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How to connect bilateral hip as a secondary to an SC knee?


BDingster

Question

Looking to connect an arthritic left hip as a secondary to a service connected rt knee.  The left leg has been my power leg for 20 years, so it has extra wear and tear. PCP PA-3 states in evidentiary notes "certainly reasonable to assume hip is caused by knee". The issue is that the VA cases I've looked at all say there is no literature that supports bilateral joints - only adjacent joints. Questions:
1) has anyone won such a case with a bilateral lower extremely?
2) does anyone know of any lit that connects opposite leg secondaries?
Thanks

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Hi BDingster, welcome to Hadit. I don't have any literature to reference you but if you are going for secondary, you must get a nexus letter and a diagnosis to your knee. There should be plenty of cases to refer to. Try looking up the BVA decisions for prior award-https://www.index.va.gov/search/va/bva.jsp 

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My original SC issue was my spine. My left leg was rule secondary due to radiculopathy and foot drop (caused by damaged nerve in lumbar spine). Then they gave me pes planus (flat foot) secondary to my lumbar condition. 2 years later, my hips and knees had started to give me pain. When I submitted the claim, I was given 10% for one knee and both hips. The left knee got a 40% rating.

Anytime your balance is off in your gait, it will eventually be reflected in the way your body habitus wears.  if it begins in the back, it will eventually be reflected in your hips and knees. If it begins in your foot, it will eventually be seen in your spine and every joint in between.

Edited by pwrslm
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The simplest answer is you are going to need an IMO/IME (INDEPENDENT MEDICAL OPINION/INDEPENDENT MEDICAL EXAMINATION) with a good medical rationale how your new disability is caused by or related to your service-connected disability. Fight fire with fire, since the VA is going to request a medical opinion, it is best that you get your own and have it documented in your records. 

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Its "all about the evidence".  Unless, a doctor has already opined something close to "your hip (issue) is at least as likely as not secondary to your knee issue".  

It take medical evidence to win this. If a doc will render such an opinion, then it should fly.  

Pretty much, your other advice has said the same thing.  

Review your file to see if your nexus, described above, is in your file.  If not, you can ask another VA doc:  "Do you think my hip issue was caused by the knee issue?"  If he responds positively, ask him to please note that on your records.  

But, if you dont have a nexus and VA docs refuse, then you will "need an IMO to win it".  

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Ask your VA PCP to provide an etiology for the knee and hip issues. If they will not put that into the record, then you will need a IMO/E. If they put this in your VAMC medical record, it should carry a lot of weight in your favor.

If you do not have a VA PCP then you should go to your existing provider and ask for the etiology. Take the least expensive route first!

Edited by pwrslm
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On 12/10/2021 at 6:55 AM, GBArmy said:

Hi BDingster, welcome to Hadit. I don't have any literature to reference you but if you are going for secondary, you must get a nexus letter and a diagnosis to your knee. There should be plenty of cases to refer to. Try looking up the BVA decisions for prior award-https://www.index.va.gov/search/va/bva.jsp 

Understood about nexus.  That website is a treasure trove.  Thank you.

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