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

[BDingster]

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

[BDingster]

20 hours ago, pwrslm said:

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!

I'm only finding out now, with 3 days until C&P just how much more should have been in my packet.  VSO said save the nexus/etiology in case of appeal.  I'm learning that much more should have been included in my packet.

Thank you for your time and leads

[BDingster]

On 12/10/2021 at 7:12 AM, pwrslm said:

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.

Regarding balance and gait, as far as I know, those have been normal - hence looking at overuse.  Lower back is also claimed as a secondary. Just had a friend suggest looking at pelvis besides the hip due to being on jump status.  It all runs together like you say. Thanks for your time.

[BDingster]

On 12/10/2021 at 1:17 PM, pacmanx1 said:

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. 

Unfortunately, my VSO advised against this.  Having done some more research, it looks like my packet is a bit deficient.  Thank you for your time.

[BDingster]

22 hours ago, broncovet said:

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".  

Included in the claim is what was noted in the OP: "certainly reasonable to assume hip issues are secondary to the knee." Similar is stated for the back.  Unfortunately, the cases I've been reading suggest that such wording is nearly worthless.  I think it's a coin flip if this gets approved or not.  Thank you for your time.

Edited December 11, 2021 by BDingster