Reduction in benefits after TKR

[Meme59]

On March 11, 2020 I had a full left knee replacement. I applied for  and was granted temporary 100% disability effective date of May 1, 2020. I will be on 100% disability until May 1, 2021.

Prior to the surgery I had a rating of 50% disability. Ratings were as follows: 30% Left knee osteoarthritis SC, 10% Tinnitus and 20% Instability of left knee.

I received a letter dated July 7, 2020 apprising me that I will be at 100%  disability for a year as stated above. As the letter continued I read that my benefits will be reduced from 50% to 40% on May 1, 2021. Of course there is no detail information on the method used to reach this new rating of 40%.

Does any one know the reason for this reduction in benefits?  Should I appeal by submitting a Supplemental Claim or submit a Higher Level Review?

Any advised is deeply appreciated.

Thank you,

Meme59

[broncovet]

Well, yes, sort of.  Your 100 percent rating is "convalescent" while you recover from TKR surgery, and, is "temporary".  As a temporary rating, unfortunately, you dont enjoy the "protections" given to P and T Vets, or over 5 years.  

You should get a C and P exam at/about 1 year, and you should be evaluated again.  As I recall, 30 percent is the minimum after TKR.  

What to do:  

    Mostly it hinges on "are you able to work" or not.  If you can go back to work, then I suggest you do just that, and spend this time looking for a job.  

    If you can not go back to work, "due to SC conditions", then you need a doc opinion stating same, and apply for tdiu.  If awarded you would be paid at 100 percent on a more permanent basis.  

    In order to get tdiu, you will "also" likely need a Voc Rehab assessment where the counselor pretty much states you are not a good candidate for "any" job.  As an example, if you could not do your present job, say as a warehouse worker, you "may" be able to retrain as, say, a computer programmer, that does not involve using your knee much.  

     You may not be feasable to be retrained, for any number of reasons.  As an example, if you are 60 years old, and have little computer experience, you are unlikely going to be able to "master" computer skills in a few short years and be a programmer, which often takes a 4 year degree.  You may have retraining possibilities, of course, and a voc rehab speciailist will probably need to "weigh in" on his opinion of the feasability  of you to be retrained and re enter the work force.  I have no idea if that is feasable or not in your case, and, it would take an expert opinion anyway. (voc rehab specialist). 

     As an alternative, there "may" be other SC disabilities that you have, but have not considered, yet, applying for.  I have no idea what these would be, but you should at least consider it.  

     On the top of the list, would probably be SC conditions for your "other" knee, because, many times you injure 1 leg the other compensates, and is overburdened causing its failure also.  I have no idea how your other knee is, but you may be able to SC it if its in bad shape also, as secondary.  You would need a medical opinion on that, not my opinion.  

     I suggest you take this time to prepare by filing for additional disabilites, or getting into voc rehab to re enter the work force, as your situation suggests.  

     cck explains it, here: https://cck-law.com/types-of-va-disabilities/knee-replacement-lawyer/#:~:text=The VA rates knee replacements,at least at 30 percent.

    Chris Attig also explains it: https://www.veteranslawblog.org/va-disability-compensation-knee-replacement/

    If you dont like the lawyers explanation, you can read 38 CFR 4.71, here:

https://www.law.cornell.edu/cfr/text/38/4.71a

    Oh, and yes, I have been through TKR, its pretty rough but my knee has recoverd.  I dont get SC for it, and I didnt fight it, because it wont make any difference as IM 100 p and T plus SMC S and an additional 30 percent wont change my income 1 cent.  

    Finally, if you are fully disabled, you should apply for SSDI ALSO.  Yes, you can get SSDI and VA benefits provided that you meet each ones criteria.  

    

Edited July 14, 2020 by broncovet

[brokensoldier244th]

Because they repaired the instability. They will still examine you again but that 20 percent you get for the knee is what the surgery was for. 

[deedub75]

I was rated at 10% for right ankle instability. I applied for an increase which was denied but then increased to 20% by a DRO. I had surgery to repair a torn ligament in the ankle and was at temporary 100% for a couple of months. I had a C&P exam after the surgery and I was reduced back to the original 10%. 

[Meme59]

My thanks to broncovet, brokensoldier244th and deedub75 for your advise on my matter. I guess will have to wait for the year to pass and  the C&P.

My left knee still buckles and the pain sometimes is worse than before I had the surgery. People tell me it is to early not to have those maladies.

Guess I have to time pass by.

Once again thank you guys for the information.

[broncovet]

I dont recommend waiting if you have a (disability)  (left knee).  The longer you wait to apply, the more it costs you in retro, that is, unless you have so much money the banks wont accept any more money from you.  Get your cfile and see if a doc mentioned your left knee as related to Right.  

Then apply.  Delays cost you retro money.