Jim,
Thanks for taking the time to read my problem. I have been rated at 50% for over 10 years (40% right knee extension 30 degrees – 10 % scars – 10% lumbar back). I have been SC on my knee since 1979 went from 0% to 10% to 30% and finally 40% in 2002. I went to the local VAMC and the DAV VRO located in the hospital, helped me start a re-evaluation for my knee – back –and hearing to include tinnitus. Hearing and tinnitus are new.

The problem I have is with the C&P exam for my knee and back (2-19-13). I requested and received copies of the exams from the hospital. Both were done on the new DBQ forms. The doctor only took 2 measurements, one for my knee flexion 30 degrees (I agree with this) but he put on the form that I had 5 degrees extension, my knee is in one position (I could not move it forward or back from where he took the measurement). This would bring my extension rating from 40% to 0%, I have no idea how he put this measurement down. He even stated I walked with a cane very slow gait and hard limp favoring my right knee. When I walk with the cane I walk on my toes with my right foot because I can no longer put my weight on my right knee. On the DBQ he stated I could put full weight on the right knee and several other things like no pain on movement, but in his remarks he stated I had constant pain in knee. The other measurement was my back, he had me stand I barely could move forward, but he put that I could move 60 degrees flexion.

I went to the VAMC on 4-10-13 for severe back pain, they took x-rays and it showed I have severe degenerative osteophytes and sclerosis. For the first time I accepted pain meds after 30 years of saying no. I saw my PCP at the VAMC on 4-25-13, and asked if he could evaluate my ROM on my knee and back (he also set me up with a pain med agreement). He said I have a ROM of 50 degrees on my right knee (that would bring my rating to 50%) and I only had 15 degrees on forward flexion for my lumbar back (40% rating). I went to the VRO and they said I should not send this information to the Oakland RO, that I should what until I get a rating back. Do you think I should send a Statement in Support Form 21-4138, listing the problems with the C&P examiner, showing point for point in reference to the DBQ the items he checked were wrong.

The C&P exams were done with an assigned outside civilian agency by the VARO, both hearing and knee and back. The doctor did one thing good on the form he stated I would not be able to work because of my knee and back, so when I go for TDIU this will help. I had to stop working almost 3 years ago because of my knee and back. Thank you very much for any advice. You are doing a great service for the vets.

Reply:

Your VSO is correct. There is nothing you can or should do now until you get a decision. If the decision isn't what you believe you deserve, you appeal because of an inadequate exam and then is when you state your disagreement with the C & P exam.

I understand that it may seem that to submit it all now would save time but it won't. These things are done in a stepwise fashion and in appropriate order. You should just wait until you get the letter. You never know that the rating may be favorable and you're done. If not, you will appeal. The majority of decisions that we receive will require an appeal. VA typically makes errors in about 70% of all initial claims. The necessity of an appeal has become a routine part of the process.