Va nexus

[Sdet74]

Hello.   I recently filed a claim with the VA for constant knee pain with any type of impact use.   I’ve been out of the military for 22 years and haven’t done any va evaluations before this.   I was medically separated with a DOD disability rating of 10% for chronic patelloformoral syndrome.  When I got out of the military I went to my own doctors when the pain got bad enough that Motrin didn’t help.   But after so many trips the Dr told me I’m just gonna not have to do anything to aggravate it beyond tolerance.   That was 14 years ago and this past year it’s gotten to the point I needed to do something.   I recently had a Cp exam and they tested strength, range of motion with pain and talked about my day to day life and what causes pain, flare ups.  I guess my main question is I submitted a claim at present without the 2 doctors who saw me directly out of the military because one has moved and the other isnt practicing.   With a diagnosis of chronic patelloformoral syndrome in my MEB board evaluation during separation and my current pain, lack of Rom and daily issues be enough to get a va rating?  

[broncovet]

It depends.  You are gonna need 3 things for SC (2 if you file for a secondary):

1.  Current diagnosis.

2.  In service event or aggravation.

3.  Nexus, or doc opinion that your current diagnosis is at least as likely as not due to your in service event.  

    You did not mention what was causing "constant knee pain".  

     If its "chronic patellofemoral syndrome" you need only apply for an increase.  

     If the diagnois is "something else" then you are going to need a doc opinion either that your "new" knee pain is a result of service OR its related to your sc patello femoral syndrome.  

[vetquest]

Bronco gives you the advice you need.  It is hard to get SC for an injury 20 years later but it is possible.  You may be denied the first time around.  Do not stop there, appeal your decision and take it to the BVA is necessary.  The VA will deny, delay and drag your case out, just do not give up.  

[Sdet74]

Basically I told the cp examiner stairs, impact on my feet beyond a light walk.  Any light jog or quick bursts even for 10 feet will cause my knee to hurt for up to a week.   Standing even for minutes in the same position.  Lifting my kids.   The examiner gave me a 3/5 on the strength resistance test.   Surprised they told me.  I couldn’t extend my leg even close to 45 degees without pain when measuring with a goniometer.   Unfortunately the Dr’s that treated me out of the military are being hard to track down for files.   In 2006 the Ortho doc told me to just live with it and not aggravate it and medicate as needed.  

[broncovet]

The Va has a "duty to assist" you to  find records.  Dont hold your breath, but it works sometimes.  

To reiterate, "focus on what is important", and that is documenting the Caluza elements I identified above.  What was your most recent diagnosis?  If its still patellofemoral syndrome, all you need to do is appy for an increase.  Also, secondaries are likely.  Is it arthritis?  Does it show up on an xray?

[GBArmy]

Agree with Bronc and Vetquest. If the pain is caused by what your s-c disability, I would get a dbq from a specialist that says so. He/she states that the old injury is now causing X, and it not only shows an increase in your disability for movement, etc., but the pain is much worse. And, if there is other issues, back, arthritis, hip or walking issues, etc., secondaries can come into play. . As Bronc indicates, if it is bad for 20 years, it is highly likely you have ,or will have ,other issues tied to it, either now or in the future.

[Sdet74]

I appreciate the responses everyone.   Since I’ve already had my CP exam last week, it’s more than likely I’m not gonna be able to a specialist to get a dbq done in time to get to the rater.   I’ve put a request in for my c-file and am trying to get my post military treatment records from my old Dr’s.  I’m hoping the cp examiner wrote my exam up in a way that created the nexus from prior service to now.   But from what I’m reading from this point it’s better to prepare for an appeal and get my ducks lined up in a row.   I know my hip hurts on that side, but I’ve not ever been seen for that.   So I didn’t really mention that in the cp exam.   Do have documentation with lower back issues the last few years from a chiropractor though.   My veteran friends have called me stubborn for not going to the VA sooner with all this.