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bolt_vet23

Medial Compartment Osteoarthropathy Claim

Question

Hello,

I’m hoping that someone can shed some light on a potential claim for me.  I have 10% service-connected disability for my torn ACL ligament, left knee to include pain and 0% for post-surgical scars.  During a recent VA appointment, the radiologist noted “X-ray of the Knee : 1. ACL repair in the left knee with medial compartment osteoarthropathy. 2. Normal right knee. Your x-ray results are as above, Knee joint x-ray was normal.”  Based on this information, I believe that the codes below would apply at the 10% level for each one. 

5003      Arthritis, degenerative (hypertrophic or osteoarthritis):

                       Degenerative arthritis established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved (DC 5200 etc.). When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 pct is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. In the absence of limitation of motion, rate as below:

                       With X-ray evidence of involvement of 2 or more major joints

                            or 2 or more minor joint groups, with occasional incapacitating

                            exacerbations.............................................................................................. 20

                       With X-ray evidence of involvement of 2 or more major joints

                            or 2 or more minor joint groups................................................................... 10

               Note (1): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be combined with ratings based on limitation of motion.

               Note(2): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be utilized in  rating conditions listed under diagnostic code  5013 to 5024, inclusive.

5257     Knee, other impairment of:

                   Recurrent subluxation or lateral instability:

                           Severe................................................................................................................ 30

                           Moderate........................................................................................................... 20

                           Slight ............................................................................................................... 10

Does this sound correct and is there anything else that I should add?

Thanks,

Bolt_Vet23

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Anyone have any thoughts on this?  Thanks

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It sounds like you did your homework, but you may be getting "the cart before the horse".  

BEFORE VA will assign a disability percentage, you must first get it SERVICE CONNECTED.  To do that, you must have the Caluza elements documented:

1.  Current diagnosis of ostearthritis. 

2.  In service event or aggravation.

3.  Doctors nexus linking number 1 and 2.  VA wont connect the dots, Your doctor has to provide same.  

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