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HLR Denied

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I filed an HLR for a previous denial for my hips issues. I filed it as a secondary to my currently service connected knees (Left and right knees). My process was, Denied, filed an HLR, error identified by the reviewer and sent back for a new medical opinion. Well, apparently they don't think your knee injuries can affect your hips. Here is a copy of my denial. Thoughts and or advice for my next step? This is twice I've been denied for this. 

"Service connection for left hip strain as secondary to the service-connected disability of

left knee strain with arthritis (limitation of flexion).

The evidence does not support a change in our prior decision. Therefore, we are confirming the

previous denial of this claim.

Service connection may be granted for a disease or injury which resulted from a service connected

disability or was aggravated thereby. The evidence does not show that left hip strain is

related to the service-connected condition of left knee strain with arthritis (limitation of flexion),

nor is there any evidence of this disability during military service. (38 CFR 3.303, 38 CFR 3.304,

38 CFR 3.310)

VA examiner of April 29, 2023, opined that there is no clear evidence from review of orthopedic

literature to suggest that an injury to one joint would have any significant impact on another or

opposite uninjured joint or limb, unless the injury resulted in a major muscle or nerve damage

causing partial or complete paralysis, or shortening of the injured limb resulting in length

discrepancy of more than 5 cm so that the individual's gait pattern has been altered to the extent

that clinically there is an obvious Trendelenburg gait. This level of severity is not supported

based on record review, history or exam. It is not unusual for two joints to share properties in the

same person, but one joint's disease does not 'spread' to another or cause damage to it. Therefore

the left hip strain is less likely than not related to the left knee strain with arthritis.

Your service treatment records do not contain complaints, treatment, or diagnosis for this

condition. The evidence does not show an event, disease or injury in service. We did not find a

link between your medical condition and military service. (38 CFR 3.303, 38 CFR 3.304)

Favorable Findings identified in this decision:

You have been diagnosed with a disability. VA examination received January 21, 2022,

diagnosed left hip strain.

The claimed primary disability is service-connected. You are service-connected for left and right

knee strain with arthritis."

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Yes. They way they do it now appeals, reviews, etc all fall under supplemental claims, and, for you, you would want to do the 20-0995 because that allows you to submit new evidence. If you do the 20-0996 its a review (like what you did before, it sounds like) but you can't submit new evidence. 

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1 hour ago, brokensoldier244th said:

Youll have to find an ortho that states otherwise, from the look of it. 

Thanks Broken. This is new territory for me. So now that I have a denied HLR, lets say I go to an Ortho and get a favorable medical opinion, would I file this as a supplemental?

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If you get denied a second time, such as denied SC, appeal to HLR and denied again, dont even think about sending it back to the VARO (HLR) for a second round of denials, but instead appeal to the BVA.  

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