Knee-related disabilities are not uncommon among Veterans, especially those who have served in physically demanding roles or have been exposed to activities that put stress on the knee joint. In fact, Limitation of Flexion of the Knee is among the top 5 VA disability claims.
The VA disability rating for knee pain is based on the severity of the condition and its impact on your ability to perform daily activities and work-related tasks. As of now, VA disability rating knee pain ranges between 10% and 30%. However, the limitation of flexion is far from the only diagnosis that is characterized by pain in the knee. Therefore, your VA disability rate can vary greatly depending on the nature of your condition, as well as factors such as:
- Medical evidence – To verify the severity of the condition, the VA will review medical documentation, including examinations, imaging studies, and reports from healthcare providers
- Degree of the limitation – The VA will examine how much the condition limits the knee’s range of motion
- Functional impact – VA evaluates how the knee condition affects your ability to perform essential daily activities, work-related tasks, and physical activities.
Chronic pain, functional impairment, severe limitation of range of motion, as well as the ineffectiveness of various forms of treatment are the criteria that can be qualifying factors for the highest VA disability rating.
In addition, it is important to point out that knee pain is mainly notorious among Veterans due to the severity of the side effects of the medications that are used to treat and manage this condition today. Those side effects can vary from additional physically disabling conditions such as Arthritis, Gastroesophageal Reflux Disease (GERD), and Irritable Bowel Syndrome (IBS) to severe mental disorders like Depression and Anxiety.
That said, let`s take a closer look at the role of knee pain in the system of VA disability rating and see how you can maximize and secure the VA benefits that you are entitled to due to this common service-related condition.
Which Knee Disorders Could Make a Veteran Eligible for VA Disability Benefits?
Even though, as we have mentioned above, knee pain is a pretty common condition among Veterans and one of the leading VA disability claims today, reporting the pain itself will not automatically qualify you for VA disability benefits.
The pain itself is considered a mere indicator of a possible chronic condition or illness, or a result of an injury. Each of these disorders may get you different VA disability ratings. That is why it is vital to determine which exact condition you are dealing with. Here at Veterans Claims United (VCU), we help Veterans get consultations from all sorts of independent medical professionals because we understand how different every case may be, and how important it is to identify the nature and severity of each disabling syndrome precisely in order to save you a great deal of time, energy and resources on the way to you maximum VA disability benefits.
The list of disabling conditions that can make you eligible for VA disability benefits includes Osteoarthritis, Rheumatoid Arthritis, Patellofemoral Syndrome, Ligament Injuries, and about a dozen more orthopedic diseases.
However, diagnosing the exact condition is only the first step on your way to receiving well-deserved VA disability benefits. Now you need to prove that it is service-related.
Proving that your knee pain is service-related
Proving service connection for knee pain in a VA disability claim means establishing a link between knee pain and your military service. The process can be pretty complex and lengthy, involving numerous nuances and bureaucratic hurdles. That is why we strongly recommend sticking to professionals’ guidance and recommendations on the way.
Here is what you need to do to establish that your knee pain is service related and therefore makes you eligible for VA disability benefits:
- Collect medical evidence
Gather thorough medical records and documentation that specify the character of your knee pain, its progression, and the history of the condition. Imaging studies (X-rays, MRI scans), diagnoses, treatment plans, surgical reports, and medical evaluations can all fall under this category.
- Provide in-service documentation
Look for any notes of knee pain or injuries during service in your medical records, incident reports, or entries in your military service records. These records can be used to prove a link between your knee problem and your time in the military.
- Get a Nexus opinion
A nexus opinion is a medical statement from a licensed healthcare professional that makes a connection between your military service and your knee pain. Such evidence that the knee condition is “at least as likely as not” will help your case greatly.
- Seek “Buddy statements”
Additional evidence to back up your claim may come from fellow service members who saw or heard about your knee pain or other injuries while you were serving in the military.
- Establish a secondary service connection
We shall touch on this topic in more detail further in this article, but in general, the idea is that the knee pain may be secondary to another service-connected condition, such as a back injury or hip condition. If you have a service-connected condition that has led to or exacerbated your knee pain, you can claim a secondary service connection.
- Determine continuity of symptoms
It may be easier to prove a link between your condition and your military service if you had knee pain while serving and can show that it has persisted or gotten worse since then.
- Seek expert opinions
Your case may be strengthened by seeking the advice of independent medical professionals who can offer their professional judgments on the connection between your knee pain and your military service.
- Gather VA medical examinations
A medical examination by a VA healthcare provider is part of the disability claims process. It can help determine the extent of any potential service connection for your knee pain.
Your chances of a successful VA disability claim increase with the degree of the link between your military service and knee pain. However, as we have already mentioned, you should not overlook the possibility of a secondary service connection for knee pain. Let`s dive in.
What is Secondary Service Connection for Knee Pain and How Does it Affect VA disability benefits?
Secondary service connection is a concept in VA disability claims where a new medical condition, known as the secondary condition, is linked to a primary service-connected condition. In this scenario, the secondary condition is not a direct result of military service, but it is caused or aggravated by a primary service-connected condition.
Suppose, you have a primary service-connected back injury that affects your gait, posture, and the way you walk. Your knees will gradually become more stressed as a result of this altered gait, which will cause discomfort and limitations. In this case, knee pain would be considered a secondary condition connected to your primary service-connected back injury.
There are several ways that a secondary service connection can affect your VA disability benefits. Here are some examples:
- Combined disability rating
If the service connection request for the secondary condition is approved, it will be assessed independently of the primary condition. Depending on how severe it is and how it affects your ability to function, the VA will give the secondary condition a disability rating. Your overall level of disability compensation will then be calculated based on the combined disability rating using a specific formula.
- Increase of benefits
Establishing a secondary service connection can lead to increased disability compensation. This is because the combined disability rating for both the primary and secondary conditions will result in a higher total disability rating, which corresponds to a higher level of compensation.
- Eligibility to benefits
You must have a current service-connected disability (the primary condition) and medical documentation demonstrating a cause-and-effect connection between the primary and secondary conditions in order to establish a secondary service connection. This means that you must show that the primary condition directly contributed to the development or worsening of the secondary condition or that it aggravated the primary condition.
- Change of the effective date
The effective date for the secondary condition is typically the date when you file a claim for a secondary service connection or the date that the secondary condition was first diagnosed or treated by a medical professional, whichever is later. This effective date can impact the number of retroactive benefits you receive.
The idea is that your knee pain may not have developed while you were in the service, but occurred much later as a symptom of a service-related accident or disease.
But what if your knee pain was diagnosed before the service and the condition worsened during your time in the military?
Service-Connected Aggravation of Knee Pain
Suppose you had a pre-existing knee condition that was diagnosed before entering military service, and that condition worsened or was aggravated during your time in the military. The key factor here is to prove that it was precisely the military service that escalated your already existing condition and caused knee pain. To do so, you can demonstrate that the demands of your military duties or specific incidents during service contributed to the worsening of your knee condition.
In this case, you may still be eligible for VA disability benefits due to pre-existing knee pain.
This scenario is called an aggravation claim, and here is what you need to know about it.
- Medical Evidence
Medical evidence is crucial in aggravation claims. You would need medical documentation that supports the fact that your knee condition worsened during your military service or that your service contributed to the deterioration of the condition.
- Continuity of Symptoms
If you can demonstrate a continuity of symptoms from the time of your pre-existing diagnosis to your military service and beyond, it can strengthen your claim for aggravation.
- Evidence of Impact
It can be helpful if you have proof that your military obligations or incidents that happened during the service made your knee condition worse. Those can be training exercises or physical demands that aggravate your symptoms.
Service-Connected Aggravation of Knee Pain
To start an aggravation claim, you will need to collect and present solid medical evidence that your knee pain existed before you started your career in the military and that it was the service that caused the worsening of your condition.
The evidence is usually:
- A current diagnosis report about your condition
- X-rays, imaging scans, chart notes, surgical reports, and other medical documentation about your knee condition that were issued before you started your military service
- Comparable medical documentation about the same condition after the service
- Nexus opinion, which is a testimony of a qualified independent healthcare professional, who would confirm the connection between the demands and circumstances of your military service and the worsening of the knee pain.
The VA knee Rating Process Explained
As you now know, the simple term “knee pain” can cover a vast range of conditions, which means that the VA disability rate can vary greatly depending on the exact nature of your knee pain and the medical evidence you can provide in the process of claiming your VA disability benefits.
That is why it may be so helpful to talk to professionals who understand all aspects and ratings available for such conditions as instability of a knee, limitation of flexion and extension, etc. Making sure that the VA is giving a proper rating and compensation in your particular case may require some very specific insights and knowledge of the latest updates in the rating system.
Based on the motion range of the knee joint, the VA disability rating can vary from 0% for normal range of motion (ROM) to up to 50% for severe limitations, significantly affecting daily activities and work tasks. The latter ones have specific disability rating charts based on the severity of the limitation.
Another section in the VA disability chart for knee pain is the Unfavorable Ankylosis.
Unfavourable ankylosis of the knee is a medical term used to describe a condition where the knee joint is completely immobile or fixed in a certain position, resulting in a severe loss of range of motion. In the context of VA disability ratings, unfavorable ankylosis of the knee is considered a serious and debilitating condition that can reach up to 60% in disability rating due to the substantial functional impairment it causes.
In some cases, your knee pain may even result in a 100% VA disability rate. For example, if your condition gets so severe that you require a surgical replacement of the entire knee joint, VA will automatically assign you a temporary 100% disability rate for a period of 1 year after the surgery.
After that period, the condition of your knee and its effect on your overall well-being will be reevaluated once again, and you will receive your permanent VA knee disability rate. If the medical examiner confirms that you suffer from weakness and severe pain during motion, you can receive a 60% VA disability rate, which is the highest rating available for residuals of the total knee replacement.
VA regulations acknowledge that knee pain can be a manifestation of various disabilities and therefore, you can receive various ratings and even combined VA disability ratings if you are suffering from a knee condition.
Knowing these ratings and specifications of different diagnoses they reflect will ensure that you receive all the VA benefits and compensations that you have deserved in the years of service.
To make navigating the complex terrain of the VA disability claim process easier and most efficient, reach out to VCU. Our team understands the challenges of the VA disability claiming process and has vast experience in providing Veterans and their families with expert guidance every step of the way. From understanding eligibility criteria to compiling comprehensive medical evidence, your journey to a more secure future begins with contacting VCU today.