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As for a HLR? or no?

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Ranmic

Question

Last Nov I filled two claims, one for an increase in my current SC knees and then I filed a second one for my hips as a secondary to my knees.  The VA combined my two claims and then I got C&P exams for my knees and my hips.  I got an increase for my knees but they said my hips were not service connected.  I'm unsure if I file a higher level review for my hips if they will review my knees also.  All I want is for them to re-evaluate my hips, and not my knees as they are maxed out for instability and knee strain and I don't want that touched.  Below is what I filed for.  Again, I did get my knees increased and now they are maxed out.  I just want to challenge my hips.  Any advice?

  • knee condition bilateral (Increase)
  • hip condition bilateral (Secondary)

 

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If you are claiming one secondary to the other than it’s possible that both will be examined. An examiner may be able to render an opinion based on what’s at hand without a physical exam but that depends on the depth of your medical notes and out strength of any imo you may have. 

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3 hours ago, brokensoldier244th said:

If you are claiming one secondary to the other than it’s possible that both will be examined. An examiner may be able to render an opinion based on what’s at hand without a physical exam but that depends on the depth of your medical notes and out strength of any imo you may have. 

I just went back and reviewed my decision letter for my claim for knees and hips.  The hips said denied, not service connected but it did say: Favorable Findings identified in this decision: "You have been diagnosed with a disability.  VA examination received January 21, 2022, diagnosed left hip strain."  It said the same thing for my right hip.

 

Looks like the reason for denial was my VA or service records didn't show any treatment or complaints for my hips.  I guess I should have been bitching more to the VA about my hips.

 

Next question.  What happens if I let the time period for the HLR expire?  Will this not be reviewable ever again?

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You can, you just lose the current filing date you have now. The issue isn’t VA, it’s service connection. Service connection starts in your STRS. Talking to the VA later about it just established that something is wrong with no tie back to your service period. That is the part you need to address.

 

Also, HLR , 21-0996, just means a review of what they already have. If you want to include new evidence it needs to be on an 0995. 

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In my opinion, based upon my own experience, I would say skip the HLR as I don't know of any examples whereby they were turned in favor of the veteran. Secondly, you need not have STR for a secondary condition that is asinine. You need a current diagnosis and in my opinion, most important treatment records. You don't mention the evidence that you submitted but it's not good enough to simply say something hurts, gather objective evidence if you have not already done so. 

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I agree with skipping the HLR and go direct to the BVA.  HLR has a low approval rate where, if you check the BVA Chairmans report, you will find around 70 to 80 percent of the appeals which reach BVA are either approved or remanded, and only about 20-30 percent are denied.

So you have about a 70 to 80 percent chance of winning if you go to BVA.  

Increase your chances by doing the following:

1.  Get your Cfile and review it.  Do you have the Caluza elements of current diagnois, in service event and nexus?  If you have those 3, your chances go way, way up.  

2.  If you are missing one or more Caluza elements, you need to fix this.  Check to see if your military records show an in service event (which led to your disability).  As pointed out, this could be secondary to your knees, but a doctor would need to render the opinion that your hip condition is at least as likely as not due to your SC knee condition(s).  

3.  If this has gone on for a long time, with repeated denials, etc, then consider professional representation.  Your representative may be able to find out if you are missing a caluza element and what it would take to fix it. (often an IMO).  

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