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C&P for Evaluation of Hip and Foot as Secondary to Service Connected Knee

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I have an upcoming C&P exam with VES orthopedic doctor to look at my left hip and left foot. I have a 10% service connected rating for my left knee from over 20 years ago. 

Recently I applied for chronic pain and received 30% rating because the left knee pain has really impacted my way of life and family issues. 

I have several years of documented issues with my left hip and left foot, and I have a nexus letter from a chiropractor stating that it is more likely than not that the left knee injury over the last 20 years has caused a change in gait that has impacted my left hip and left foot. I also submitted the foot orthopedic doctor statement that says the same thing for my left foot. The hip orthopedic doctor said something similar, but said "the patient believes that the knee injury impacted his gait over 20 years and caused the left hip and left foot to have issues", later he clarifies that he thinks the left knee injury could have certainly impacted the left hip.


I also submitted to the VA a medical study and article from five doctors that link and show that a knee injury can impact and cause hip issues on the same side. 


I have MRIs and X-rays showing the left hip issue is severe and I cannot even tie my shoes anymore. My left foot has issues that cause severe pain when walking on hard surfaces. 


Do I need to bring the MRIs and Xrays and nexus letters or anything else like the article from the five doctors to the appointment with the VES doctor?

At this stage, I don't even care about a percentage I just want the VA to acknowledge and link my left hip and left foot issues to the service connected left knee.

I was told by several doctors I should just get the hip replacement because I have tried for over six years now to use other methods like physical therapy, massage, etc., but noting can make the arthritis go away. I am only in my late 40s also. 

Any advice greatly appreciated. 


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Thank you Broncovet, this is great advice, and when I had my chronic pain exam I explained the situation the same way. Really my wife has no idea how much pain I am in some days and how I wake up screaming from the knee and now hip pain. I actually feel like my hip is worse than my left knee now in terms of how if impacts my life. 

So your other advice is not to bring the MRIs or Xrays or the article by the five doctors to the VES exam?

What do you think about the hip orthopedic doctor saying "patient believes..." instead of what the other doctors (chiropractor and foot orthopedic doctor) said as "the left knee impacted the patient's gait over 20 plus years of walking and more likely than not affected the left hip and left foot". The strongest wording is from the chiropractor but is that enough? 

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It sounds like you have it figued out well.  Just go to the c and p exam, and best is to show up on time or early.  

But practice what you are gonna say when he asks, "How are you today?"  

If you say the proverbial "fine", you will be backpedaling the whole exam.  Instead, its best to tell "how it was on your worst day"..  

Example: (Use your own example, from your life, not mine)

Today, doc is not bad.  On Thursday (your worst day), the pain was so bad I nearly went to the ER.  Then describe the pain.  

A c and p exam is not the time to suck it up and tell the doc "everything is fine" when its not.  

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In my opinion the chiropractor will be of no use because the are viewed low on the totem pole. I recommend you get a Va dr or a private dr to state such things. In regards to bringing your stuff to the c&p it’s ok but expect that they refuse to look at it as they are only focused on what’s in your file. Regardless I too brought a dbq and imo to the appointment only for the examiner to state it was irrelevant. Keep us informed on how your exam went.

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