Winning VA Compensation For Knees: Part 2 

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?

I’m glad my videos helped. If you, or other veterans, have any specific questions fill out the contact form at vamadness.com.

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.

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.

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.

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.

Best of luck!

How did it go? Did you get a more than one rating for your knees

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

Typically, VA will not award 5055 TKR and 5257 on the same knee. You certainly can try.

@@VAMADNESS We're about to find out!

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!

If you need any specific advice, fill out the contact form at vamadness.com.

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 see you went to vamadness.com, so I'll answer through email.

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.

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.

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.

@@user-mr4mi1ls2r 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.

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%.

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.

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.

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.

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%.

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.

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

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.

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.

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.

As stated on the video, if ROM is not ratable, then painful motion/pain on use is considered and is rated at 10%.

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.

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.

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.

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.

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.

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

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.

I’d need more info to give you good answers. Fill out the contact form at vamadness.com.

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.

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.

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!

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.

VA assigns a code for each rated condition. Pain is not a condition and does not have a code.

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.

I'm not sure, but it seems to fit the bill.

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.

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.

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.

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.

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.

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.

I’ve been forced to stop giving out any information that can be considered legal advice. Ask your question to a VSO and lawyer.

It is completely normal. The opinion currently on hand likely was not adequate so VA is asking for a clarification or new opinion. If you want to help build a better VA, don’t forget to check out my book: www.amazon.com/dp/B0CPTNRMD8.

The same as any other left and right lower extremity conditions with the combined lower extremity issues getting an extra 10%.

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.

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.

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.

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.

As explained in the video, 4 separate ratings are possible on a knee.

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.

As far as a rating 100% flexion doesn't rate; however, it the flexion movement is panful it will be rated at 10%.

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.

5256 is for ankylosis of the knee. Ankylosis is not a common condition; thus, few veteran get rated for it.

If you have questions or need any specific advice, just fill out the contact form at vamadness.com.

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.

If you need any specific advice, fill out the contact form at vamadness.com.