im wondering is what my overall percentage would be.

Back Condition:

1. Diagnosed Lumbosacral Strain

2. Range of Motion 0-50 Which should warrant a 20% rating??

3. Functional Loss: yes

4. Pain on motion and repetitive use

5. Guarding or muscle spasms: Yes

6. numbness, pain, paresthesias: Mild on right side all 4 boxes checked

7. Cane and braces used

Right and Left Knee:

1. Left meniscal tear

2. Patellofemoral Pain in left knee

3. ROM R Knee: Flexion 0-130 and 130-0 they say that normal is 0-140 and 140-0

4. ROM L Knee: 15-110 and 110-15 normal is 0-140 and 140-0

5. Strength testing is 5/5 on both knees

6. No subloxation

7. Lateral Instability: Moderate Left knee, Slight Right knee

8. cane and braces used

9. Meniscus surgery 3 times scars noted but not large and not painful


any input would be awesome. As soon as I can get the C&Ps uploaded I will do that but if there are questions please ask. Based on this i feel that this is close to what I may get. 20% left knee limitation of extention and 20% left knee instability, 10% Right knee instability, do i get the bilateral factor and how does that apply???? and then 20 percent for lumbosacral strain due to the range of motion. Thanks for all the help!

Edited by armyvet89
Left info out.

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Your best bet for knee ratings is to check out the rating chart, on this site, and see where you fall according to your ROM and such. Yes, you will get the bilateral factor. Here's how that works, first you need opposing body parts to be SC, for you both knees will cover that.  For sake of argument, I will use the rate figures you used at 20% each knee...20%+20%=36% combined rating. Bilateral factor is an additional 10% added straight to the bilateral rating, not factored in as an additional rating but added like regular math. So...36%= 3.6 bilateral factor.  And therefore 36%+3.6=39.6%. Then your next rating would be added to that VA fuzzy math style. Now if you add that additional 10% to the 36% you would end up at 42%, and the bilateral factor would be 4.2, bumping you to 46%, and therefore your comp pay rate would be 50%.

Those bilateral factor points make a huge difference at the end of the day, because it usually gets you bumped to the next higher pay rate.  And as you can  see from my math, the bilateral factor is worth several hundred dollars a month. 

Hope that answered your question.

Semper Fi

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Thanks Andyman. That does help another question. I feel like I should get 20% for ROM and 20% for instability both for my left knee. This isn't pyramiding correct? And then 10% instability for my right knee. So basically 20, 20, 10, 10 with the last 10 being the bilateral factor. Am I right?

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I can't say whether or not it's pyramiding, since I'm not familiar with it enough to know.  There are some on here who can give you a better answer.  But I can tell you this, I have 10% for each knee and 10% for bilateral patella femoral pain syndrome.  But originally it was just the 10% for the pain.  Then 15 years later got the 10% each for ROM/instability. Most likely you will get the more serious issue for the rate(by law they have too)per knee depending on which is more severe, the ROM or instability. Those are both physical manifestations of the disability, and pain is how it feels.  It is possible to have reduced ROM or stability without being painful. 

Hope this doesn't muddy the water too much more for you.


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So you are saying that you now have a rating for both instability and limited ROM? Thats what I was wondering. Because the things he checked off on and noted show 20% for ROM and due to the box "Moderate" instability being checked I feel like thats another 20% under DC 5257. Or do they normally just rate one DC?

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Per knee. Can you have more than 1 rating for your knee and if so is it common?

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