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Va Disability Rating For Knee Surgery

The Different Disability Ratings For Knee Replacement Surgery

VA Disability for Knee Conditions & Pain

In the case of knee replacement surgery, it is critical to understand the various disability ratings available. Following total knee replacement surgery, the disability rating for the first year after surgery is 100%. A minimum rating of 30% is assigned at the end of the evaluation period. In response to current wait times, most patients are expected to receive their knee surgery within 4-6 weeks of making an appointment.

Va Rating For Bilateral Knee Injuries & Conditions

Berry LawDisability Ratings

Military service can expose Veterans to countless situations that cause future injuries, disabilities, or illnesses. Luckily, Veterans who suffer from an injury during their time in the service are eligible to receive benefits from the Department of Veterans Affairs.

The process of making a service connection can be long and difficult. Veterans should be prepared with information ahead of time so that they are prepared to make an effective claim.

One common injury that many Veterans suffer from is knee pain. Whether it is from wear and tear, injuries, or combat, Veterans are often able to receive benefits for their service-connected knee injury.

While knee conditions are a common reason to file a VA claim, many Veterans are not successful in receiving as high a rating as they deserve. The VA denies around 30% of disability claims each year, making it crucial for Veterans to prepare themselves or consult an expert before filing their knee-related claims.

Limitation Of Extension Of The Knee

An extended knee refers to a knee that cannot straighten all the way and is only limited in extension. According to the diagnostic code 5261, knee pain is rated as 0%, 10%, 20%, 30%, 40%, and 50% disabled. Typically, the more difficult it is to straighten a knee , the higher the disability rating.

The range of motion measurements for each disability rating is similar to the limitations of flexion of the knee. When the leg can be straightened only to within 45 degrees, it is given a rating of 50%. On the other hand, if it can only be straightened to 10 degrees, it is rated 10%.

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The Impact Of Knee Replacement Surgery

A total knee replacement is the surgical procedure that replaces the entire joint in one fell swoop. If you cant work due to a permanent injury, you may be eligible for SSD and SSI benefits. In certain cases, if you are suffering from chronic pain and cannot work for more than a year. In 2020, a knee replacement in the United States will cost between $30,000 and $50,000. The implantation of a knee prosthesis has the potential to result in a disability rating of 100% for one year after the surgery. To obtain a disability rating, you must be able to prove 30 percent disability after a year of post-knee replacement.

How Does The Va Rate Knee Pain

VA Ratings for Knee Pain: How to Maximize Your Benefits

The VA will rate knee pain and conditions under many different diagnostic codes, depending on the specific problem, or problems, caused by a knee condition. For example, there are ratings available for instability of the knee, limitation of extension, knee replacements, etc. It is important to be aware of all the different ratings, and whether you are entitled to compensation for multiple ratings. This way, you can make sure the VA is giving you the proper percent rating and all of the compensation youre entitled to for your knee disability.

Below is a list of ratings that can potentially be assigned to the same underlying disability:

Rating decisions for one disability can be complicated. The general rule regarding multiple ratings for the same disability is, the evaluation of the same disability under various diagnoses is to be avoided. However, VA regulations specifically provide that the knee joint can be evaluated under multiple diagnostic codes where there are different manifestations of the same disability. So, as long as the knee disability affects you in separate and distinct ways, you can receive multiple ratings.

Remember that instability of the knee is a rating that is often overlooked. However, if you have problems with your knee dislocating or giving out because of a service-connected disability, instability of the knee can be rated in addition to other ratings for the same knee.

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We Help Veterans Get More Than Va Benefits For Their Knee Pain

I have been fighting the VA since I was discharged in 1972. I injured both my right knee and back while serving in the USAF. When I left, I went to the VA for my discharge exam. From there until 2008, it has been nothing but a struggleMy last appeal was denied Jan of 2015. I still had a low %. After spending 2 weeks in research, I called Woods & Woods. Until then, my representation was miserable. That is not so with my current rep. Thank you, Woods & Woods.

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Many of our clients were guys that didnt think their aches and pains were enough to get Veterans Disability. Once they called in, we worked on their case and found that they had more qualifying disabilities than they realized. If one knee is injured, the other knee and hip are making up for the weakness, so there may be secondary-service connected disabilities. Your best bet is to get your case before our team so that we can get you the best VA Rating you qualify for.

Best Ways To Get A Va Rating For Knee Pain

I hope you enjoy reading this blog post.

If you want to learn how to implement these strategies to get the VA benefits you deserve, to speak with a VA claim expert for free.

In this guide, well explore how to get a VA Rating for Knee Pain even if youve already filed, been denied, or gave up.

Limitation of Flexion of the Knee or Knee Pain is the #3 most common VA claim.

VA Disability for Knee Pain ranges from 10 percent to 30 percent with an interim break at 20 percent.

The highest schedular rating for knee pain, also called Limitation of Flexion of the Knee is 30%, and includes the following symptoms:

  • Recurrent subluxation or instability: Unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribes both an assistive device , crutch, walker) and bracing for ambulation.

Your final VA Disability Rating for Knee Pain depends upon the Frequency, Severity, and Duration of symptoms and any impairment or loss .

Chronic Knee Pain can have considerable debilitating effects on veterans, especially due to the side effects of medications taken to manage your pain, which can lead to a variety of other disabling conditions such as various Orthopedic Conditions, Plantar Fasciitis, Arthritis, GERD and IBS, and Depression and Anxiety.

Thus, its possible for to get various conditions service connected Secondary to Knee Pain.

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What Do I Need To Prove To Obtain Disability Benefits For My Knee Replacement

The success of every disability benefits claim or appeal hinges on one thing: proving your condition is a result of an event, illness, or injury that occurred during your military service.

If you cannot prove your need for a knee replacement stemmed from an in-service injury, illness, or event, you will not be eligible for benefits.

Buddy And Lay Statements

Winning VA Compensation For Knees: Part 2

There are also additional documents that can help prove service connection and increase disability rating. Buddy statements and lay statements can be very influential in receiving more compensation for knee injuries or knee joint pain. A buddy statement is written by another service member, while a lay statement is from a family member or peer.

These statements help communicate to the C& P examiner how your service-connected knee condition affects your daily activities. If youre missing the necessary medical evidence or your service records have been lost, buddy and lay statements can help push your case through. Depending on the severity described in statements, these documents can be helpful in getting an increase to ratings above 50%. Buddy and lay statements should be submitted to the C& P doctor to strengthen your claim.

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Can Knee Pain Cause Depression And Anxiety

Service connected Knee Pain can absolutely lead to day-to-day work and life challenges such as immobility and weight gain.

Thus, Knee Pain can impact a veterans work, life, and social functioning, which can cause or aggravate Depression and Anxiety.

Accordingly, a veteran can be service connected for Depression and Anxiety secondary to Knee Pain.

Depression and Anxiety VA ratings depend on the severity of a veterans mental health symptoms, meaning, the more severe your symptoms, the higher the VA rating for Depression and Anxiety.

The average VA Rating for Depression and Anxiety is currently at 70%, but veterans can be rated from 0% to 100% with breaks at 10%, 30%, 50%, 70%.

Va Disability Ratings For Knee Pain

Once your knee condition is service connected, VA will assign a disability rating ranging between 0 and 100 percent. More serious and disabling knee injuries are assigned higher ratings.

Overall, VA ratings for knee pain depend on various factors, such as:

  • The type of knee injury
  • The severity of the diagnosed knee condition
  • The knees range of motion
  • The pain it causes

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What Are The Common Treatments For Knee Pain And Injuries

If a Veteran notices a bilateral knee injury, it is important that they seek a diagnosis and treatment as soon as possible. Luckily, there are many forms of treatment. These treatments fall into two categories: surgical and non-surgical options.

Non-surgical options:

  • Rest: One of the most important treatments for bilateral knee conditions is to let the knees rest. When the knee needs to heal, pressure and stress will only aggravate the condition.
  • Physical therapy: Your physician might recommend exercises to strengthen leg muscles and make your knees function properly.
  • NSAIDs: Doctors may also prescribe anti-inflammatory drugs to reduce knee pain and swelling.
  • Steroids: In addition to pain relievers, your physician may suggest corticosteroids in the form of a pill or an injection. These steroids reduce inflammation and slow the progression of a knee condition.

Surgical options:

  • Arthroscopic surgery: This surgery uses a small, thin incision and a camera probe to diagnose and treat painful conditions like a torn ACL.
  • Meniscectomy: This surgery removes a torn portion of the meniscus, a cartilage pad in the knee that is a common cause of knee pain and injury.
  • Knee replacement: This option may be necessary when all other treatment plans have been ruled out. Knee replacements can be partial, full, or even bilateral, depending on the severity of the condition or injury.

Veterans should consult their doctor for the best form of treatment for their specific knee condition.

Va Compensation For Knee Brace

Va Range Of Motion Chart For Knee

The Department of Veterans Affairs provides compensation benefits to Veterans who are disabled as a result of injury or disease incurred or aggravated during active military service. Benefits may also be available to certain Veterans spouses, children, or parents. One of the benefits available is reimbursement for the cost of a knee brace. The Veteran must have a doctors prescription for the brace, and the brace must be approved by the VA. The VA will reimburse the Veteran up to $1,000 for the cost of the brace.

The following is a summary of the VAs Annual Benefits Report for Fiscal Year 2020. There is a third leading cause of disability: limited knee flexion. There are several different types of knee pain, and each is assessed using a different set of criteria. Veterans who have had preexisting medical conditions worsen as a result of their service are also compensated. When the knee does not freeze but rather becomes limited in extension and unable to straighten completely, the knee has a limitation of extension. The VAs evaluation of this condition is based on a veterans ability to move their knee at the appropriate range of motion. Disability ratings in various categories range from 0 to 20, 30 to 40, and 50 percent.

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Knee Replacement Surgery: The Risks And Rewards

A common way to relieve chronic pain is to have a knee replacement surgery. Complications, on the other hand, can make it more difficult to return to work. If you had knee replacement surgery on a knee with degenerative joint disease, or if you sustained a bad knee injury and the surgery failed, you may be entitled to Social Security disability benefits. All applicants for Social Security disability benefits must have major joint dysfunction due to any underlying cause, as well as gross anatomical deformity . Furthermore, you must have chronic joint pain and stiffness and demonstrate significant functional impairment. Although most people consider knee replacement surgery to be a successful procedure, it is common for permanent work restrictions to occur. For example, crutches are commonly used by most employees for three to six weeks following surgery. While most daily activities are resumed, it is not uncommon for a person to be placed on temporary leave. If youre considering knee replacement surgery, you should consult with your doctor to see if this is the right procedure for you. Furthermore, if you are considering the surgery, discuss any potential benefits or risks with your insurance company. If you are eligible for Social Security disability benefits, you must apply as soon as possible.

A Scar Is More Than Just Skin Deep

The depth of the disfigurement is one-half inch or more. Characteristic 2 is a scar that crosses the middle of the face. A scar that covers the entire face. This condition results from a scar covering more than half of the head. X-ray reveals a scar on an X-ray, the type 5 . The scarring can be distinguished as this. Scars of the 7th type have been identified. The scar causes the affected area to become less able to perform routine activities . A scar must meet at least one of the eight VA standards in order to qualify for a rating.

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Total Knee Replacement Disability Rating

Diagnostic Code 5055 covers individuals who receive a total knee replacement. Any veteran who gets a total knee replacement will automatically receive a temporary 100 percent VA disability rating for surgery. This is the only time a veteran can receive a temporary rating. After one year passes, the knee will be reevaluated based on the remaining conditions. The highest rating available for post-surgery symptoms after one year is 60 percent.

A bilateral VA disability rating for both knee replacements is treated the same way. After one year, however, the post-surgery symptom rating can be bilateral, which might increase the maximum compensation available. VA knee replacement compensation allows veterans to recover without having to work and damage their knees during the healing process after surgery.

Am I Eligible For Disability Benefits From Va

VA Disability Ratings for Joint Replacements

You may be eligible for disability benefits if youve had surgery or received other treatment at a VA hospital, approved hospital, or outpatient center for a disability related to your military service . You must meet one of these requirements.

If you had surgery, both of these must be true for you:

  • The surgery required a recovery time of at least one month or reports show that the surgery or treatment was for a service-connected disability, and
  • The surgery resulted in severe issues, like:
  • Surgical wounds that havent totally healed
  • Stumps of recent amputations
  • Being unable to move due to being put in splints or casts to help with healing
  • Being unable to leave your house
  • Being required to use a wheelchair or crutches

If you didnt have surgery, this must be true:

You had one or more major joints immobilized by a cast.

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What Is The Current State Of The Law On Rating Total And Partial Knee Replacements

In May 2016, the Federal Circuit Court of Appeals affirmed the rating process explained in this post. You can read the Courts decision here it begins with a jurisdictional question which it narrowly resolved in this Veterans favor.

Whats interesting about the decision is that the Fed Circuit called out the CAVC for what it very politely called a stretch in logic. Heres how.

The CAVC decided that the VA could not rate a Partial Knee Replacement using the same diagnostic code as a Total Knee Replacement because every part of the knee was not replaced, and the rating criteria DC 5055 excluded a less than total knee replacement.

The Fed Circuit didnt buy the VAs arguments, finding them light on support in the facts the Court pointed out that the majority of BVA decisions actually concluded exactly the oppositea fact conveniently overlooked by the CAVC and the VA. .

The Fed Circuit also caught the VA red-handed playing silly red-tape games.

The VA argued that DC 5055 was unambiguous in excluding Partial Knee Replacements from its rating criteria.

However, while on appeal, the VA published Interpretative Guidance explaining this point and seeking to clarify that DC 5055 did not apply to partial knee replacements.

The Fed Circuit said Not so fast, VAyou cant argue something is clear while releasing guidance that purports to clear up an ambiguity on the same issue you argue is unambiguous.


38 CFR 4.71, DC 5256

Depression And Anxiety Secondary To Knee Pain

According to the Mayo Clinic, Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest.

Clinical Depression is most often diagnosed as Major Depressive Disorder , and it affects how you feel, think, and behave and can lead to a range of mental, emotional, physical, and social problems.

Veterans may have trouble accomplishing normal day-to-day activities, you may be too depressed to leave your home or get out of bed, and sometimes you may even feel as if life isnt worth living .

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