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Nexus letter if I have photographic proof?

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LKF050813

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Hello, new here. Working through getting an increase on my s/c issues and it has been brought to my attention I should have had my left knee s/c this whole time (medically retired 12 years ago). I have photographs of me competing in triathalons while wearing a knee brace on my left knee while on active duty. Platts data with my matching bib number backs up the dates of the photographs. Is this enough for the VA to service connect or should I still get a nexus letter? I’m s/c for pes planus and right knee, so could definitely get a letter for left knee secondary to those issues, but would prefer to just submit what I have. It seems like a smoking gun, but don’t want to assume how the VA will look at this.

Thank you!

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38 minutes ago, john999 said:

Yeah, I like your chance at getting the knee connected as secondary. You know you have enough to get TDIU as is without getting 100% schedular.  I had TDIU for years before I got actual 100%.  Getting from 90% to 100% is very hard.  You need an extra 50% to get there.  VA math is a killer.  I had 93% rounded down to 90%.  I finally got 100% when I added an extra 80% and even then I got 98% rounded up to 100%.  If you are not working just go for TDIU. Much easier!

I have the TDIU claim running concurrently to the s/c increases and new knee claim. I haven’t been able to work since I got out and had no idea what TDIU even was until my husband’s VSO told me I should apply. I also didn’t know I should have done this years ago or pipe up about my left knee while I was still active. The VA did my disability claim and C&P exams a full year before my official discharge…again, I had no idea what was going on and didn’t know to ask any questions. So I’ve been paying out of pocket for surgeries and all of my healthcare because I didn’t know I was 100% covered by the VA.

It’s unfortunate, but I’m thankful to be headed in the right direction now. I’m at 82% and think I can easily get to 90%, but I’d take TDIU in a heartbeat since my conditions are permanent or only getting worse.

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You want to prove that you have a disability.  You don't want to show yourself doing a triathalon to show disability.  The VA might ask "Hey, if you can compete in a triathalon what disability do you have?"  If you had a picture of yourself limping with a crutch that would be better. This is just my common sense opinion.

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The disability I have is chodromalacia/osteoarthritis of my left knee. Since I left the service, that knee has continued to rapidly deteriorate. The point of showing me running with a knee brace is that I was in pain and trying to self-diagnose and treat. The onset of chondromalacia began while I was on active duty, which my understanding is the point of a nexus. Lots of veterans have rated disabilities and are not wheelchair bound, myself included.

Also, it was a sprint triathlon…which is a 3k…I struggled through 2 of them before giving it up entirely due to progressive bilateral knee pain.

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You need a nexus letter.  Dont expect VA to change the Caluza elements for you anytime soon.  The Caluza elements, required for service connection are:

1.  Current diagnosis of a disability.  

2.  Documentation of an in service event (you allege caused your disability).  

3.  Nexus, or doctor's opinion that your current condition is at least as likely as not due to one or more events in military service.  

Its shortened to 2 if you have an already service connected condion:

1.  Current diagnosis.

2.  Doctor's opinon that your Current diagnosis (newly applied for disability condition) is at least as likely as not related to your service connected disability.  (such as a result of medications for it, or, arthritis, if you injured a knee, etc).  

    The photo would help to establish Caluza  item number 2 (above, top) ...documentation of an in service event, but it does not prove your nexus.  

Your current disability could have been caused by stuff in the photo, by a car accident, or something entirely different later.   The photo helps document in service events, it does not provide a nexus in my opinion.  

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16 hours ago, john999 said:

You want to prove that you have a disability.  You don't want to show yourself doing a triathalon to show disability.  The VA might ask "Hey, if you can compete in a triathalon what disability do you have?"  If you had a picture of yourself limping with a crutch that would be better. This is just my common sense opinion.

I agree with john999. I would not give them anything that shows you running or exercising with a brace. I can almost guarantee that that VA will look at it and eater lowball your claim or deny it because the treatment you were getting at the time fix the problem. Hears what you need to look at.

Can you tell us what you were medically retired with? (list all of it.) The more information we have the better we can help.

1. Is there a in service medical record of you injuring your knee?

2. Have you been treated by the VA for your knee injury that you are claiming? 

3. It appears that you are treated for your chondromalacia / osteoarthritis by a non VA doc. This is very common condition as we age. (and abuse our knees) The question is will your doc write a Nexis letter saying it is more likely than not Grater than 50% that you R or L  knee chondromalacia / osteoarthritis was caused by your (Marching, combat boots, running in combat boots, or working on???) Your Nexis letter will have to state how you got injured. How it has worsened over time. And have to state;  "it is more likely than not Grater than 50% that you knee chondromalacia / osteoarthritis was caused by you service."

4. You will need a Disability Benefits Questioner, (DBQ) for a minimum of your knee. (maybe more than one) Most docs don't like to fill them out DBQ's because they are complicated and take to much time.

You might be able to secondary SC it to one of the reasons you were medically retired for.

 

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Ok thank you for your feedback. That answers my questions and it appears it’s definitely worth my time to get the nexus letter from an orthopedic surgeon. I had an MRI in 2014 (2 years after my medical retirement) that showed grade II/III chondromalacia in that knee, so my surgeon is comfortable in stating the wear and tear began several years earlier and was certainly aggravated by running, climbing up and down ladder wells and climbing helicopters.

My claim is currently entered as trying to s/c my knee just on its own. I’m already s/c for my right knee and both feet (pes planus) so I could connect my left knee as secondary to those, which it likely is anyways. Should I try to add a knee secondary to feet/right knee onto the current new knee claim in motion? I’ve not had very good VSO advisement on this and am desperately just trying to do this right the first time. Their opinion is to just try it and appeal if it doesn’t work, but this is very stressful and I have mental and behavioral health issues (also s/c) that I’m trying to work through in parallel to this claim.

 

So in case I babbled too much and made this confusing, my basic question is will the VA take a nexus letter stating my left knee is secondary to my service connected right knee and flat feet of the claim doesn’t specifically state it’s secondary? How do I fix this?

thank you again!

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