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Knee Replacement And % Rating


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11 replies to this topic

#1 3 years to retire

 
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Posted 16 July 2006 - 08:52 AM

I have a 30% knee service connected va disability. I talked to the DAV guy at the VA hospital about having my knee replaced by my private Dr. (OWCP will pay 100%). I am hoping to stay off of work for about 3 months. I have two months of leave I can use.
DAV guy told me this:
1) when I get my knee replaced it will " automatically approved when requested" (when we file for upgrade) take my rating to 40% - the highest it can go. I will be Max out on my left knee.
2) while I am off of work and having my knee replaced, I will get 100% disability (when we file for it) for several months - it will just be temporary for a limited time - "automatically approved when requested."

Is this information correct? Any information I should know before I go for the knee replacement?

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#2 JR Reihs

 
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Posted 16 July 2006 - 09:28 AM

3,

I think you should be very careful about who you intend to seek compensation from, if OWCP has approved this injury and it is also service conected I think you may find yourself in a pickle if you claim full compensation from both, as I beleive one will offset the other, and at some point you will be forced into making a choice.

Personaly since you are close to retirment , I would go with the VA, as they will grant up to 12-13 months of 100% for a knee replacement, without to much hassle, and you could save your leave in case of complications, or use it in conjunction , that is up to you.

I belive the 40% might be correct, if that includes a arthritis rating, I was always told it was 30% for a new knee period, but I have not had mine yet due to other problems that mat have occured, and my age, so I am not positive on that, and it was several years ago when I looked into this.

John may be able to chime in on this , but I think you are treading on some thin ice as to the OWCP vs VA, and you should look into this further before making that selection to see where your best option lays between the 2.

I understand with OWCP you get your doctor , and in the end some good shorttime $$, but with the VA you get less $$ but for life, personaly I would use my own insurance if I could and go with the VA, and get away from OWCP as fast as I could , but only you know your finance's so , just be careful and CYA.

Edited by JR Reihs, 16 July 2006 - 09:29 AM.


#3 3 years to retire

 
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Posted 16 July 2006 - 04:00 PM

JR thanks for the information. I am currently working and am not receiving any money from owcp. I found out that you cannot received money from both for the same injury. But, I do want my owcp (private) Dr. to do the operation. He will charge owcp but I will not receive any money. I will use my Sick leave for two months and then request leave without pay (lwop) for the rest of the time I am off. I might use owcp for rehab. I trust the owcp ( private) Dr. and feel he will do a better job than the VA. As I stated I will not draw any $ from owcp. I agree with you and will continue to collect VA disability. Do you think I could cause trouble by using my owcp dr., etc, while drawing va benefits, and without drawing any money from owcp personally? I just want to use the dr. and the private hosptial. The DAV saw no problem with this, but he felt that I could collect owcp and va at the same time too. Which I do not think I can. So that is why I am asking everyone.
I have in the past turned all documentation from my owcp dr to the va and have told them about me seeing him with owcp paying him several times a year. Plus I use him for my pain pills. I have made sure my VA dr knows all of this. I am not recieving any $ from owcp and I am still working. Hope this clears this up a little. Your advise is right on about receiving $ from owcp and Va at the same time for the same injury. Thank again.
3,

I think you should be very careful about who you intend to seek compensation from, if OWCP has approved this injury and it is also service conected I think you may find yourself in a pickle if you claim full compensation from both, as I beleive one will offset the other, and at some point you will be forced into making a choice.

Personaly since you are close to retirment , I would go with the VA, as they will grant up to 12-13 months of 100% for a knee replacement, without to much hassle, and you could save your leave in case of complications, or use it in conjunction , that is up to you.

I belive the 40% might be correct, if that includes a arthritis rating, I was always told it was 30% for a new knee period, but I have not had mine yet due to other problems that mat have occured, and my age, so I am not positive on that, and it was several years ago when I looked into this.

John may be able to chime in on this , but I think you are treading on some thin ice as to the OWCP vs VA, and you should look into this further before making that selection to see where your best option lays between the 2.

I understand with OWCP you get your doctor , and in the end some good shorttime $$, but with the VA you get less $$ but for life, personaly I would use my own insurance if I could and go with the VA, and get away from OWCP as fast as I could , but only you know your finance's so , just be careful and CYA.



#4 JR Reihs

 
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Posted 16 July 2006 - 05:26 PM

3,

It is a sticky situation you are in for sure, but as long as you are giving the VA the information then you should be ok, i do not trust what the DAV said about it, it is possible, but it could bite you later, but since you are still working and do not intend to file LW with OWCP then it seems you have a good handle on this.

Good luck to you.

#5 3 years to retire

 
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Posted 23 August 2006 - 03:34 PM

I checked with my doctor and he has decided that I should do a knee scope. It will be an out-patience operation. OWCP will pay for the operation. As before I will not ask for any money for compensation from owcp. My question now is how will this effect my VA disability rating. I am 30% now on my knee, and can go to 40% at the most. I was told that if I have my knee totally replaced it would go up to 40 %. With the scope will the rating go up, go down or stay the same. I could handle the rating staying the same. Going up (which would surpise me for receiving the scope) would be even better. Cannot afford the rating to go down. It would be better not to do the scope and limp along than take a chance on that. The knee hurts, and if the scope could help relive the pain that would be good. But cannot take a chance on losing any VA rating.

1) I was going to apply for 100% temporary VA rating while I recover from the total knee replacement. Should I still request that with the knee scope or leave it alone?
2) I was going to also request a increase in my knee rating with the total knee replacement, should I request that with a knee scope or leave it alone?
Thanks for the help...

#6 JR Reihs

 
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Posted 24 August 2006 - 01:58 PM

If the doctor can support a finding of Arthritis then you want to file a clain for this as it will grant you another 10%. I do not think you will get an increase any other way, but if the scope causes you to loose over a month of work , you MIGHT check to see if you are entitled to further benefits.

#7 LarryJ

 
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Posted 24 August 2006 - 07:27 PM

I had a shoulder "scoped" several years ago. Thursday, In at 10 A.M. out by 12 noon, home by 4 P.M. Back to work on Monday. Then, a couple years later, I had a bicep muscle come unattached at the shoulder. Now bouys and gulls, I have never given birth, but I have been shot, stabbed ( still have a piece of the tip of the blade in the cervical spine, BTW ) had my ankle broken, 4 ribs cracked and a few other small mishaps, BUT I HAVE NEVER HURT LIKE SHOULDER SURGERY CAN HURT!
Morphine is good, more morphine is better.............................a LOT of morphine is NICE...... :D

#8 mssoup1

 
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Posted 25 August 2006 - 04:40 PM

[font=Arial][size=3]

Years ago, my husband had a tendon in his shoulder repaired and moved due to an injury. He also recently underwent two total knee replacements. There was no comparison in the two. The pain from the shoulder surgery was far worse that the knee surgeries.

But, as we ladies who have given birth can attest, you men don't know what pain is until you experience child birth. HA! HA!

Hope all goes well with you.

mssoup1

#9 3 years to retire

 
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Posted 26 August 2006 - 07:53 AM

Thanks for everyone advise and comments. It is good to have a place where we can ask questions and explore possibilities. Of course we have no control on what the VA will decide but it helps to play out all of the possibilities. Peace.

#10 etihwr

 
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Posted 10 November 2007 - 01:53 PM

Your DAV Rep is wrong. You can only get 30% from the start. If after 1 year you continue to suffer from knee problems, you can get reevaluated and get bumped to either 60% or 100%. Very likely you would only get 60%. Though they say 100%, by statue, you can only get 80% for the leg, so the 100% would be reducted to 80%. If your getting now 30% for the knee and 10% for arthritis (thus making it 37%) your better off with the rating you have now. You can then claim the operation with the VA and they will give you a temporary rating of 100% for the operation and for the rehab time (probably 6 months) there after.
5055 Knee replacement (prosthesis).
Prosthetic replacement of knee joint:
For 1 year following implantation of prosthesis 100
With chronic residuals consisting of severe painful motion or weakness in the affected extremity 60
With intermediate degrees of residual weakness, pain or limitation of motion rate by analogy to diagnostic codes 5256, 5261, or 5262.
Minimum rating 30


I have a 30% knee service connected va disability. I talked to the DAV guy at the VA hospital about having my knee replaced by my private Dr. (OWCP will pay 100%). I am hoping to stay off of work for about 3 months. I have two months of leave I can use.
DAV guy told me this:
1) when I get my knee replaced it will " automatically approved when requested" (when we file for upgrade) take my rating to 40% - the highest it can go. I will be Max out on my left knee.
2) while I am off of work and having my knee replaced, I will get 100% disability (when we file for it) for several months - it will just be temporary for a limited time - "automatically approved when requested."

Is this information correct? Any information I should know before I go for the knee replacement?



#11 jimlane1949

 
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Posted 10 November 2007 - 09:52 PM

I am dense can you tell me what owcp stands for?

#12 jbasser

 
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Posted 11 November 2007 - 03:10 PM

Workers comp.

BTW has anyone passed a Kidney Stone?

There aint no matching or equivalent pain.




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