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welcome to cck live my name is Emma Peterson and today I'm joined by my colleagues Frank
Padula and Michelle dutori and we're going to be discussing secondary conditions to knee pain
so knee pain and knee disabilities in fact are one of the most prevalent conditions
among veterans with about 98 000 veterans becoming service connected for a knee disability in 2020.
now knee pain and knee disabilities can be rated under a variety of diagnostic codes
and they all fall under 38 CFR section 4.71 A so for example you could have limitation of flexing
of your knee and that's under a diagnostic code 5260 and this refers to the range of the motion
of your knee As you move it or curl it inwards towards your body typically VA rates this based
on how far you can move it towards your body and they look at your range of motion similarly
limitation of extension of the knee or diagnostic code 5261 refers when the knee is not frozen but
is limited in terms of how far you can extend it meaning you can't straighten it all the way
there's also a couple other diagnostic codes that are pretty you regularly used including
instability of the knee under diagnostic code 5257 ankylosis of the knee under 5256 total
knee Replacements under code 5055 and partial knee Replacements which don't have their own
diagnostic code but are often rated under the symptoms and residuals that they cause
um so Frank why don't you walk us through some of the secondary conditions so not if any disability
themselves the secondary conditions that can result from having one of these knee disabilities
absolutely um so secondary service connection um it's important to understand that disabilities can
become service connected on a secondary basis when veterans show VA that the disability was either
caused or aggravated by the primary disability that is already service connected and Veterans
can file a claim for secondary service connection using va's claim form the VA form 21526ez which is
the same way that they would file for any other disability and some common secondary conditions
to knee disabilities it's important to note knee disabilities are pretty Common Primary
disabilities that result in secondary disabilities that can be subject to service connection um again
some of the most common secondary disabilities include maybe other Orthopedic disabilities
um so other Orthopedic disabilities can arise from the service-connected knee disability for
example me disabilities might affect a person's posture or they might affect the way that that
person may walk and in turn that could result in another knee disability a hip disability or even
a back disability A good rule of thumb related to that is to remember that me disabilities most
commonly affect parts of the body that may might be above the knees for example as I just mentioned
maybe the hips or the back and related to that as well veterans might have a harder time showing
that their knee disabilities affected parts of the body that are below the knees maybe something like
the ankle or a foot disability so Michelle can you tell us a little bit about arthritis give them so
a knee condition can sometimes cause a person to develop arthritis or vice versa meaning that their
arthritis can maybe cause any condition so that would mean that some veterans might be eligible to
become secondary service connected for arthritis if it develops as a result of the knee condition
or secondary to a service connection for a knee condition if it develops as a result of arthritis
another common secondary service connection that maybe people don't notice or know as much about
is GERD which is gastroesophageal reflux disease and basically that this is a condition where the
stomach acid flows back up the esophagus which connects the stomach the mouth to the stomach
there's often we see happens because veterans are prescribed NSAIDs or pain medication in
its common side effect of the medication that they're taking I think that's something to be
mindful of when we're talking about gerd or maybe even IBS is that it doesn't necessarily need to be
secondary to it but it could also be aggravated by it so like it could not often caused directly by
it meaning that like you had gerd before you had IBS before but the medication then causes your
condition to worsen or have more flare-ups as a result so I think that's always a little bit of
an aspect that sometimes you don't think about is like yeah maybe I had the condition but because
I'm now taking this medication my condition is worse so I think that that's an aspect that
people don't think about um when they're kind of thinking about these secondary service connections
like GERD and you know IBS is another one that I sometimes as well absolutely and so the to
Michelle's point you can still file for service connection even if something has been aggravated
by your service connected condition maybe not caused by it directly but just made worse by
it another common secondary condition that we see a lot is depression you know knee pain can
be extremely debilitating it can limit someone's Mobility and so as such many veterans experience
depression anxiety or other psychiatric symptoms as a result of the pain and physical limitations
caused by their knee disabilities so if a veteran develops depression or any other
psychiatric disability as a result of their need condition or any other condition really
the impact has in their day-to-day life they may be eligible for secondary service connection
um Frank talk to us more about limited mobility and how that can also cause
impacts on someone's livelihood yeah so you know it's important to also understand that
obesity could serve as an intermediate step between knee disabilities and another disability
you know and for example what that means knee disabilities may make it harder for someone
to exercise and remain at a weight that is not considered obese so therefore the knees could
be linked to obesity and the Obesity could be linked to another disability that could be subject
to service connection so important takeaway there is that obesity itself can't be service
connected but anything it causes or worsens and there's a whole host of conditions out there
um could potentially be service connected right another disability it kind of goes back to
Michelle's point with the gerd it's also important to understand that medications used to treat knee
disabilities could have other side effects that are subject to service connection as well for
example headaches could be a common side effect of the medication used to treat knee disabilities
um so therefore in that scenario headaches could be subject to service connection secondary to knee
disabilities because of the medications used to treat those knee disabilities
now Michelle talk to us about tbiu and knee conditions
so I will quote Frank on this they often come with really severe limitations so one thing
that you don't necessarily always think is knee conditions unemployability but unfortunately when
people have knee conditions they become very disabled and very limited in their ability
sit stand walk lift and it becomes very limiting in what they're able to do
so this is when we start talking about tdiu or total disability based on individual unemployed
ability you have the scheduler criteria which is when you have one condition rated at 60 or more
than one condition or if the combined rating of 70 and one condition at least 40 percent where you're
saying you're unable to secure file and or follow substantially gainful employment because of these
service connected conditions keep in mind just because you don't meet the scheduler criteria does
not mean that you are not entitled you can meet the extra scheduler criteria which is anything
that falls below the scheduler criteria so I think it's just something to be thinking about
when you do get service connected for your need conditions that you know maybe you're not
entitled to a higher rating under your schedule or Diagnostics but you might be able to still go
for unemployability because the severity of those knee conditions impact your ability to work and
therefore would entitle you to unemployability benefits so I think it's also something just to
think about as well when you're talking about conditions or things to apply for when you're
applying for your your increase ratings for your need conditions or in general for
your knee conditions great thanks Michelle and thanks Frank and thank you all for watching
more information on the conditions discussed in this video can be found on our blog also
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thank you
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