Does Braces Warrant A Seperate Rating (Knee) in VA Disability Claims (General) Forum

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Does Braces Warrant A Seperate Rating (Knee)

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Desiretofish

Does Braces Warrant A Seperate Rating (Knee)

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Posts: 653

Jun 2 10 6:18 PM

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If you have been prescribed/wear braces by the VA Ortho doc for your knees does that warrant a seperate rating (for instability purposes)?

Just had a re-evaluation on my sc knee condition and I felt it went fairly smooth compared to the initial C&P for service connection.

Desiretofish

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opey71.mobilecatering

#1

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Posts: 203

Jun 2 10 7:18 PM

I have never heard of a separate claim for instability purposes but I bet one of the experts will chime in here. The Va will pay for your braces and possibly a clothing allowance depending if your brace is metal or not but thats all I am aware of.

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USNDW

#2

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Posts: 4378

Jun 2 10 7:31 PM

5256 Knee, ankylosis of:
Extremely unfavorable, in flexion at an angle of 45° or more	60
In flexion between 20° and 45°	50
In flexion between 10° and 20°	40
Favorable angle in full extension, or in slight flexion between 0° and 10°	30
5257 Knee, other impairment of:
Recurrent subluxation or lateral instability:
Severe	30
Moderate	20
Slight	10
5258 Cartilage, semilunar, dislocated, with frequent episodes of “locking,” pain, and effusion into the joint	20
5259 Cartilage, semilunar, removal of, symptomatic	10
5260 Leg, limitation of flexion of:
Flexion limited to 15°	30
Flexion limited to 30°	20
Flexion limited to 45°	10
Flexion limited to 60°	0
5261 Leg, limitation of extension of:
Extension limited to 45°	50
Extension limited to 30°	40
Extension limited to 20°	30
Extension limited to 15°	20
Extension limited to 10°	10
Extension limited to 5°	0
5262 Tibia and fibula, impairment of:
Nonunion of, with loose motion, requiring brace	40
Malunion of:
With marked knee or ankle disability	30
With moderate knee or ankle disability	20
With slight knee or ankle disability	10
5263 Genu recurvatum (acquired, traumatic, with weakness and insecurity in weight-bearing objectively demonstrated)	10

I didn't see anything about braces, but instability will have a rating
If you have a metal hinged brace check out the clothing allowance

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opey71.mobilecatering

#3

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Posts: 203

Jun 3 10 6:08 AM

It sounds like he is saying the braces make him unstable? If so would that be rated if he was stable without the brace?

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Desiretofish

braces

#4

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Posts: 653

Jun 3 10 6:26 AM

I was given the braces because my knees were very unstable(very unstable was doctors statement).

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vetforus

#5

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Posts: 3006

Jun 3 10 8:30 AM

One of my knees instability is severe and one is mild, both Service Connected. I tried a brace and did not see a benefit, just more difficulty using it so I declined and took a cane. The brace won't give you a seperate rating. Knee issues are no fun, especially when you never know when you'll fall next.

You paid a price, you deserve to be compensated. Thank you for your Service.

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Desiretofish

instability

#6

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Posts: 653

Jun 3 10 8:38 AM

Is instability a separate rating.{knee}.

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NavyNCC

#7

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Posts: 4640

Jun 3 10 8:42 AM

Navy Chief
Initiated by Choice
Proud of Tradition

Desiretofish wrote:
Is instability a separate rating.{knee}.

You have gotten some good answers so far, but just to clarify, instability in and of it self is not a seperate rating.

With that being said, if the instability is the worsening of a service connected condition, for instance the SC knee is now unstable and requires a brace, put in for an increase.

Thank you for your Service,

NavyNCC

"We keep you alive to serve this ship"

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vetforus

#8

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Posts: 3006

Jun 3 10 8:43 AM

Desire,
Yes, Severe is 30%, Moderate is 20% and mild is 10%. If you have both knee issues then the bi-lateral kicks in.

You paid a price, you deserve to be compensated. Thank you for your Service.

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vetforus

#9

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Posts: 3006

Jun 3 10 8:46 AM

Navy,
I see we posted at the same time. I gave my answer based on my SC conditions. Back 40%, Left knee 30%, Right Knee 10%. If you have documented medical evidence about instability of your knees you will get the ratings.

You paid a price, you deserve to be compensated. Thank you for your Service.

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NavyNCC

#10

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Posts: 4640

Jun 3 10 8:48 AM

Navy Chief
Initiated by Choice
Proud of Tradition

vetforus wrote:
Desire,
Yes, Severe is 30%, Moderate is 20% and mild is 10%. If you have both knee issues then the bi-lateral kicks in.

While instability can be used to determine the percentage of disability, it is not a seperate rating. In other words you won't have a rating for the knee and a seperate rating for instability of the same knee.

NavyNCC

"We keep you alive to serve this ship"

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lvacjoub

#11

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Posts: 1414

Jun 3 10 9:19 AM

Navy, instability in a knee can justify a separate rating when the knee is already rated for limited motion or for arthritis.

Ivac

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Desiretofish

#12

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Posts: 653

Jun 3 10 9:42 AM

Ivacjoub,

Thanks. That is what I thought when I read the 5257 code above concerning lateral instability (knee: other impairment of). It makes sense that it is a seperate rating. I probably phrased my question wrong when I asked if braces warranted a seperate rating. Should have phrased it as "does instability of the knee (the reason braces are prescribed) warrant a seperate rating. Thanks to all that responded. Learn something new everyday.

Desiretofish

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cruiser

#13

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Posts: 17464

Jun 3 10 10:03 AM

The knee is a unique animal when it comes to a VA disability evaluation. It is the only joint in the body that can have two separate orthopedic ratings. This isn't because the knee is special or unique but merely because of the way the evaluation criteria is written. I don't think it was VA's intent when they wrote the criteria but since the criteria are regulatory they are stuck with what they have until, if and when, they decide to re-write them.

It was the VA General Counsel who wrote the opinion that requires VA to do this despite what the original intent of the regulation may have been. I think that this is a good argument against those who maintain that the General Counsel is merely a rubber stamp for the Secretary of Veterans Affairs and writes whatever opinion the Secretary wants. You see this argument a lot pertaining to the Agent Orange opinion regarding presumptive exposure for blue water navy guys.

Cruiser

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Vike17

#14

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Posts: 1971

Jun 3 10 10:44 AM

See VAOPGCPREC 23-97 and 9-98

Vike 17

A-Btry, 3/35 Field Artillery
72nd Field Artillery Brigade
"Fire Mission"

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NavyNCC

#15

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Posts: 4640

Jun 3 10 11:13 AM

Navy Chief
Initiated by Choice
Proud of Tradition

lvacjoub wrote:
Navy, instability in a knee can justify a separate rating when the knee is already rated for limited motion or for arthritis.

Ivac

See that is why we ask in a public forum... I stand corrected.

NavyNCC

"We keep you alive to serve this ship"

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The Old Medic

#16

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Posts: 6053

Jun 3 10 11:14 PM

opey71 wrote:
It sounds like he is saying the braces make him unstable? If so would that be rated if he was stable without the brace?

Nobody prescribes braces for knees that are stable.

US Army 1959-1969; Germany 1960-63; Medic 1964-69
SFC E-7 MOS: 55G10 (60-63) , 91B40, 91C40, 91F40 (64-69)
Registered Nurse, 1968-2005 (Licensed, not practicing after 1975)
Ed.D in Rehabilitation Counseling, Certified Rehabilitation Counselor Retired, Licensed Clinical Psychologist, Independent Social Security Contract Vocational Expert 1983-2005, Contract Medical Expert 1987-2005
60% Service Connected Disabled; Life Member of the DAV since 1980

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cruiser

#17

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Posts: 17464

Jun 4 10 8:59 AM

OK, the question was

Does Braces Warrant A Seperate Rating (Knee)

The short answer is "No."

The simple act of wearing a brace doesn't warrant any type of evaluation, in and of itself. An evaluation can be assigned for loss of range of motion and an evaluation can be assigned for instability. While one can make an assumption that there is at least some instability in the knee if a brace has been prescribed, the fact is that the doc must specifically say that the knee is unstable. In that case the evaluation for instability is based on the doc's statement that there is an unstable knee, NOT the fact that a brace is being worn.

Keep in mind that there are various types of compression sleeves that are worn on extremities for reasons other than stability. For example, over the years I've had contraptions prescribed that I wore on both my wrist and my elbow that were designed to place pressure at certain points for pain control. The Rating Specialist isn't a doctor and isn't allowed to diagnose or offer medical opinions. If the doc SAYS that your knee is unstable you may well be entitled to an evaluation based on that instability.

Cruiser

Cruiser

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