My primary care manager (PCM) put “knee brace use” in my record when I got a referral for MRI for me knee. Result: Torn meniscus and arthritis. For C&P exam I wore the knee brace and I have a permanent limp. The C&P examiner noticed my limp and brace right away and mentioned it. Glad I brought it and didn’t go “tough guy” mode.
Never go tough guy mode lol It just helps the VA so much. I got pissed when my doc for c and p mentioned something like “you can do it “ I bout lost my shit lol
Wow! Thank you so much VA Madness and the attorney on your show ! Excellent help for veterans on this issue! As soon as funds become available I’m buying a copy of your book! Once again ….. THANK YOU 🙏 🙏
Glad you liked the video; watch all three of my knee videos for the full knee story. If you need any specific advice, fill out the contact form at vamadness.com.
Thanks for all your videos. It took me years to understand the process and you have nailed perfectly. I try to get other to watch and learn from you. Thanks.
This is great information! I have my higher level interview this morning. Currently 10% for my SC knee overall and 10% for left knee flexion and extension. But 0% for others. I feel like my overall left knee should be at least 20% with patella and joint effusions, osteoarthritis. Now a recent meniscus tear in my SC knee. Very long history of knee braces from the VA. I’m 80% overall as I have a SC from my back rated at 40% and other stuff like HTN. So this video is very helpful when I want to make certain points with the Higher Level interview this morning. Thank you!
Glad the video helped. When there is pain on both extension and flexion, the minimum rating is 10% for extension and a separate 10% rating for flexion. If there is also instability a third separate rating for instability, in your case, 20% with a doctor prescribed knee brace. Keep fighting until you get what deserve.
@@VAMADNESS UPDATE: I think your information in this video made a difference! I was able to use your information intelligently and cite 5257 and 5258; history of instability, pain, effusion and knee braces issued by the VA which is clearly in my record. I also cited 5260 and gave her real-life examples. The HLR lady was very nice and it really is an informal phone call. So now the update on the same day I spoke with her is “The VA identified an error that must be corrected” and I’m waiting to see if they want anything else from me (supplemental claim) or what their next step may be. Thank you and your guest for this informative video! One of the best that I’ve seen that gives exact and useful information! I’ll keep you updated.
Veterans who have knee pain symptoms caused by osteoarthritis degenerative bone lost should tell their C&P Examiner about intermittent flare ups. Range of motion is measured with a goniometer to determine flexión however ROM can vary depending on fusion (inflammation). Crepitus a popping grinding sound is rated at 30%.
If you have questions or need any specific advice, just fill out the contact form at vamadness.com. PS: Check out my new book. Every veteran should read it: www.amazon.com/dp/B0CPTNRMD8
Just wondering, would a VA examiner have the veteran remove their knee brace for the ROM examination? Also, thank you so much for sharing your time and knowledge helping vets around the world!
I'm fairly sure a brace would have to be removed since the brace is for stability and the ROM measurements are not done in a standing position. Thank you. We vets must support each other.
A very detailed video! Thank you for posting. I got a little over-informed with so many medical terms and VA regs terms (that's on me, not you). A summation would be appreciated. 4 ratings possible for each knee with different min & max ratings? Please let me know if I got that much right.
Yes, as long as the facts fit four ratings are possible. If you have questions or need any specific advice, just fill out the contact form at vamadness.com.
My situation may add some context to 5257. I had a partial patellectomy while serving. It got a VA rating of 20% for chronic patellar chondromalacia. After 6 arthroscopic surgeries over 40 years to clean out the debris I had the knee completely replaced two years ago. That moved me up to an overall rating of 50%. Sadly, my TKR procedure has left me with a diagnosis of moderate lateral instability with pain behind the knee and limited motion due to that pain. The chief of orthopedics at my local VA prescribed and procured a very expensive brace and a quad strengthening program to hopefully reduce the instability and eliminate the pain. She does not think it will help in my case but it's the next step. The options after that are to partially redo the TKR either by replacing the middle insert with a thicker one or replace the femoral insert and middle insert with a different type, in essence re-do the TKR. I filed a claim for instability (should be of the 20% variety) and have my C&P appointment very soon.
Eugene, Appreciate your response and offer to call you. Before I do that, let me lay out the scenario. Assuming I can get approval for either my knee or my back, should I chose one and focus on it and use the other as a secondary? Or is it better to do both. If yes on one claim, which one would be the best one to go for. I have Mil STRs for 1982 back injury, L1 & 2 compression, and knee injuries in 1968 and 1977. BTW, having difficulty finding doctors in Central Florida area who will do DBQs or IMO's.
Always file all claims you want to file at the same time. Since there are in service events for both the knees and back, they are both directly related to service. Typically, treatment providers will not fill claim related forms/opinions; however, mostly these forms/opinions are not needed.
@@VAMADNESS Eugene, Thank you and as always your advice is filled with experience and good common sense. As I receive more copies or my mil STRs and my civilian records and go through them, I realize that first of all no one can really understand the writings/scribblings of doctors. However, I have found references to headaches, "pain experienced in chest after eating" and shortness of breath. I already have a post service private gastro doc who has diagnosed me with Barrett's Esophagus so perhaps I have a GERD claim.
@@JamesNorman-g1i Sounds like you may have a GERD claim. If have questions or need any specific advice, just fill out the contact form at vamadness.com.
Interesting. 5258 "Locking" semilunar cartilage. I had the locking before my Arthroscopic surgery. My surgeon said that the meniscus was torn so bad that it would fold into itself and cause the locking. I actually started having my knee started giving out after surgery. I am still sitting at 10 percent to this day. Thanks for the information.
@@VAMADNESS I did search your site and used the language from your form to help me formulate my statement. I submitted my new claim last Thursday. I had my C&P yesterday with LHI. I used your trigger words to describe my condition. I eagerly await the results. I may reach out if you do not mind to help me understand the decision. I appreciate everything you do, say and post. It helps us old vets try to navigate this system. Thanks
What I went to my C&P. exam with 2 weeks ago but 1st: 2017 got 10% on knees after 0% in 2016 when I got 60% for failed hernia surgery. Im approved for a full knee replacement by VA surgeons hopefully in Jan 2025. C& P was for worsening knee. I brought my cane & brace issued by my pcp. I made copies of all my knee related sickbay calls in service documented. Next my personal statement which there are videos on I wrote & rewrote it about 4 drafts. The goal was to document how my knee pain affects my day to day life actually had to quit my construction job after 25 yrs. Next documentation of my civilian knee surgery - medial meniscus. Copies of everything the VA has on my knees mris x rays doctors reports ANYTHING. it all makes an airtight case they cannot refute & dispells any notion of any bullshit. Hoping for the best. I did my job of being very VERY thorough.
This response is not intended to be legal or medical advice. I am not a lawyer, medical professional, or claims agent. Per my personal knowledge and direct experience, knees are really pretty simple to get rated properly. Knee limitations of motion ratings are fairly hard to get per a measurement. Hopefully your statement, accounted for and described flare-ups in a way so a proper flare-up estimate can be assigned by the examiner. The estimate is often how a limitation rating is attained. For instability you either have the required tissue damage or you don’t. Same principle for meniscus, you either have a meniscus issue with pain, swelling, and locking or you don’t. I’ve got my fingers crossed for you. Let us know what happens.
I have locked knee and 30 degree movement forward or back. Plus instability and pain.The other night I fell when my dog tried to chase a cat my left knee went out.Then I hurt my right knee
Very good information, I had three nexus letters one from a VA NP and two by private Doctor’s for left knee secondary service connected right knee overcompensation wear and tear and it was denied. The rule of benefit of the doubt in on appeal. Flare ups are rarely mentioned by Veterans. Today my range of motion maybe limited and a few days later I may have full ROM, how is ROM measured with a goniometer in this case?
Most nexus letters don’t provide the thorough medical rationale required by the VA. One knee causing problems with the other knee is typically denied by VA at the regional office level. Very often this type of claim ends up at the BVA. If your nexus letters are adequate, you will eventually win the claim. Most veteran do actually site flareups as a factor; however, they do not explain their flareup limitations properly. Watch part 1 of my knee video series and review the knee statement posted on vamadness.com to ensure you are properly rated. If you have any specific questions fill out the contact form at vamadness.com.
I have 10% and 0% for both knees and they both have pain with rom in both directions. I also have instability in my left knee which I was given a rigid brace. I was also given a knee brace for my right knee that is also hinged, and is also considered ridged.
Well, it all depends. As noted in my knee videos, there are four possible separate ratings for a knee; two are per ROM limitations. One for instability and one for meniscus dislocation/removal; however, your symptoms and diagnoses must also fit. If nothing rates but there is pain then a 10% rating is given. Only if the facts fit, can you get these ratings. If you have questions or need any specific advice, just fill out the contact form at vamadness.com.
This is for my knees. I have issues with instability, flexion, extension and pain in both knees. The symptoms are slightly different in each knee. As it sits now I have several contentions lined out for the knees. I have not submitted the claim yet. They are as follows: -Left knee limitation of flexion -Left knee limitation of extension -Left knee instability -Left knee condition painful motion -Right knee limitation of flexion -Right knee limitation of extension -Right knees instability -Right knee condition painful motion Or should I just combine it all under bilateral Knee condition? I have written personal statements for each symptom of the knee. In my statement I include pain location, pain level, frequency and severity of symptoms and I explain how my job impacted my knees and how the knee condition affects my social and occupational life. How would you present it and is this a pyramid if I am reporting seperate symptoms for 1 body part?
The best way to ensure you get properly rated is with accurate information on the possibilities. My knee series answers your questions. Watch part 1, 2, and 3 of the knee video series as they explain exactly what’s what about knee claims. If you have questions or need any specific advice, just fill out the contact form at vamadness.com.
Hello Eugene so glad I found your Utube great content. I am rated 10% on left and right knee degenerative joint disease ,10% right ankle for degenerative joint disease and tinnitus 10% . The VA has given me knee braces for each and an ankle brace that I wear daily , will this help me to get an increase? Thanks again
Greetings, great video!! Question: If you claim knee instability only and have other conditions would the total knee be evaluated during the C&P exam? Would you recommend claiming all conditions for your knee upfront?
If you have several knee conditions, there isn’t a need to list them separately; however, you certainly can call them out. I typically call out my key documents in my statement. You can claim “Knee problems. See medical documentation.” Just make sure VA has your medical info or access to your info. The exam will evaluate your knee and the medical information of record. Ensure you watch all part 1, 2, and 3 of my knee video series. If you need any specific advice, fill out the contact form at vamadness.com.
This response is not intended to be legal or medical advice. I am not a lawyer, medical professional, or claims agent. Per my personal knowledge and direct experience, be assertive. The goniometer is typically used; if it’s not, tactfully inform the examiner it is required. That should resolve the issue. If it doesn’t, then report the situation to the VA.
I had a botched lateral release that causes instability and led to a plica. The plica caused instability with locking and buckling. It led to my severely broken ankle which is now secondary.
I'm sorry to hear of your situation, but at least you have the ankle as a secondary. If you need any specific advice, fill out the contact form at vamadness.com.
This will be my third supplemental for the same knee. Do I need/should I include va case law or the like? Va c and p examiners have failed twice to measure extension movements in my knee with history of torn meniscus.
This response is not intended to be legal advice. I am not a lawyer or claims agent. Per my personal knowledge, VA regulation states that measurements must be taken, so caselaw isn’t needed. Actually, I doubt there is any caselaw that applies as the government would never challenge the fact that measurements must be taken. Also, due to VA incompetence, it’s normal to file for the same issue repeatedly. It’s called being on the VA hamster wheel that keeps veterans running in place without positive results.
My knee is killing me, my Dr gave a knee brace a yr ago and my pm Dr installed a StimWave unit for pain, which isn’t working that great, I can hear the crunchy when I move it, I pop it out in basic and they wanted to do surgery, but I wasn’t ready, now I’m!
Thanks for all your videos, very helpful! My Physical Therapist gave me knee braces for both knees and a cane, can I get 20% or do a doctor have to prescribe the knee braces?
For the 20% the rating schedule states “medical provider prescribes a brace and/or assistive device (e.g., cane(s), crutch(es), walker).” The key words are “medical provider” and “prescribes.” The physical therapist certainly seems to qualify as a provider and if some sort of paper work had to be completed by the physical therapist to get you the braces and cane that likely qualifies as prescribed. The 20% also must involve a sprain, ligament tear; or surgical repair of the quadriceps tendon, the patella, or the patellar tendon.
I have arthritis in both knees but, was only awarded 20% for right knee and denied my left knee. Right knee was direct service connected. Do you have any suggestion how to connect to my left knee disability?
I didn't see a link posted to examples cases from the veterans board of appeals and how they apply this from you speaker. It would be very interesting if he did....thanks
Here is the link www.index.va.gov/search/va/bva.html; however, it isn’t working today as is often the case with government websites. These decisions are informational only and are not evidence for use in other cases.
I have been 10% for 5 years, I have lost almost all flexion. Had it reassed and was told I could only get a higher rating if I needed a knee replacement.
As noted in the video, flexion can be rated to 30%. Ensure you watch part 3 of my knee video series to learn about increases. If you have questions or need any specific advice, just fill out the contact form at vamadness.com.
This response is not intended to be legal or medical advice. I am not a lawyer, medical professional, or claims agent. Per my personal knowledge and direct experience, instability is a separately rated condition. This fact is explained in detail in this video, ensure you watch this video to learn what’s what with knee ratings.
I have SC bilateral arthoplasty, rated at 40% per knee. My left knee, 2 yrs after replacement, popped out of joint. The VA gave me a knee brace for instability for this post-surgical new knee. Am I able to get another rating for the brace on top of the rating for the arthoplasty? BTW, the knee brace validated a VA clothing allowance for new trousers.
I'm a newbie at this. I'm 73 year old and served as paratrooper with the 82 nd Airborne Division from 71 to 63 . Had both knees replaced have a bad back, as a fact I'm going to Walter Reed Hospital on the 5 th to see a Neurological surgeon. I recently started the process to apply for disability. My question is is it better to go to a law firm specializing in VA disability or use a vso at the County or at a VFW
Lawyers will only take cases after claims are denied; thus, lawyers are not an option during the initial claim process. VSOs, county or service organizations, may be helpful when filing claims dependent on the expertise of the particular person assigned to your case. It’s best to educate yourself on the process as much as possible on the internet. Generally, service connecting a disability requires three elements; (1) a current diagnosis, (2) an event in service, and (3) a medical nexus (link) between the event in service and the current diagnosis. The nexus is typically provided at the C&P exam if the other elements are present. As long as the issue started in service, symptoms continued after service, and you have a current diagnosis, service connection is likely. A relevant and detailed personal statement is the foundation of a claim. Statement examples are available to subscribers to my website vamadness.com.
When a private Doctor ask for medical records from the VA to write a nexus letter. Does the VA also send the C&P exams done or does the Doctor have to ask for them ? Thank you, Sir..
The VHA (healthcare) is responsible for handling veteran healthcare needs: they are not connected to the VBA (disability benefits). A request to the VHA will not get any disability benefit information such as a C&P exam results because the VHA does not have any disability benefit information on file. You will have to get a copy of your C&P exam results from the VBA to give to your nexus writer.
I'm new to VA claims and I'm seeking some clarification. My VSO wrote a claim: "Bilateral knee condition." My C&P exam is soon. The knee has instability; pain; arthritis; and a meniscectomy. Four different things. Will the examiner turn the "Bilateral Knee Condition" claim into four separate claims during the exam or is that the responsiblity of myself and the VSO? I'm worried my VSO was too vauge and I don't understand if their original claim was supposed to be vauge and it gets more specific and split up throughout the investigation/examination.
This response is not intended to be legal or medical advice. I am not a lawyer, medical professional, or claims agent. Per my personal knowledge and direct experience, your VSO did OK as far as the claim description entry. Hopefully, you filed a detailed statement with the claim explaining exactly how your knee issues are related to service and reported all of your knee symptoms and functional limitations. A statement should also include a description of your increased problems during knee flareups in reference to ratable issues per the rating schedule. A VA medical examiner is required to read your statement. Also hopefully, you submitted your knee medical records or give VA permission to access your records. Your service medical records, post service medical records, and statement should contain all the evidence you need to get the claim approved and rated properly.
I had a Total Knee Replacement on my left knee. Which was the better knee. In April of 2020 by the VA but was not given any convalescence. Even though I have had pain in movement and resting on occasion. And I have had my knee give out or lock up from just standing. And they will not operate on the right knee because i
I was kicked off mid statement. The VA will not operate on my right knee even though it has continually gotten worse and the braces have not worked and has made it difficult to maintain employment. It has been now 3 years since my TKR and have not been able to work and as a result now Homeless. And have not been able to get ANY ASSISTANCE from the VA or it's affiliates. What can I do? And that doesn't even include my eye issues from a virus contracted during my tour to the Philippines where I almost lost my eye.
@@theRoyalOne2U If your knee is service-connected, convalescent pay is authorized if the recovery period is at least 30 days. You need to file an application for benefits to get the convalescent pay. Keep in mind, compensation benefits require the condition be service-connected. If you believe your issues are related to service file an application for benefits. VA also offers a pension for eligible veterans. Most VA hospitals have veteran service representatives that can assist you in applying for benefits. The VA has programs for homeless veterans, so see the social worker at your nearest VA facility to see what benefits are available to you in your area. If you need any specific advice, fill out the contact form at vamadness.com.
I have a c/p for my hip on Friday…if connected, i need to claim secondary insomnia or whatever it’s supposed to be! I cannot sleep due to pain in my knees, but hips more than anything…where do i start 😢
@@kitana370 It is certainly possible to have insomnia secondary to pain. Seek treatment if you haven’t for your own peace of mind and you’ll need a diagnosis for the claim. Insomnia is considered a mental health claim. If you need any specific advice, fill out the contact form at vamadness.com.
Hi. I have 2 - 10% and 2 - 0% ratings bilateral knees. I have 2 - 10% and 4 - 0% for bilateral hips. One of my C & P examiners noted my tears in both knee meniscus' but started it wasn't service related because the diagnoses that I have for my knees couldn't have caused the tears. Does this seem reasonable?
To be properly rated for any issues, you need a diagnosis; thus, to get the shin rated you need a shin diagnosis. Logically, you should have filed the claim as a shin claim. Shin splints are on the same DBQ as the knee, so things may workout fine; however, if you filed the claim without a shin type diagnosis, you can only hope the VA examiner will issue a diagnosis. This a far from certain. Mostly, VA examiners do not issue new diagnoses at C&P exams, but it is possible.
This response is not intended to be legal or medical advice. I am not a lawyer, medical professional, or claims agent. Per my personal knowledge and direct experience, a statement should be submitted with the knee claim as it is your opportunity to say your piece. Filing a statement is optional; however, it is really the foundation of the claim. Typically, a VSO will not assist you in writing a statement and, for a reason I don’t understand, VSOs rarely advise a veteran to write a statement. If your claim was filed recently, it’s not too late to add one to the record. You can upload a statement at VA.gov or give it to your VSO to submit.
Eugene, Getting ready for my hearing and tinnitus C&P exam and I have a question. I have mil history of 10+ continuous years of range time w/ weapons up to 185 decibels. Have private ENT doc hearing test with "more likely than not" nexus statement for hearing loss and tinnitus. . Also have VA hearing test and I have been issued hearing aids. Now, since I have VA hearing aids and if the C&P says its service connected, will I get compensation or, is my hearing loss compensation just a pair of hearing aids? Does the VA consider hearing aids enough compensation?
As a reference [oint for others. The C&P PTSD teleconference went reasonably well. Login instructions were clear and easy to follow. The Doctor allowed my wife to be in the room as a witness. Took about 30 minutes and she asked about 14 questions. Typed in my responses as I gave them. closed with a reminder that if the claim is approved, I can expect a reconnect from the VA in about 12 months. With that in mind, I did my after action report and gathered all of my presubmission notes, etc. and filed them away. I recommend you not toss aside anything that you used to prepare for the claim or the C&P exam.
Hearing loss can and does get ratings depending on the hearing test results. Winning the claim is dependent on the hearing test results from your military separation physical. There must be documented hearing loss in service to get service connected.
Watch my arthritis video to understand arthritis ratings. The short answer is, it’s unlikely the arthritis will have any impact on your rating. As explained in the video, you either have the problems that qualify for one of the 4 rating types or you don’t. Also, as explained in the video, ACL and a meniscus issues could possibly get separate ratings depending on your symptoms. If you decide to file for an increase, ensure you file a detailed relevant statement. Statement examples are available at vamadness.com. Don’t forget to check out my book: www.amazon.com/dp/B0CPTNRMD8.
My three knee videos point to every relevant fact in knee claims. Watch all three to learn these facts and if the doctor’s notes callout these facts, then include them with your claim. A DBQ will be filled out at the C&P exam, but if you want to get your own completed that’s fine; however, it won’t necessarily help your rating.
Hi had a 10% then had an update had a torn ACL had. Surgery to repair the acl in 2010 now I am at 20% I feel that I’ve been very under rated they also cleared up so arthritis in the knee also my left knee has become unstable from using it more my right knee has buckled and is very unstable and painful my walking is limited time and speed is reduced by 1/2 standing in line is tiring and painful using stairs up or going down is very slow and painful don’t know if the knee is going to hold or buckle
Ensure you are using an assistive device in case your knee does give out. As noted in part 2 of my knee series, four separate ratings are possible on a knee depending on the situation and evidence. In part 1 of my knee series, I talk about the importance of a statement which ensures a proper rating. In part 3 of my knee series, I discuss the C&P exam and increase ratings. Following my advice as presented in the videos will eventually get you properly rated. If you need any specific advice, fill out the contact form at vamadness.com.
You will have to be enrolled in the VA healthcare system and coordinate with your VA primary healthcare giver to get a brace. I don’t know if VA outsources orthotic devices, so you may have to go to a VA hospital to get the brace. Call your nearest VA clinic/hospital to find out the exact procedure. If you want to help build a better VA, don’t forget to check out my book: www.amazon.com/dp/B0CPTNRMD8.
Just started medboard process for ACL, PCL, and MCL reconstruction on my left knee. Do you think I can get 30 percent for my left knee considering I have a brace prescribed to me?
As noted in the video there are four possible separate ratings on a knee. Instability with a brace alone is a 20% rating, so if you are also rated for ROM or painful motion you should get to 30%.
I am 20% but wonder about the "bilateral factor" which is supposed to add 10% when 2 joints are involved. Also I read one decision where the BVA told the RO to rate the "bakers cyst" of the Veterans knees separately. Most knees with bakers cyst have internal derangement cartlidge etc.
The bilateral factor is for paired upper or lower extremities, but not for one upper and one lower. A right knee and a left elbow would not get the bilateral factor. As explained in the video there are four possible ratings. 2 ROMs, instability, and meniscus. A Baker's cyst is no different from any other knee condition if it affects ROM or causes painful movement it will be rated. There is no separate special rating for a Baker's cyst.
I was rated at 10% per knee back in 98. I have pain regularly... Right knee been scoped. I stumble often. Does it mean I should request a new re-evaluation? Brace!!! The VA sent me some for each leg. Crazy
Absolutely file an increase. If you have painful motion on both the extension and flexion motions you get 10% for each motion plus 20% each knee for instability with a knee brace. That’s a 10%, 10%, and a 20% for each knee. Make sure you watch both of my knee videos (part 1&2). Plus watch part 3 that I will be releasing in a few days.
If you were a cadet under title 10 rules, can you be awarded a claim due to knee injury while exercising during your time off? Should I not even bring up the damage I had due to exercise in my off duty time?
So can we just file a new claim on the range of motion instead of filing a CUE claim? Cause I only have 10% for both knees mind you there labeled “strain”and I have so many of these symptoms buckling pain in both ranges of motion numbness down to my knees.
What to do is dependent on several factors; if you are outside of your appeal period, you can file an increase. To know if VA made a mistake or not, you’ll need a copy of the C&P exam results. If there is a mistake and you are within your appeal period, you contest that mistake per your appeal options; however, if you are outside your appeal period, file a supplemental claim with new and relevant evidence or a CUE. Most VA errors are not CUE. Your exam results will determine what’s what. If you need any specific advice fill out the contact form at vamadness.com.
What can I do if my VA doctor misdiagnosed me. For almost 3 years I was told that I had costochondritis but it turned out to be Ovarian Cancer. Is there a type of attorney that I can reach out to? I've tried several but no one wants to do the representation. Any information will greatly be appreciated.
There are lawyers that handle VA medical malpractice cases that you can find per a google search. The key to getting representation is if your situation will lead to a positive outcome; both in winning the case and a substantial monetary award. My own experience tells me that if your case of misdiagnosis has caused you permanent residuals, you should be able to find a law firm to take your case.
Just went had meniscus surgery that was service connected but now I feel a lot weaker on both sides and was presicribed a brace before and can you give me a estimate on how much I get ?
It really depends on your symptoms; if there is locking, then a 20% rating is possible. If the meniscus has been removed and it is painful even when you are idle, then a 10% is possible. If you need any specific advice, fill out the contact form at vamadness.com.
I had my C&P exam for insomnia the physiologist ask me was the insomnia caused by my depression or my knee pain and tinnitus. I said the insomnia was caused by knee pain and tinnitus, so will I get insomnia secondary to my knee pain and tinnitus
Insomnia claims are often won secondary to service-connected conditions that cause pain. Service connection and ratings are two separate issues. Regardless of why you have insomnia, insomnia is typically rated under mental health; thus, if you already are rated for a mental health condition you will not receive a separating rating for insomnia.
I’m curious about TKA revisions, and if they’re rated. I had a LTKA in 7/2021, and a revision on 1/5/2023. The Surgeon found not only a lot of scar tissue, but also Polyethylene wear. Is this ratable?
Knee ratings always follow the rating schedule; hence, all issues are compared to the schedule. Knees are rated per ROM, meniscus problems causing locking, ligament/tendon/kneecap problems causing instability, and in the case of knee replacements severe pain/weakness. The scar tissue and polyethylene wear problems are compared to the rating schedule in the same manner as any other knee issue. For example, if the scar-tissue/polyethylene issues cause ROM loss resulting in a higher rating than your current rating then the higher rating would apply. If you need any specific advice, fill out the contact form at vamadness.com.
A successful knee replacement is typically rated at 30%. Sometimes I do still see instability rated in conjunction with the replacement. Keep in mind if you have a brace prescribed the rating will be 20%.
Thank you for your video!!! wonder if anyone know if it is worthwhile to file a claim on my knee. They went through my medical for another injury and they noted that my knee surgery twice wasn't claimable due to it happening on a basketball court. I was speaking with a friend and he said that the injury could have been caused on the court but my knee could have been weakened due to the type of work I was in. Jumping in and out of semi trucks; roughly three feet and climbing in all day. just curious.
both operations removed cartilage. second one was I guess to clean up what they missed as my knee was still locking up. And now popping and near locking but pops like a knuckle.
Hi Eugene, I'm rated at 30% for one knee and getting treatment for the other, I would like info on filing secondary for the other, do you think that you could give me some insight?
The theory is that favoring the injured knee causes an over use injury to the previously non-injured knee. VA typically denies this type of claim, so you will very likely need a good independent medical opinion to win the claim.
@@VAMADNESS Thank you for the quick response. One more thing, I had a torn ACL and I’m rated at 30% overall between the two knees. I recently had an MRI, the pain and locking got to be too much, which revealed I have no cartilage, bone on bone. I have my C&P exam tomorrow. Any suggestions? I’m 70% overall. Thank you again for what you do for us.
@@clarencedolan699 If you have not watched my latest video "Winning VA Compensation For Knees Part 3: the Knee C&P Exam and Knee Increases" watch it now.
Well, the chronic residuals are clearly noted on the schedule: “severe painful motion or weakness.” If you claim you have one or both of those residuals and the medical examiner agrees, you’ll be rated at the 60% level. Keep in mind, severe painful motion and severe weakness are not defined on the schedule. You must, through your statements (both written and verbal) convince the medical examiner of the severity of your pain and/or weakness. If you have questions or need any specific advice, just fill out the contact form at vamadness.com.
Hi I have a question regarding my claim that submitted in 2016. The va didn't give me a rating for my knee that I hurt several time in the navy. I even had surgery. I submitted a new claim with the DAV. I va says that I need to send in 20-0995 form. Should I try filing all over again or should I just hire a lawyer and let him do all of this and maybe I could get back pay from when I was turned down? Plz help
Any claim that has been denied in the past can only be readdressed on a supplemental claim, so the VSO filed the wrong form. Just file the right form now; if you haven’t properly prepared your claim, you may still have problems getting service connected. Ensure you watch all three of my knee videos and prepare a detailed statement. If you win, it’s unlikely you’ll be able to get the claim back dated; however, dependent on your exact situation it is possible. If you need any advice, just fill the contact form at vamadness.com and I’ll be happy to advise.
If you are rated for knee instability, a prescribed brace will grant a higher rating. A brace is only relevant in getting a higher rating and has nothing to do with service connection. Don’t forget to check out my book: www.amazon.com/dp/B0CPTNRMD8. The book is about fixing the VA so all veterans can be better served.
Then the the denial is easily overcome by simply pointing to the entrance exam results. No need to address aggravation. If you are within the appeal period, just file an HLR.
File for an increase. Ensure you watch part 3 of my knee video series and write a good increase statement per my increase example posted at my vamadness.com. If you have any other questions, fill the contact form at vamadness.com.
@@davidmedrano709 For shoulders the dominant side may be rated higher than the non-dominant dependent on what the examiner determined. You would need to have your C&P exam results to know if the dominant side was properly rated.
As noted in the video there are four possible separate ratings for a knee; you either have the ratable problem on exam or you don’t. You either have the required diagnosis or you don’t. You have the corresponding symptoms or you don’t. A rating will not come from how you file. Follow the advice noted in all three knee videos and you’ll be fine. If you have questions or need any specific advice, just fill out the contact form at vamadness.com.
This response is not intended to be legal or medical advice. I am not a lawyer, medical professional, or claims agent. Per my personal knowledge and direct experience, VA does not assign separate ratings for painful flexion and painful extension. The lawyer in this video does same to indicate that it is possible; however, I have never seen that happen nor have found any cases where it has been awarded. I have found cases where flexion or extension was rated as limited and the other function (flexion or extension) was rated as painful motion.
So I had a full knee replacment on April 1st. They only gave me only 4 months. They rated me at 10 percent following my convo rating. Question I have is they called it a resurfacing and not a replacment. Is there a difference. According what I am reading I should have atvleastb30 percent and not theb10 They awarded me.
The 30 minimum rating only applies to actual knee replacements: in other words, the knee was replaced with a prosthetic. If you know for sure a prosthetic replaced the knee, then just file a higher level review stating that. The rating schedule states “evaluate resurfacing under diagnostic codes 5250 through 5255; there is no minimum evaluation for resurfacing.” To know if you were rated properly, fill out the contact form at vamadness.com.
@@VAMADNESS I get confused about there verbiage. So they cut off the head of my femur replaced the entire end with titanium cut the top of my tibia off and put a piece of titanium in it and placed plastic between them. The only bone left in my knee is half of the knee cap. The back of it was ground off and a titanium plate was installed. I am rated at 100 percent already but not P&T. They say I need follow up for my knee as a resurfacing. Not sure what they consider my knee.
@@markberenbrok627 Defining a total knee replacement is medical call. We lay people don’t get to say; however, googles note a total knee replacement as “all 3 compartments of the knee are replaced with a metal alloy and polyethylene implant system.” In your case, you note the patella was not replaced so this could be the problem. It may help if you talk to your doctor to get a proper definition of your procedure.
It’s actually not a court case, it’s a VA General Counsel memorandum. Just google VAOPGCPREC 9-2004 and you’ll find it. In other words, veterans have been getting screwed on their knee claims since that determination was made. VA knew what they should be doing, but made no effort to follow the memorandum in awarding ratings. Shame on VA.
After receiving a TKR and 5 mo at a 100% the rating automatically reduces to 30%. My question is how long will the 30% remain in effect? Is that a lifetime/permanent decsion?
Let me ask one more?. I also ask this same ? to Combat Craig. IF my prescribed meds help keep my diagnosis at bey can/will they canc my Pct. Example: 1) meds for a mental diagnosis, 2) meds for a physical diagnosis.
@@guyshort2649 Generally, ratings are determined at the C&P exam or private exam typically per a DBQ: thus, during a VBA re-eval or a veteran requested increase VA can lower your rating if the condition improved. Why the condition improved, through meds or whatever, is irrelevant. Ratings held for five years must show sustained improvement to be lowered; 100% ratings must show material improvement to be lowered; and rating held for 20 years cannot be lowered. If you need any specific advice fill out the contact form at www.vamadness.com.
Certainly, there is articular cartilage at the knee joint; however; it is not separately ratable as a knee specific claim which is why we do not mention it on this video. Articular cartilage problems, like arthritis, will only be rated if no other knee codes apply. See my arthritis video for a full explanation. The meniscus is separately ratable as a knee specific claim.
@@Johnny-ow4ph There are two measurements and two estimates: you get the highest of the four. If you have any specific questions fill out the contact form at vamadness.com.
Question: Why do people with knee issues get rated for 5260 instead of 5256? The percentages are completely different. 5256 pertains to the knee specifically but I see most people here referring to 5260
I know how it works without even watching this video. If you have arthritis in your knees and can’t walk without limping, it’s 10%. It takes an act of God to go higher. If you get a total knee replacement, it’s 30% with 4 months worth of 100% back paid to you if everything is going like it should.
For the most part you are correct; however, many veterans do not report their flare-ups in a way for a reasonable flare-up estimate can be made by the examiner. A good flare-up description often does result in a rating higher than 10%. Also, many veterans do not get MRIs, so they do not qualify for one or more of the other possible knee ratings. For veterans with significant mobility problems, a loss of use SMC rating may apply. Typically, for veterans with no instability, no locking knees, no ROM problems, and no mobility problems a 10% rating for painful motion is the likely rating.
Actually, you are incorrect. General Counsel memorandum VAOPGCPREC 9-2004 held: “Separate ratings under DC 5260 (leg, limitation of flexion) and DC 5261 (leg, limitation of extension), both currently codified at 38 C.F.R. § 4.71a, may be assigned for disability of the same joint.” I thoroughly fact check anything I say on all of my videos. My words and claims are as good as gold.
@@VAMADNESS same joint for functional loss yes they are rated separately but painful motion alone can be rated either for flexion or extension separate ratings for ONLY painful motion for DC 5260 and 5261 would be pyramiding
@@hggfu I don’t disagree with your interpretation, which is why on part-1 of my knee video series I tell veterans how to document their functional issues on a detailed statement. Pain always includes some type of functional loss: the key is to ensure VA knows the details per a statement. Also, I rarely see veterans with joint problems with full and complete ROM as measured or per flareups. Any degree of ROM loss is functional loss even if not ratable. Keep in mind, pyramiding determinations at the BVA are inconsistent: one judge may say it is pyramiding while a different judge would say it isn’t. Never accept an RO decision disallowing separate rating for flexion and extension when the record notes pain for both and any type or degree of functional loss for both. To end this question, I’m filing an increase for my knees and hopefully the RO and BVA will disallow separate ratings: then I’ll appeal to the CAVC and get a final answer. In any event, I’ll share the results in a video.
@@VAMADNESS but what you're not understanding is the VA will not compensate painful motion as separate ratings alone. So you will get painful motion for either extension or flexion but not both. However just because painful motion may cause limitation of motion or affect your range of motion doesn't mean you can get painful motion for both flexion and extention. What people fail to realize is there is a pecking order for all joint issues. The VA looks to compensate you first for limitation of motion, then painful motion, (provided that there isn't any limitation of motion) then finally arthritis. For example if you have a knee injury and you tell the examiner you have painful motion of flexion and extention and after the examiner examins your knee with flare ups it's determined your knee is 60 for flexion and zero extention.(gonimeyer readings) So you will be rated zero percent for limitation of flexion as 60 Is a noncompensable rating for limitation of flexion however though you have a zero for extention they will give you 10 percent for limitation of extention due to painful motion. Notice the VA did not give a 10% rating for painful motion of flexion because you received 10% for painful motion for extention and to do so for flexion in this example would constitue pyramiding. Finally pyramiding is cut in dry found in 38 CFR 4.14 and the VA, RO BVA will not compensate for symptoms that overlap its not a matter of misinterpretation and it's pretty straight forward. If your examiner says your symptoms overlap then your ratings will be combined, it's that simple. This also include mental disorders respiratory disorders digestive disorders. If the symptoms overlap they will be combined and the higher evaluation will be given to the veteran. But for the knee again, if you have painful motion on flexion and extention and everything else is normal.(range of motion) then you will get 10% for painful motion for only one condition.
@@hggfu Pyramiding determinations are far from set in stone. In preparation for an upcoming foot video, I’ve reviewed 20,000 BVA decisions dealing with foot code pyramiding. There is no consistency whatsoever. I was actually shocked to see what some judges are allowing. Look for yourself, don’t take my word for it. What I’ve learned is virtually anything is possible at the board. I am a person who likes rules. Well written rules make for consistency. VA makes bad rules: leaving open the door for wide-ranging interpretations; a virtual paradise for lawyers. VAOPGCPREC 9-2004 determined separate ratings for extension and flexion are allowed without addressing how painful motion fits into the equation; thus, leaving the door wide open for valid arguments for separate rating based on painful motion. This notion is supported on the knee DBQ that specifically asks if there is painful extension and if there is painful flexion. If only one rating for painful motion was possible, the question should simply ask if there is painful motion: the fact that both flexion and extension are painful would be completely irrelevant. I think we have to agree to disagree on this one until we get a court ruling on the question to settle the matter. I am enjoying our conversation.
My primary care manager (PCM) put “knee brace use” in my record when I got a referral for MRI for me knee. Result: Torn meniscus and arthritis. For C&P exam I wore the knee brace and I have a permanent limp. The C&P examiner noticed my limp and brace right away and mentioned it. Glad I brought it and didn’t go “tough guy” mode.
Hopefully the examiner noted the limp and brace for the record.
@@VAMADNESS she definitely did. In fact she mentioned it as she was reading the doctor note about need for a brace, which was reassuring to hear.
Never go tough guy mode lol
It just helps the VA so much. I got pissed when my doc for c and p mentioned something like “you can do it “ I bout lost my shit lol
I’ve had two c and p exams and neither performed an extension test. Currently service connected at ten percent. Is it required to do extension tests?
Great video, wish I had this info 5 years ago...you have outstanding info enjoy all your videos I'm now 100%P&T
OMG, by far the best video on UA-cam! Thank you Sir.
You’re welcome. Don’t forget to check out my book: www.amazon.com/dp/B0CPTNRMD8.
Great video, preparing for knee c&p exam on 2.28.24. Using a lot of your information
@@bulldog9479 Make sure you watch my other knee videos to learn all you need to know about knee claims.
Wow! Thank you so much VA Madness and the attorney on your show ! Excellent help for veterans on this issue! As soon as funds become available I’m buying a copy of your book!
Once again ….. THANK YOU
🙏 🙏
Great job on bringing on an expert guest speaker about knees! 📚
Much love and appreciation for this post!!!
You guys rock!!!
Glad you liked the video; watch all three of my knee videos for the full knee story. If you need any specific advice, fill out the contact form at vamadness.com.
Great info and I very very very very much like how straight forward you are in your speaking skills !!!!!!
Thank you. I do my best to support my sister and brother veterans. If you have any specific questions, fill out the contact form at vamadness.com.
Thanks for all your videos. It took me years to understand the process and you have nailed perfectly. I try to get other to watch and learn from you. Thanks.
I’m glad my videos helped. If you, or other veterans, have any specific questions fill out the contact form at vamadness.com.
This is great information! I have my higher level interview this morning. Currently 10% for my SC knee overall and 10% for left knee flexion and extension. But 0% for others. I feel like my overall left knee should be at least 20% with patella and joint effusions, osteoarthritis. Now a recent meniscus tear in my SC knee. Very long history of knee braces from the VA. I’m 80% overall as I have a SC from my back rated at 40% and other stuff like HTN. So this video is very helpful when I want to make certain points with the Higher Level interview this morning. Thank you!
Glad the video helped. When there is pain on both extension and flexion, the minimum rating is 10% for extension and a separate 10% rating for flexion. If there is also instability a third separate rating for instability, in your case, 20% with a doctor prescribed knee brace. Keep fighting until you get what deserve.
@@VAMADNESS UPDATE: I think your information in this video made a difference! I was able to use your information intelligently and cite 5257 and 5258; history of instability, pain, effusion and knee braces issued by the VA which is clearly in my record. I also cited 5260 and gave her real-life examples. The HLR lady was very nice and it really is an informal phone call. So now the update on the same day I spoke with her is “The VA identified an error that must be corrected” and I’m waiting to see if they want anything else from me (supplemental claim) or what their next step may be. Thank you and your guest for this informative video! One of the best that I’ve seen that gives exact and useful information! I’ll keep you updated.
Great video!!!! Preparing for c & p exam on knees on2.28.24 and using information learned from here for the exam
Best of luck!
How did it go?
Did you get a more than one rating for your knees
Great info my knees are killing me as they were while I was on active duty. I am going to reach out to you. Thank you for the share ✌🏾
Veterans who have knee pain symptoms caused by osteoarthritis degenerative bone lost should tell their C&P Examiner about intermittent flare ups. Range of motion is measured with a goniometer to determine flexión however ROM can vary depending on fusion (inflammation). Crepitus a popping grinding sound is rated at 30%.
Thank you for your comment, but there is no specific rating for crepitus in any joint including the knee.
Yes there is. You might want to check the codes again.
Great info. I had knee issues and most of the issues described and was not given a rating by the VA😮
If you have questions or need any specific advice, just fill out the contact form at vamadness.com. PS: Check out my new book. Every veteran should read it: www.amazon.com/dp/B0CPTNRMD8
Just wondering, would a VA examiner have the veteran remove their knee brace for the ROM examination? Also, thank you so much for sharing your time and knowledge helping vets around the world!
I'm fairly sure a brace would have to be removed since the brace is for stability and the ROM measurements are not done in a standing position. Thank you. We vets must support each other.
A very detailed video! Thank you for posting. I got a little over-informed with so many medical terms and VA regs terms (that's on me, not you). A summation would be appreciated. 4 ratings possible for each knee with different min & max ratings? Please let me know if I got that much right.
Yes, as long as the facts fit four ratings are possible. If you have questions or need any specific advice, just fill out the contact form at vamadness.com.
My situation may add some context to 5257. I had a partial patellectomy while serving. It got a VA rating of 20% for chronic patellar chondromalacia. After 6 arthroscopic surgeries over 40 years to clean out the debris I had the knee completely replaced two years ago. That moved me up to an overall rating of 50%. Sadly, my TKR procedure has left me with a diagnosis of moderate lateral instability with pain behind the knee and limited motion due to that pain. The chief of orthopedics at my local VA prescribed and procured a very expensive brace and a quad strengthening program to hopefully reduce the instability and eliminate the pain. She does not think it will help in my case but it's the next step. The options after that are to partially redo the TKR either by replacing the middle insert with a thicker one or replace the femoral insert and middle insert with a different type, in essence re-do the TKR. I filed a claim for instability (should be of the 20% variety) and have my C&P appointment very soon.
Typically, VA will not award 5055 TKR and 5257 on the same knee. You certainly can try.
@@VAMADNESS We're about to find out!
Eugene, Appreciate your response and offer to call you. Before I do that, let me lay out the scenario. Assuming I can get approval for either my knee or my back, should I chose one and focus on it and use the other as a secondary? Or is it better to do both. If yes on one claim, which one would be the best one to go for. I have Mil STRs for 1982 back injury, L1 & 2 compression, and knee injuries in 1968 and 1977. BTW, having difficulty finding doctors in Central Florida area who will do DBQs or IMO's.
Always file all claims you want to file at the same time. Since there are in service events for both the knees and back, they are both directly related to service. Typically, treatment providers will not fill claim related forms/opinions; however, mostly these forms/opinions are not needed.
@@VAMADNESS Eugene, Thank you and as always your advice is filled with experience and good common sense. As I receive more copies or my mil STRs and my civilian records and go through them, I realize that first of all no one can really understand the writings/scribblings of doctors. However, I have found references to headaches, "pain experienced in chest after eating" and shortness of breath. I already have a post service private gastro doc who has diagnosed me with Barrett's Esophagus so perhaps I have a GERD claim.
@@JamesNorman-g1i Sounds like you may have a GERD claim. If have questions or need any specific advice, just fill out the contact form at vamadness.com.
Interesting. 5258 "Locking" semilunar cartilage. I had the locking before my Arthroscopic surgery. My surgeon said that the meniscus was torn so bad that it would fold into itself and cause the locking. I actually started having my knee started giving out after surgery. I am still sitting at 10 percent to this day. Thanks for the information.
You are very likely under rated. Follow my increase statement example and file an increase.
@@VAMADNESS I did search your site and used the language from your form to help me formulate my statement. I submitted my new claim last Thursday. I had my C&P yesterday with LHI. I used your trigger words to describe my condition. I eagerly await the results. I may reach out if you do not mind to help me understand the decision. I appreciate everything you do, say and post. It helps us old vets try to navigate this system. Thanks
@@TheGrainSideUp I'm here whenever you need advice.
What I went to my C&P. exam with 2 weeks ago but 1st: 2017 got 10% on knees after 0% in 2016 when I got 60% for failed hernia surgery. Im approved for a full knee replacement by VA surgeons hopefully in Jan 2025. C& P was for worsening knee. I brought my cane & brace issued by my pcp. I made copies of all my knee related sickbay calls in service documented. Next my personal statement which there are videos on I wrote & rewrote it about 4 drafts. The goal was to document how my knee pain affects my day to day life actually had to quit my construction job after 25 yrs. Next documentation of my civilian knee surgery - medial meniscus. Copies of everything the VA has on my knees mris x rays doctors reports ANYTHING. it all makes an airtight case they cannot refute & dispells any notion of any bullshit. Hoping for the best. I did my job of being very VERY thorough.
This response is not intended to be legal or medical advice. I am not a lawyer, medical professional, or claims agent. Per my personal knowledge and direct experience, knees are really pretty simple to get rated properly. Knee limitations of motion ratings are fairly hard to get per a measurement. Hopefully your statement, accounted for and described flare-ups in a way so a proper flare-up estimate can be assigned by the examiner. The estimate is often how a limitation rating is attained. For instability you either have the required tissue damage or you don’t. Same principle for meniscus, you either have a meniscus issue with pain, swelling, and locking or you don’t. I’ve got my fingers crossed for you. Let us know what happens.
I have locked knee and 30 degree movement forward or back. Plus instability and pain.The other night I fell when my dog tried to chase a cat my left knee went out.Then I hurt my right knee
Very good information, I had three nexus letters one from a VA NP and two by private Doctor’s for left knee secondary service connected right knee overcompensation wear and tear and it was denied. The rule of benefit of the doubt in on appeal. Flare ups are rarely mentioned by Veterans. Today my range of motion maybe limited and a few days later I may have full ROM, how is ROM measured with a goniometer in this case?
Most nexus letters don’t provide the thorough medical rationale required by the VA. One knee causing problems with the other knee is typically denied by VA at the regional office level. Very often this type of claim ends up at the BVA. If your nexus letters are adequate, you will eventually win the claim. Most veteran do actually site flareups as a factor; however, they do not explain their flareup limitations properly. Watch part 1 of my knee video series and review the knee statement posted on vamadness.com to ensure you are properly rated. If you have any specific questions fill out the contact form at vamadness.com.
I have 10% and 0% for both knees and they both have pain with rom in both directions. I also have instability in my left knee which I was given a rigid brace. I was also given a knee brace for my right knee that is also hinged, and is also considered ridged.
Well, it all depends. As noted in my knee videos, there are four possible separate ratings for a knee; two are per ROM limitations. One for instability and one for meniscus dislocation/removal; however, your symptoms and diagnoses must also fit. If nothing rates but there is pain then a 10% rating is given. Only if the facts fit, can you get these ratings. If you have questions or need any specific advice, just fill out the contact form at vamadness.com.
This is for my knees. I have issues with instability, flexion, extension and pain in both knees. The symptoms are slightly different in each knee. As it sits now I have several contentions lined out for the knees. I have not submitted the claim yet. They are as follows:
-Left knee limitation of flexion
-Left knee limitation of extension
-Left knee instability
-Left knee condition painful motion
-Right knee limitation of flexion
-Right knee limitation of extension
-Right knees instability
-Right knee condition painful motion
Or should I just combine it all under bilateral Knee condition?
I have written personal statements for each symptom of the knee. In my statement I include pain location, pain level, frequency and severity of symptoms and I explain how my job impacted my knees and how the knee condition affects my social and occupational life.
How would you present it and is this a pyramid if I am reporting seperate symptoms for 1 body part?
The best way to ensure you get properly rated is with accurate information on the possibilities. My knee series answers your questions. Watch part 1, 2, and 3 of the knee video series as they explain exactly what’s what about knee claims. If you have questions or need any specific advice, just fill out the contact form at vamadness.com.
You are truly the best
Hello Eugene so glad I found your Utube great content. I am rated 10% on left and right knee degenerative joint disease ,10% right ankle for degenerative joint disease and tinnitus 10% . The VA has given me knee braces for each and an ankle brace that I wear daily , will this help me to get an increase? Thanks again
Greetings, great video!!
Question: If you claim knee instability only and have other conditions would the total knee be evaluated during the C&P exam?
Would you recommend claiming all conditions for your knee upfront?
If you have several knee conditions, there isn’t a need to list them separately; however, you certainly can call them out. I typically call out my key documents in my statement. You can claim “Knee problems. See medical documentation.” Just make sure VA has your medical info or access to your info. The exam will evaluate your knee and the medical information of record. Ensure you watch all part 1, 2, and 3 of my knee video series. If you need any specific advice, fill out the contact form at vamadness.com.
If Doctor doesn’t use the goniometer at the CnP ….should I call the VA after the exam ?? I have one In Another week. Thanks.
This response is not intended to be legal or medical advice. I am not a lawyer, medical professional, or claims agent. Per my personal knowledge and direct experience, be assertive. The goniometer is typically used; if it’s not, tactfully inform the examiner it is required. That should resolve the issue. If it doesn’t, then report the situation to the VA.
I had a botched lateral release that causes instability and led to a plica. The plica caused instability with locking and buckling. It led to my severely broken ankle which is now secondary.
I'm sorry to hear of your situation, but at least you have the ankle as a secondary. If you need any specific advice, fill out the contact form at vamadness.com.
This will be my third supplemental for the same knee. Do I need/should I include va case law or the like? Va c and p examiners have failed twice to measure extension movements in my knee with history of torn meniscus.
This response is not intended to be legal advice. I am not a lawyer or claims agent. Per my personal knowledge, VA regulation states that measurements must be taken, so caselaw isn’t needed. Actually, I doubt there is any caselaw that applies as the government would never challenge the fact that measurements must be taken. Also, due to VA incompetence, it’s normal to file for the same issue repeatedly. It’s called being on the VA hamster wheel that keeps veterans running in place without positive results.
My knee is killing me, my Dr gave a knee brace a yr ago and my pm Dr installed a StimWave unit for pain, which isn’t working that great, I can hear the crunchy when I move it, I pop it out in basic and they wanted to do surgery, but I wasn’t ready, now I’m!
If you need any specific advice, fill out the contact form at vamadness.com.
Best explanation out there.
Thanks for all your videos, very helpful! My Physical Therapist gave me knee braces for both knees and a cane, can I get 20% or do a doctor have to prescribe the knee braces?
For the 20% the rating schedule states “medical provider prescribes a brace and/or assistive device (e.g., cane(s), crutch(es), walker).” The key words are “medical provider” and “prescribes.” The physical therapist certainly seems to qualify as a provider and if some sort of paper work had to be completed by the physical therapist to get you the braces and cane that likely qualifies as prescribed. The 20% also must involve a sprain, ligament tear; or surgical repair of the quadriceps tendon, the patella, or the patellar tendon.
I have arthritis in both knees but, was only awarded 20% for right knee and denied my left knee. Right knee was direct service connected. Do you have any suggestion how to connect to my left knee disability?
What to do is dependent on the exact situation. Fill out the contact form at vamadness.com and we’ll figure out a plan.
ok thank for reply. will do!
Great info! Thank u for helping us learn
I didn't see a link posted to examples cases from the veterans board of appeals and how they apply this from you speaker. It would be very interesting if he did....thanks
Here is the link www.index.va.gov/search/va/bva.html; however, it isn’t working today as is often the case with government websites. These decisions are informational only and are not evidence for use in other cases.
I have been 10% for 5 years, I have lost almost all flexion. Had it reassed and was told I could only get a higher rating if I needed a knee replacement.
As noted in the video, flexion can be rated to 30%. Ensure you watch part 3 of my knee video series to learn about increases. If you have questions or need any specific advice, just fill out the contact form at vamadness.com.
If I Bi-lateral knee issues and have instability on my right knee and also on my left is that considered pyramiding by the Va guide lines? Thank You..
This response is not intended to be legal or medical advice. I am not a lawyer, medical professional, or claims agent. Per my personal knowledge and direct experience, instability is a separately rated condition. This fact is explained in detail in this video, ensure you watch this video to learn what’s what with knee ratings.
I have SC bilateral arthoplasty, rated at 40% per knee. My left knee, 2 yrs after replacement, popped out of joint. The VA gave me a knee brace for instability for this post-surgical new knee. Am I able to get another rating for the brace on top of the rating for the arthoplasty? BTW, the knee brace validated a VA clothing allowance for new trousers.
I see you went to vamadness.com, so I'll answer through email.
I'm a newbie at this. I'm 73 year old and served as paratrooper with the 82 nd Airborne Division from 71 to 63 . Had both knees replaced have a bad back, as a fact I'm going to Walter Reed Hospital on the 5 th to see a Neurological surgeon. I recently started the process to apply for disability. My question is is it better to go to a law firm specializing in VA disability or use a vso at the County or at a VFW
Lawyers will only take cases after claims are denied; thus, lawyers are not an option during the initial claim process. VSOs, county or service organizations, may be helpful when filing claims dependent on the expertise of the particular person assigned to your case. It’s best to educate yourself on the process as much as possible on the internet. Generally, service connecting a disability requires three elements; (1) a current diagnosis, (2) an event in service, and (3) a medical nexus (link) between the event in service and the current diagnosis. The nexus is typically provided at the C&P exam if the other elements are present. As long as the issue started in service, symptoms continued after service, and you have a current diagnosis, service connection is likely. A relevant and detailed personal statement is the foundation of a claim. Statement examples are available to subscribers to my website vamadness.com.
When a private Doctor ask for medical records from the VA to write a nexus letter. Does the VA also send the C&P exams done or does the Doctor have to ask for them ? Thank you, Sir..
The VHA (healthcare) is responsible for handling veteran healthcare needs: they are not connected to the VBA (disability benefits). A request to the VHA will not get any disability benefit information such as a C&P exam results because the VHA does not have any disability benefit information on file. You will have to get a copy of your C&P exam results from the VBA to give to your nexus writer.
This guys videos are like cheat codes.
I'm new to VA claims and I'm seeking some clarification. My VSO wrote a claim: "Bilateral knee condition." My C&P exam is soon.
The knee has instability; pain; arthritis; and a meniscectomy. Four different things.
Will the examiner turn the "Bilateral Knee Condition" claim into four separate claims during the exam or is that the responsiblity of myself and the VSO?
I'm worried my VSO was too vauge and I don't understand if their original claim was supposed to be vauge and it gets more specific and split up throughout the investigation/examination.
This response is not intended to be legal or medical advice. I am not a lawyer, medical professional, or claims agent. Per my personal knowledge and direct experience, your VSO did OK as far as the claim description entry. Hopefully, you filed a detailed statement with the claim explaining exactly how your knee issues are related to service and reported all of your knee symptoms and functional limitations. A statement should also include a description of your increased problems during knee flareups in reference to ratable issues per the rating schedule. A VA medical examiner is required to read your statement. Also hopefully, you submitted your knee medical records or give VA permission to access your records. Your service medical records, post service medical records, and statement should contain all the evidence you need to get the claim approved and rated properly.
@@VAMADNESS understood. Thank you.
What if you had meniscus surgery on both knees to relieve the pain?
I had a Total Knee Replacement on my left knee. Which was the better knee. In April of 2020 by the VA but was not given any convalescence. Even though I have had pain in movement and resting on occasion. And I have had my knee give out or lock up from just standing. And they will not operate on the right knee because i
I was kicked off mid statement.
The VA will not operate on my right knee even though it has continually gotten worse and the braces have not worked and has made it difficult to maintain employment. It has been now 3 years since my TKR and have not been able to work and as a result now Homeless. And have not been able to get ANY ASSISTANCE from the VA or it's affiliates. What can I do? And that doesn't even include my eye issues from a virus contracted during my tour to the Philippines where I almost lost my eye.
@@theRoyalOne2U If your knee is service-connected, convalescent pay is authorized if the recovery period is at least 30 days. You need to file an application for benefits to get the convalescent pay. Keep in mind, compensation benefits require the condition be service-connected. If you believe your issues are related to service file an application for benefits. VA also offers a pension for eligible veterans. Most VA hospitals have veteran service representatives that can assist you in applying for benefits. The VA has programs for homeless veterans, so see the social worker at your nearest VA facility to see what benefits are available to you in your area. If you need any specific advice, fill out the contact form at vamadness.com.
I have a c/p for my hip on Friday…if connected, i need to claim secondary insomnia or whatever it’s supposed to be! I cannot sleep due to pain in my knees, but hips more than anything…where do i start 😢
@@kitana370 It is certainly possible to have insomnia secondary to pain. Seek treatment if you haven’t for your own peace of mind and you’ll need a diagnosis for the claim. Insomnia is considered a mental health claim. If you need any specific advice, fill out the contact form at vamadness.com.
Hi. I have 2 - 10% and 2 - 0% ratings bilateral knees. I have 2 - 10% and 4 - 0% for bilateral hips. One of my C & P examiners noted my tears in both knee meniscus' but started it wasn't service related because the diagnoses that I have for my knees couldn't have caused the tears. Does this seem reasonable?
I’d need more info to give you good answers. Fill out the contact form at vamadness.com.
I submitted knee pain this morning, it's not so much with mobility but with my shins. How do they examine shin pain?
To be properly rated for any issues, you need a diagnosis; thus, to get the shin rated you need a shin diagnosis. Logically, you should have filed the claim as a shin claim. Shin splints are on the same DBQ as the knee, so things may workout fine; however, if you filed the claim without a shin type diagnosis, you can only hope the VA examiner will issue a diagnosis. This a far from certain. Mostly, VA examiners do not issue new diagnoses at C&P exams, but it is possible.
Great information, thank you
10:07 where do you make a statement? Can you do it alone or does a VSO need to do it?
This response is not intended to be legal or medical advice. I am not a lawyer, medical professional, or claims agent. Per my personal knowledge and direct experience, a statement should be submitted with the knee claim as it is your opportunity to say your piece. Filing a statement is optional; however, it is really the foundation of the claim. Typically, a VSO will not assist you in writing a statement and, for a reason I don’t understand, VSOs rarely advise a veteran to write a statement. If your claim was filed recently, it’s not too late to add one to the record. You can upload a statement at VA.gov or give it to your VSO to submit.
Can you have pain in the knee cap with with weight bearing on it and get rated? Or is it strictly range of motion that is rated?
As stated on the video, if ROM is not ratable, then painful motion/pain on use is considered and is rated at 10%.
When u claim for knee condition, will va rater give u 3 codes? Flexion extension and pain?
VA assigns a code for each rated condition. Pain is not a condition and does not have a code.
Eugene, Getting ready for my hearing and tinnitus C&P exam and I have a question. I have mil history of 10+ continuous years of range time w/ weapons up to 185 decibels. Have private ENT doc hearing test with "more likely than not" nexus statement for hearing loss and tinnitus. . Also have VA hearing test and I have been issued hearing aids. Now, since I have VA hearing aids and if the C&P says its service connected, will I get compensation or, is my hearing loss compensation just a pair of hearing aids? Does the VA consider hearing aids enough compensation?
As a reference [oint for others. The C&P PTSD teleconference went reasonably well. Login instructions were clear and easy to follow. The Doctor allowed my wife to be in the room as a witness. Took about 30 minutes and she asked about 14 questions. Typed in my responses as I gave them. closed with a reminder that if the claim is approved, I can expect a reconnect from the VA in about 12 months. With that in mind, I did my after action report and gathered all of my presubmission notes, etc. and filed them away. I recommend you not toss aside anything that you used to prepare for the claim or the C&P exam.
Hearing loss can and does get ratings depending on the hearing test results. Winning the claim is dependent on the hearing test results from your military separation physical. There must be documented hearing loss in service to get service connected.
My Dr gave me a prescription for a knee patella sleeve. Is that considered a patella brace?
I'm not sure, but it seems to fit the bill.
I have 10% on my knee meniscus and ACL, now I have arthritis on the same knee would that count as a rating for increase my percentage?
Watch my arthritis video to understand arthritis ratings. The short answer is, it’s unlikely the arthritis will have any impact on your rating. As explained in the video, you either have the problems that qualify for one of the 4 rating types or you don’t. Also, as explained in the video, ACL and a meniscus issues could possibly get separate ratings depending on your symptoms. If you decide to file for an increase, ensure you file a detailed relevant statement. Statement examples are available at vamadness.com. Don’t forget to check out my book: www.amazon.com/dp/B0CPTNRMD8.
Do any doctor notes help or should a DBQ form be filled out when submitting a claim for knee pain?
My three knee videos point to every relevant fact in knee claims. Watch all three to learn these facts and if the doctor’s notes callout these facts, then include them with your claim. A DBQ will be filled out at the C&P exam, but if you want to get your own completed that’s fine; however, it won’t necessarily help your rating.
Hi had a 10% then had an update had a torn ACL had. Surgery to repair the acl in 2010 now I am at 20% I feel that I’ve been very under rated they also cleared up so arthritis in the knee also my left knee has become unstable from using it more my right knee has buckled and is very unstable and painful my walking is limited time and speed is reduced by 1/2 standing in line is tiring and painful using stairs up or going down is very slow and painful don’t know if the knee is going to hold or buckle
Ensure you are using an assistive device in case your knee does give out. As noted in part 2 of my knee series, four separate ratings are possible on a knee depending on the situation and evidence. In part 1 of my knee series, I talk about the importance of a statement which ensures a proper rating. In part 3 of my knee series, I discuss the C&P exam and increase ratings. Following my advice as presented in the videos will eventually get you properly rated. If you need any specific advice, fill out the contact form at vamadness.com.
I am not near a VA hospital, how do I go about requesting a knee brace for a service connected knee rating?
You will have to be enrolled in the VA healthcare system and coordinate with your VA primary healthcare giver to get a brace. I don’t know if VA outsources orthotic devices, so you may have to go to a VA hospital to get the brace. Call your nearest VA clinic/hospital to find out the exact procedure. If you want to help build a better VA, don’t forget to check out my book: www.amazon.com/dp/B0CPTNRMD8.
Just started medboard process for ACL, PCL, and MCL reconstruction on my left knee. Do you think I can get 30 percent for my left knee considering I have a brace prescribed to me?
As noted in the video there are four possible separate ratings on a knee. Instability with a brace alone is a 20% rating, so if you are also rated for ROM or painful motion you should get to 30%.
I am 20% but wonder about the "bilateral factor" which is supposed to add 10% when 2 joints are involved. Also I read one decision where the BVA told the RO to rate the "bakers cyst" of the Veterans knees separately. Most knees with bakers cyst have internal derangement cartlidge etc.
The bilateral factor is for paired upper or lower extremities, but not for one upper and one lower. A right knee and a left elbow would not get the bilateral factor. As explained in the video there are four possible ratings. 2 ROMs, instability, and meniscus. A Baker's cyst is no different from any other knee condition if it affects ROM or causes painful movement it will be rated. There is no separate special rating for a Baker's cyst.
I was rated at 10% per knee back in 98. I have pain regularly... Right knee been scoped. I stumble often. Does it mean I should request a new re-evaluation? Brace!!! The VA sent me some for each leg. Crazy
Absolutely file an increase. If you have painful motion on both the extension and flexion motions you get 10% for each motion plus 20% each knee for instability with a knee brace. That’s a 10%, 10%, and a 20% for each knee. Make sure you watch both of my knee videos (part 1&2). Plus watch part 3 that I will be releasing in a few days.
@@VAMADNESS Thanks! I have just started the process for evaluation of my hip/lower back/shoulder. This process is really confusing.
@@alanbrock9557 You’re welcome. If you need any specific advice fill out the contact form at www.vamadness.com.
If you were a cadet under title 10 rules, can you be awarded a claim due to knee injury while exercising during your time off? Should I not even bring up the damage I had due to exercise in my off duty time?
I’ve been forced to stop giving out any information that can be considered legal advice. Ask your question to a VSO and lawyer.
So can we just file a new claim on the range of motion instead of filing a CUE claim? Cause I only have 10% for both knees mind you there labeled “strain”and I have so many of these symptoms buckling pain in both ranges of motion numbness down to my knees.
What to do is dependent on several factors; if you are outside of your appeal period, you can file an increase. To know if VA made a mistake or not, you’ll need a copy of the C&P exam results. If there is a mistake and you are within your appeal period, you contest that mistake per your appeal options; however, if you are outside your appeal period, file a supplemental claim with new and relevant evidence or a CUE. Most VA errors are not CUE. Your exam results will determine what’s what. If you need any specific advice fill out the contact form at vamadness.com.
What can I do if my VA doctor misdiagnosed me. For almost 3 years I was told that I had costochondritis but it turned out to be Ovarian Cancer. Is there a type of attorney that I can reach out to? I've tried several but no one wants to do the representation. Any information will greatly be appreciated.
There are lawyers that handle VA medical malpractice cases that you can find per a google search. The key to getting representation is if your situation will lead to a positive outcome; both in winning the case and a substantial monetary award. My own experience tells me that if your case of misdiagnosis has caused you permanent residuals, you should be able to find a law firm to take your case.
Just went had meniscus surgery that was service connected but now I feel a lot weaker on both sides and was presicribed a brace before and can you give me a estimate on how much I get ?
It really depends on your symptoms; if there is locking, then a 20% rating is possible. If the meniscus has been removed and it is painful even when you are idle, then a 10% is possible. If you need any specific advice, fill out the contact form at vamadness.com.
@@VAMADNESS thank you sir
thank you!!
I had my C&P exam for insomnia the physiologist ask me was the insomnia caused by my depression or my knee pain and tinnitus. I said the insomnia was caused by knee pain and tinnitus, so will I get insomnia secondary to my knee pain and tinnitus
Insomnia claims are often won secondary to service-connected conditions that cause pain. Service connection and ratings are two separate issues. Regardless of why you have insomnia, insomnia is typically rated under mental health; thus, if you already are rated for a mental health condition you will not receive a separating rating for insomnia.
Thanks
I’m curious about TKA revisions, and if they’re rated. I had a LTKA in 7/2021, and a revision on 1/5/2023. The Surgeon found not only a lot of scar tissue, but also Polyethylene wear. Is this ratable?
Knee ratings always follow the rating schedule; hence, all issues are compared to the schedule. Knees are rated per ROM, meniscus problems causing locking, ligament/tendon/kneecap problems causing instability, and in the case of knee replacements severe pain/weakness. The scar tissue and polyethylene wear problems are compared to the rating schedule in the same manner as any other knee issue. For example, if the scar-tissue/polyethylene issues cause ROM loss resulting in a higher rating than your current rating then the higher rating would apply. If you need any specific advice, fill out the contact form at vamadness.com.
@@VAMADNESS thank you for your very detailed response! I just find it odd for the poly to be worn out in 18 months.
I have total replacement 30% and 10% for instability
A successful knee replacement is typically rated at 30%. Sometimes I do still see instability rated in conjunction with the replacement. Keep in mind if you have a brace prescribed the rating will be 20%.
Thanks!
9/22/2023
How would the bilateral factor play into the rating for bilateral knee replacement?
The same as any other left and right lower extremity conditions with the combined lower extremity issues getting an extra 10%.
Thank you for your video!!! wonder if anyone know if it is worthwhile to file a claim on my knee. They went through my medical for another injury and they noted that my knee surgery twice wasn't claimable due to it happening on a basketball court. I was speaking with a friend and he said that the injury could have been caused on the court but my knee could have been weakened due to the type of work I was in. Jumping in and out of semi trucks; roughly three feet and climbing in all day. just curious.
both operations removed cartilage. second one was I guess to clean up what they missed as my knee was still locking up. And now popping and near locking but pops like a knuckle.
Hi Eugene, I'm rated at 30% for one knee and getting treatment for the other, I would like info on filing secondary for the other, do you think that you could give me some insight?
The theory is that favoring the injured knee causes an over use injury to the previously non-injured knee. VA typically denies this type of claim, so you will very likely need a good independent medical opinion to win the claim.
Thanks, I'll be going to your site about some more things going on.
What kind of knee brace is required by doctor for 20%? I'm 10% for right knee patellofemoral pain syndrome. 30% total. Thank you
The requirement is that the assistive device be prescribed. The exact brand, construction material, or configuration is not specified.
@@VAMADNESS Does it have to come from a VA doctor?
@@clarencedolan699 Any qualified medical professional from any treatment facility can prescribe the assistive device.
@@VAMADNESS Thank you for the quick response. One more thing, I had a torn ACL and I’m rated at 30% overall between the two knees. I recently had an MRI, the pain and locking got to be too much, which revealed I have no cartilage, bone on bone. I have my C&P exam tomorrow. Any suggestions? I’m 70% overall. Thank you again for what you do for us.
@@clarencedolan699 If you have not watched my latest video "Winning VA Compensation For Knees Part 3: the Knee C&P Exam and Knee Increases" watch it now.
Sure wish there was a discussion about chronic residual 34:48
Well, the chronic residuals are clearly noted on the schedule: “severe painful motion or weakness.” If you claim you have one or both of those residuals and the medical examiner agrees, you’ll be rated at the 60% level. Keep in mind, severe painful motion and severe weakness are not defined on the schedule. You must, through your statements (both written and verbal) convince the medical examiner of the severity of your pain and/or weakness. If you have questions or need any specific advice, just fill out the contact form at vamadness.com.
Hi I have a question regarding my claim that submitted in 2016. The va didn't give me a rating for my knee that I hurt several time in the navy. I even had surgery. I submitted a new claim with the DAV. I va says that I need to send in 20-0995 form. Should I try filing all over again or should I just hire a lawyer and let him do all of this and maybe I could get back pay from when I was turned down? Plz help
Any claim that has been denied in the past can only be readdressed on a supplemental claim, so the VSO filed the wrong form. Just file the right form now; if you haven’t properly prepared your claim, you may still have problems getting service connected. Ensure you watch all three of my knee videos and prepare a detailed statement. If you win, it’s unlikely you’ll be able to get the claim back dated; however, dependent on your exact situation it is possible. If you need any advice, just fill the contact form at vamadness.com and I’ll be happy to advise.
I have knee braces for both knees you say that’s a rating just for having a brace?
If you are rated for knee instability, a prescribed brace will grant a higher rating. A brace is only relevant in getting a higher rating and has nothing to do with service connection. Don’t forget to check out my book: www.amazon.com/dp/B0CPTNRMD8. The book is about fixing the VA so all veterans can be better served.
Looking for advice on filing claim for aggravation for my hiata hernia. Va says my entrance exams show pre-existing but both exams show different
Then the the denial is easily overcome by simply pointing to the entrance exam results. No need to address aggravation. If you are within the appeal period, just file an HLR.
Are knee joint issues rated at a separate rating?
As explained in the video, 4 separate ratings are possible on a knee.
I'm rated 20% for my right knee, getting a knee brace measured and prescribed by the VA. What happens?
File for an increase. Ensure you watch part 3 of my knee video series and write a good increase statement per my increase example posted at my vamadness.com. If you have any other questions, fill the contact form at vamadness.com.
My right knee is my dominant side service connected at 20% shoulder it be rated at 30
The dominant side is not relevant in knee claims.
What Bout both shoulders rated 20%
@@davidmedrano709 For shoulders the dominant side may be rated higher than the non-dominant dependent on what the examiner determined. You would need to have your C&P exam results to know if the dominant side was properly rated.
Do you present one symptom at a time so the VA can’t bundle and one gets under rated.
As noted in the video there are four possible separate ratings for a knee; you either have the ratable problem on exam or you don’t. You either have the required diagnosis or you don’t. You have the corresponding symptoms or you don’t. A rating will not come from how you file. Follow the advice noted in all three knee videos and you’ll be fine. If you have questions or need any specific advice, just fill out the contact form at vamadness.com.
I algo got only 10 and i have pain om both motions
This response is not intended to be legal or medical advice. I am not a lawyer, medical professional, or claims agent. Per my personal knowledge and direct experience, VA does not assign separate ratings for painful flexion and painful extension. The lawyer in this video does same to indicate that it is possible; however, I have never seen that happen nor have found any cases where it has been awarded. I have found cases where flexion or extension was rated as limited and the other function (flexion or extension) was rated as painful motion.
So I had a full knee replacment on April 1st. They only gave me only 4 months. They rated me at 10 percent following my convo rating. Question I have is they called it a resurfacing and not a replacment. Is there a difference. According what I am reading I should have atvleastb30 percent and not theb10 They awarded me.
The 30 minimum rating only applies to actual knee replacements: in other words, the knee was replaced with a prosthetic. If you know for sure a prosthetic replaced the knee, then just file a higher level review stating that. The rating schedule states “evaluate resurfacing under diagnostic codes 5250 through 5255; there is no minimum evaluation for resurfacing.” To know if you were rated properly, fill out the contact form at vamadness.com.
@@VAMADNESS I get confused about there verbiage. So they cut off the head of my femur replaced the entire end with titanium cut the top of my tibia off and put a piece of titanium in it and placed plastic between them. The only bone left in my knee is half of the knee cap. The back of it was ground off and a titanium plate was installed. I am rated at 100 percent already but not P&T. They say I need follow up for my knee as a resurfacing. Not sure what they consider my knee.
@@markberenbrok627 Defining a total knee replacement is medical call. We lay people don’t get to say; however, googles note a total knee replacement as “all 3 compartments of the knee are replaced with a metal alloy and polyethylene implant system.” In your case, you note the patella was not replaced so this could be the problem. It may help if you talk to your doctor to get a proper definition of your procedure.
@@VAMADNESS Thank you so much. Of course they rescheduled. I plan on seeing my Dr and having him give me a jother copy of the surgical report.
Can Sean post that link to the court case that talks about 10% for each flexion and extension that he was referring to?
It’s actually not a court case, it’s a VA General Counsel memorandum. Just google VAOPGCPREC 9-2004 and you’ll find it. In other words, veterans have been getting screwed on their knee claims since that determination was made. VA knew what they should be doing, but made no effort to follow the memorandum in awarding ratings. Shame on VA.
@@VAMADNESS thank you for responding and for all you do to help us Veterans!
@@oldsergeant9999 You're welcome!
After receiving a TKR and 5 mo at a 100% the rating automatically reduces to 30%. My question is how long will the 30% remain in effect? Is that a lifetime/permanent decsion?
The 30% is now your permanent minimum rating for that knee.
@@VAMADNESS Thank you
Let me ask one more?. I also ask this same ? to Combat Craig. IF my prescribed meds help keep my diagnosis at bey can/will they canc my Pct. Example: 1) meds for a mental diagnosis, 2) meds for a physical diagnosis.
@@guyshort2649 Generally, ratings are determined at the C&P exam or private exam typically per a DBQ: thus, during a VBA re-eval or a veteran requested increase VA can lower your rating if the condition improved. Why the condition improved, through meds or whatever, is irrelevant. Ratings held for five years must show sustained improvement to be lowered; 100% ratings must show material improvement to be lowered; and rating held for 20 years cannot be lowered. If you need any specific advice fill out the contact form at www.vamadness.com.
My flexion is 100 degress what does that mean?
As far as a rating 100% flexion doesn't rate; however, it the flexion movement is panful it will be rated at 10%.
He keeps assuming it’s the meniscus. There is something called articular cartilage too - the cartilage under the kneecap.
Certainly, there is articular cartilage at the knee joint; however; it is not separately ratable as a knee specific claim which is why we do not mention it on this video. Articular cartilage problems, like arthritis, will only be rated if no other knee codes apply. See my arthritis video for a full explanation. The meniscus is separately ratable as a knee specific claim.
@@VAMADNESS 👍
Played all armfores sports for four years, can prove it, need help, please send some information.
If you have questions or need any specific advice, just fill out the contact form at vamadness.com.
wHICH PART OF THE EXAM DOES THE VA RATE THE ACTUAL AWARD FOR KNEE ISSUES. THE PASSIVE OR ACTION PART OF THE EXAM?
MEANING WHEN YOU GO AND GET THE C&P EXAM
WHEN THE EXAMINER BENDS THE KNEE OR WHEN YOU BEND IT.
@@Johnny-ow4ph There are two measurements and two estimates: you get the highest of the four. If you have any specific questions fill out the contact form at vamadness.com.
MUCH appreciate your response. This is great stuff.
The put my insomnia as secondary to left knee, tinnitus and depression. What does that mean
That the insomnia is being caused or aggravated by the left knee, tinnitus and depression problems.
Will it be a separate rating from the depression
@@melvinroberts9263 No.
Thanks for the great advice I will give you another donation for the great help
@@melvinroberts9263 I'm here whenever you need answers.
Question: Why do people with knee issues get rated for 5260 instead of 5256? The percentages are completely different. 5256 pertains to the knee specifically but I see most people here referring to 5260
5256 is for ankylosis of the knee. Ankylosis is not a common condition; thus, few veteran get rated for it.
I know how it works without even watching this video. If you have arthritis in your knees and can’t walk without limping, it’s 10%. It takes an act of God to go higher. If you get a total knee replacement, it’s 30% with 4 months worth of 100% back paid to you if everything is going like it should.
For the most part you are correct; however, many veterans do not report their flare-ups in a way for a reasonable flare-up estimate can be made by the examiner. A good flare-up description often does result in a rating higher than 10%. Also, many veterans do not get MRIs, so they do not qualify for one or more of the other possible knee ratings. For veterans with significant mobility problems, a loss of use SMC rating may apply. Typically, for veterans with no instability, no locking knees, no ROM problems, and no mobility problems a 10% rating for painful motion is the likely rating.
Can't get painful motion. For extention and flexion of the same knee, that's pyramiding
Actually, you are incorrect. General Counsel memorandum VAOPGCPREC 9-2004 held: “Separate ratings under DC 5260 (leg, limitation of flexion) and DC 5261 (leg, limitation of extension), both currently codified at 38 C.F.R. § 4.71a, may be assigned for disability of the same joint.” I thoroughly fact check anything I say on all of my videos. My words and claims are as good as gold.
@@VAMADNESS same joint for functional loss yes they are rated separately but painful motion alone can be rated either for flexion or extension separate ratings for ONLY painful motion for DC 5260 and 5261 would be pyramiding
@@hggfu I don’t disagree with your interpretation, which is why on part-1 of my knee video series I tell veterans how to document their functional issues on a detailed statement. Pain always includes some type of functional loss: the key is to ensure VA knows the details per a statement. Also, I rarely see veterans with joint problems with full and complete ROM as measured or per flareups. Any degree of ROM loss is functional loss even if not ratable. Keep in mind, pyramiding determinations at the BVA are inconsistent: one judge may say it is pyramiding while a different judge would say it isn’t. Never accept an RO decision disallowing separate rating for flexion and extension when the record notes pain for both and any type or degree of functional loss for both.
To end this question, I’m filing an increase for my knees and hopefully the RO and BVA will disallow separate ratings: then I’ll appeal to the CAVC and get a final answer. In any event, I’ll share the results in a video.
@@VAMADNESS but what you're not understanding is the VA will not compensate painful motion as separate ratings alone. So you will get painful motion for either extension or flexion but not both.
However just because painful motion may cause limitation of motion or affect your range of motion doesn't mean you can get painful motion for both flexion and extention.
What people fail to realize is there is a pecking order for all joint issues. The VA looks to compensate you first for limitation of motion, then painful motion, (provided that there isn't any limitation of motion) then finally arthritis.
For example if you have a knee injury and you tell the examiner you have painful motion of flexion and extention and after the examiner examins your knee with flare ups it's determined your knee is 60 for flexion and zero extention.(gonimeyer readings)
So you will be rated zero percent for limitation of flexion as 60 Is a noncompensable rating for limitation of flexion however though you have a zero for extention they will give you 10 percent for limitation of extention due to painful motion. Notice the VA did not give a 10% rating for painful motion of flexion because you received 10% for painful motion for extention and to do so for flexion in this example would constitue pyramiding.
Finally pyramiding is cut in dry found in 38 CFR 4.14 and the VA, RO BVA will not compensate for symptoms that overlap its not a matter of misinterpretation and it's pretty straight forward. If your examiner says your symptoms overlap then your ratings will be combined, it's that simple. This also include mental disorders respiratory disorders digestive disorders. If the symptoms overlap they will be combined and the higher evaluation will be given to the veteran.
But for the knee again, if you have painful motion on flexion and extention and everything else is normal.(range of motion) then you will get 10% for painful motion for only one condition.
@@hggfu Pyramiding determinations are far from set in stone. In preparation for an upcoming foot video, I’ve reviewed 20,000 BVA decisions dealing with foot code pyramiding. There is no consistency whatsoever. I was actually shocked to see what some judges are allowing. Look for yourself, don’t take my word for it. What I’ve learned is virtually anything is possible at the board. I am a person who likes rules. Well written rules make for consistency. VA makes bad rules: leaving open the door for wide-ranging interpretations; a virtual paradise for lawyers. VAOPGCPREC 9-2004 determined separate ratings for extension and flexion are allowed without addressing how painful motion fits into the equation; thus, leaving the door wide open for valid arguments for separate rating based on painful motion. This notion is supported on the knee DBQ that specifically asks if there is painful extension and if there is painful flexion. If only one rating for painful motion was possible, the question should simply ask if there is painful motion: the fact that both flexion and extension are painful would be completely irrelevant. I think we have to agree to disagree on this one until we get a court ruling on the question to settle the matter. I am enjoying our conversation.
Had to stop after 30 seconds due to the whiney fake way he talks!
If you need any specific advice, fill out the contact form at vamadness.com.