Jump to content
  • veteranscrisisline-badge-chat-1.gif

  • Advertisemnt

  • 14 Questions about VA Disability Compensation Benefits Claims

    questions-001@3x.png

    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
    Continue Reading
     
  • Ads

  • Most Common VA Disabilities Claimed for Compensation:   

    tinnitus-005.pngptsd-005.pnglumbosacral-005.pngscars-005.pnglimitation-flexion-knee-005.pngdiabetes-005.pnglimitation-motion-ankle-005.pngparalysis-005.pngdegenerative-arthitis-spine-005.pngtbi-traumatic-brain-injury-005.png

  • Advertisemnt

  • VA Watchdog

  • Advertisemnt

  • Ads

  • Can a 100 percent Disabled Veteran Work and Earn an Income?

    employment 2.jpeg

    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

  • 0
Sign in to follow this  
pminme

Which ROM is used for Compensation

Question

I’m being rated on both knees.  I know ROM is involved in rating the case, but which ROM do they use?  Initial, after 3, or flare up?  

Share this post


Link to post
Share on other sites

Recommended Posts

  • 1
On 11/18/2018 at 2:35 AM, pminme said:

I’m being rated on both knees.  I know ROM is involved in rating the case, but which ROM do they use?  Initial, after 3, or flare up?  

Limitation of Motion of the Knee

Code 5261: If the knee is not frozen, but is limited in extension and cannot straighten all the way, then it is rated under this code. If the leg can only straighten to within 45° of being completely straight, then it is rated 50%. If it can straighten to 30°, it is rated 40%. To 20°, it is rated 30%. To 15°, it is rated 20%, To 10°, it is rated 10%, and to 5°, it is rated 0%.

extension of the knee

Code 5260: If the knee can straighten, but cannot bend all the way, then it is rated under this code. If the knee can only bend to 15°, then it is rated 30%. If it can bend to 30°, it is rated 20%. To 45°, it is rated 10%, and anything 60° or more is rated 0%.

Now if the knee can move, but cannot either bend all the way or straighten all the way, then it can be rated TWICE—once under code 5261, and once under this code 5260.

Share this post


Link to post
Share on other sites
  • 0

The logical answer is the range of motion  (ROM) will be measured during the C&P exam. I think you would need to make a trip to the emergency room during flare ups in order to document rom.

Share this post


Link to post
Share on other sites
  • 0

Here's an article that might be helpfulScreen Shot 2019-01-15 at 3.23.16 AM.png

Share this post


Link to post
Share on other sites
  • 0

I understand when it will be used;  my question was which ROM measurement is used for the actual determination.  There are three different ROM measurements the C&P takes:  resting, after use, and when in extreme flair up.  Which does the evaluator use for their determination?

Share this post


Link to post
Share on other sites
  • 0

The VA is NOT a unified body.  Your examiner can use either of the 3 you listed, or make up his own.  Im having a "senior" moment and cant remember the case right now, but there is a well known cavc case where "pain" has to be considered.  In other words, this suggest the rom measurement should be taken when you first experience pain in bending the appendage, not the max the physical therapist can get in spite of your pain.  

As far as "flare ups", sometimes the examiner will opine if he thinks you are in flare up, and document it accordingly.  Remember, tho, we have to show continuity of symptoms..if it hurt for a while then goes away that is considered an "acute" condition.  The VA rates us on "chronic" conditions, that is, while the pain may wax and wane, it pretty much limits our ability to work.  You wont get paid for a sprained ankle that heals up, but only if this sprained ankle leaves "residuals" such as degenerative arthirits or other chronic symptoms.  

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Answer this question...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Sign in to follow this  

  • Our picks

    • I filed a claim in october of 2018 for ptsd and TDIU, long story short I tried to do everything myself and didn't have the proper diagnosis so I was service connected for anxiety based on having a medical marijuana card diagnosis for anxiety but the rating was 30% and I much worse off then that. So I obtained a referral from the va to a fancy psychiatrist from the university of north florida's behavior health department and was diagnosed with ptsd, bi polar 1 and panic disorder. I used this new medical evidence as my supplemental claim evidence and filed it April 16, 2019 after receiving my letter March 20, 2019. My claim is now at Pending Decision Approval with an estimated completion date of july 2, 2019 which is super fast from all I have read. My question is, Am I going to be awarded tdiu with the evidence I submitted if they adjust me up to 70% which I think it will . Or if they award 70% for ptsd on this new supplemental claim will i have to re-apply for tdiu again? Or would that all be considered in the final review of the entire claim? Thanks for any help.

      1-22 1BCT 4th I.D. "Regulars by God"
      • 3 replies
    • how do you figure when they will start paying me at the 100% rate, housebound..?  They will start the pay before they finish the back pay?  That would be nice !!
    • Hello:

      If you receive a hysterectomy while you are filing for disability through the VA, will it still count?

      I am out of the military.

      Thank you
      • 1 reply
    • Help needed bad  Male MST
      Is there anything for a man who's been diagnosed with PTSD secondary to MST. I see all this information and it's primarily speaking as if it only happened to females. If anybody has any advice for a man who suffers from this condition please let me know I'm not alone. Also let me know of any coping skills you've learned as I have lived the last 25-30 years of my life in full flight from reality. 
      • 9 replies
    • Occasionally it becomes necessary for HadIt.com to come to the community to help raise funds. This is one of those occasions.

      A couple of things to keep in mind

      Financial contributions are never required, but always appreciated.


      NOT tax deductible, HadIt.com is NOT a non profit and any contribution you make is just a gift and cannot be deducted on your taxes.


      If you prefer to give through a subscription, you may subscribe here the rates are $5 per month or $50 per year and gives you an ad free experience on the forums.



      Thank you for your support!
      • 3 replies
  • Ads

  • Popular Contributors

  • Ad

  • Latest News
×
×
  • Create New...

Important Information

{terms] and Guidelines