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Reduction In Rating


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7 replies to this topic

#1 Mcafee

 
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Posted 22 October 2011 - 06:41 AM

Hello All Hoipe All Is Well

When I recieved my Rating notice along with something that appears like a SSOC upon one year of convalesense a review of TKR they have speculated a reduced rating by 20 %

I will obtain an opinion of course what I do not understand even with TKR in hopes of a better quality of life and hopefully pain free.

How can the RO make such a statement prior to the year being up? I find this quite arrogant.

Thank you for your feed back

They have also rescheduled a new C+P exam due to the past three exams are and have been found to inadequate and i did challenge these exams and RO never responded because I showed the exams to an outside physician his opinion clearly showed that the exams were not followed according to clinicians guide.

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#2 Berta

 
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Posted 22 October 2011 - 07:26 AM

I agree they are arrogant but one needs to consider in some cases a TKR leaves minimal or no further disability and the rating could potentially be proposed to be reduced.

My neighbor who mows my horse pastures has 2 TKRs (USAF vet) and seems to think his rating is 40% ( he isnt sure so I dont know if that is correct)
He is 74 and even with other disabilities he still does some mowing and also has 2 volunteer jobs involving 3 or 4 days a week but he has told me lately his hips are giving him problems and I think they would possibly be a secondary SC to the TKP for him.

He seems reluctant to file a claim and he says he gets great treatment from the Bath NY VAMC.

Every TKR situation is different.

They sure cant propose to reduce if some rater 'thinks' your disability rating is too high.

"They have also rescheduled a new C+P exam due to the past three exams are and have been found to inadequate and i did challenge these exams and RO never responded because I showed the exams to an outside physician his opinion clearly showed that the exams were not followed according to clinicians guide"

GOOD FOR YOU. I did that too many times =I challenged them with medical evidence and common sense.It worked .

For my last claim however they disregarded my challenges until I got some IMOs.

The IMO criteria is here in our IMO forum.

#3 brokensoldier244th

 
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Posted 22 October 2011 - 08:05 AM

For those of us 'young un's" what is TKR/TKP?

#4 Berta

 
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Posted 22 October 2011 - 08:32 AM

^Total Knee Replacement

#5 brokensoldier244th

 
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Posted 22 October 2011 - 08:53 AM

Gothca. Thanks!

CAS

#6 JR Reihs

 
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Posted 23 October 2011 - 07:19 PM

I was under the impression that a TKR would rate no lower than 30% and no higher than 40%, add in that with a TKR you will still have arthritis to some degree which should rate 10% in itself. Altered gait would also factor in with Hip and lower back problems. Scaring is another animal............Conecting the dots are not hard as long as the medical shows the conection.

#7 USNDW

 
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Posted 23 October 2011 - 11:02 PM

Minimum rating following a TKR, after the convalescent period is 30%. Maximum is 60% if there are chronic residuals of weakness OR pain OR loss of ROM

I would think the only way to get 40% if there was loss of range of motion to satisfy that, otherwise there is no other rating % for a TKR, only 100% for the 12 month+ 1 month of surgery, 60% for the chronic pain or weakness and 30% minimum. No standard for 10-20-40-50-70-80 or 90%


I would hope that they would do a C&P exam before reducing your rating because if you do have the chronic residuals to satisfy the criteria for 60% then the C&P examiner should be taking the records from your orthopedic surgeon or your PCM and give those records much consideration.

My original VA rating contained a 30% for a TKR, even though there was massive medical evidence, including pain management records to prove there was chronic pain & weakness. I had to file a NOD and was later awarded the 60%.



Good luck

#8 cooter

 
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Posted 23 October 2011 - 11:50 PM

I had my TKR in 08, and 1 year later they had me come in for the post-op examination. During the exam the Dr examined the ROM of the knee, which he flexed my leg from the knee 3 times and the 3rd time showed less ROM than the first one. I also told him my knee would buckle about 4 times a week with a lot of pain. Three months later, I was increased to 60% which really surprised me cause I never put in for an increase.

What I don't understand is, how can they propose a reduction when you haven't even had your post-op examination yet! Or did you?
The post-op exam usually tells if the surgery was anything less than 100% success. Which means, any residuals at all classifies 30% and could increase to 60% if the residuals allow. "Anything less than 100% success" is their own words in the regs. The fact you still have pain is enough to beat this!

I wouldn't worry to much about this, as they are jumping the gun without any evidence.



Coot




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