Hip/Knee/Ankle Arthritis secondary to Back Surgery/DDD

[KansasNavy]

I have had two back surgeries (both in service) on L4/L5/S1.  Rated 40% Static.  I also have PN in Left Leg at 40% static and Right leg 10% Static.  I now have arthritis in Hip/Knee and Ankle of Left leg more so than the right.  When I injured my back in service there was a lot of damage done on the left side.  Was recently diagnosed with arthritis in Hip/Knee/Ankle 7 years after getting out of the service.  Has anyone ever claimed SC and was successful getting arthritis in the Hip/Ankle/Knee secondary to Back surgery/DDD?  Its really my left side that is really bad.  Right leg is much better than left side.  My back is still bad, just hasn't completely done me in yet.

Thanks in advance

[GBArmy]

KansasNavy Sounds like you're dealing with a lot of pain, so consider a MH disability as part of what you are going to submit, but watch out for pyramiding. I would send in a Intent to File form 21-0996 today to lock in your EED (early effective date) immediately, so you can work on evidence. Asking if anyone else has had a s-c to back for arthritis doesn't really matter. Your claim, like all claims, are unique and different facts cloud up similar situations. You must get a diagnosis on your conditions and this would be secondary conditions, so a IMO/nexus on the connection is critical. You must get a doctor to say x causes y. IMHO you can get it with good evidence. Also realize that though your conditions are static, they now will be re-evaluated as part of the development. If your conditions are the same or worse and you have had continued treatment/documentation in tour file, you should be o.k.

[brokensoldier244th]

He can use a 21-0966. 

 

0996 is an appeal form. 

 

-cas

[broncovet]

As always, you need all 3 caluza elements for SC.  (Its reduced, to 2, however, for secondary SC.)  For secondary you need:

1.  Current diagnosis.  

2.  Nexus, or doc opinion between your present SC condition and your proposed new Secondary.  

Example:

    "If" your doctor(s) opine that your arthritis and other knee problems are "at least as likely as not" related to your SC Degenerative disk disease, then you should be able to get rated for secondary conditions.  

     If your VA doc wont make such a nexus statement, then perhaps a private IMO will.  

     Remember, it does not matter what you think, what I think, what your VSO thinks, or even what President Elect Biden thinks.    It matters what your doctor writes down. (competent medical evidence).  Favorable competent medical evidence, coupled with Caluza elements wins claims.   

[brokensoldier244th]

The VA doctor doens't HAVE to make a direct connection like that. So long as your medical records or trtmnt post svc are well documented, the C &P examiner will make that call. VA doctors are not part of the benefits side directly, as such they rarely make blatant statements in VA verbiage for claims. You can ask, but they are not required to render a specific opinion related to a disability claim. Generally, they try to stay out of it. I don't necessarily agree with that, but from their end they generally focus on treatment and leave the claims side alone.  Thats where the private doctor comes into play. VA docs feel 'stuck' in that they work for VA, but a wholly different arm of it, they aren't disability doctors, so they don't make opinions like that, even for private disability claims (ive been through this) . 

[flow1972]

If you have the diagnosis for the secondary conditions, submit a claim for them as secondary to whichever already SC'd condition you believe they are caused or worsened by.  You aren't SC'd on "back surgery".  You're SC'd on a condition or conditions that were caused by (residuals of) your back surgery.  Do some research.  Find medical papers or opinions that show how condition "XYZ" has been shown to cause or impact the condition(s) you're looking to claim as secondary.  Better yet, find favorable BVA decisions similar and include those in your claim.  The C&P doc will make a determination if it's at least as likely as not the condition is caused/worsened by the SC'd condition(s).

And to echo what someone else said...just because it's listed as static doesn't mean they won't "re-evaluate" when you file a claim for secondary.  If the secondary condition carries symptomology of the first...they will most definitely re-evaluate the already SC'd condition(s) to determine if there is truly a secondary condition or if the original condition is actually "worse" or mis-diagnosed.

 

Example:  I submitted a claim for radiculopathy diagnosed as Carpel Tunnel Syndrome as secondary to already SC'd Cervical Strain.  My Cervical Strain was re-evaluated to determine if the radiculopathy was a missed diagnosis in the initial evaluation or if the Carpel Tunnel was a condition of it's own.  It was determined that it was a missed diagnosis of the initial evaluation and added on as two ratings for right and left radiculopathy leaving the cervical strain as already rated.  Could have gone differently though.

Edited January 14, 2021 by flow1972