Getting both knees replaced after TDRL

jozzz123

jozzz123

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Registered Member
The question I have is this. I am getting both knees replaced after this is all complete and i am back home. I am being put on TDRL 60% DOD 80% VA. After I get my knees done does anyone think that my percentages will go down and taken off TDRL and just separated with compensation? I mean I am getting the knees done regardless, but if that means I loose retirement, I will need to make some more changes financially.
 
I am not a professional on this. But my thought process, I would think that they would go up! What are you on TDRL for? was it for both your knees? If you are going to prosthetic knees I would think the percentages would be higher but I know also it would depend on your ROM. But there is a minimum for prosthetics for the joints too.
 
jozzz123 said:
The question I have is this. I am getting both knees replaced after this is all complete and i am back home. I am being put on TDRL 60% DOD 80% VA. After I get my knees done does anyone think that my percentages will go down and taken off TDRL and just separated with compensation? I mean I am getting the knees done regardless, but if that means I loose retirement, I will need to make some more changes financially.
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Minimum rating is 30% for each knee. Have you been to by a doctor this is required, or is it something you think needs to be done?

5055 Knee replacement (prosthesis).
Prosthetic replacement of knee joint: For 1 year following implantation of prosthesis 100

With chronic residuals consisting of severe painful motion or weakness in the affected extremity 60

With intermediate degrees of residual weakness, pain or limitation of motion rate by analogy to diagnostic codes 5256,
5261, or 5262.

Minimum rating 30
 
jozzz123 said:
The question I have is this. I am getting both knees replaced after this is all complete and i am back home. I am being put on TDRL 60% DOD 80% VA. After I get my knees done does anyone think that my percentages will go down and taken off TDRL and just separated with compensation? I mean I am getting the knees done regardless, but if that means I loose retirement, I will need to make some more changes financially.
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My initial question is "Did the DoD IDES PEB determine an unfitting condition for each knee?" If your answer is "no" then the DoVA shall rate your bilateral knee replacement as a military veteran. If your answer is "yes" then the DoD - Army shall perform a TDRL re-evaluation.

From my experiences and information received from a Regional VA Office representative, the DoVA usually are less likely to award disability compensation for the completion of an elective medical surgery. The Regional VA Office representative asked the question "What is the purpose of any medical surgery?" then she replied it's to make any medical condition better and the DoVA doesn't compensate for an improved medical condition.

To that extent, if there exist medical condition complications from a successful surgery, or additional medical condition complications as a direct result of a failed surgery then there exist a possibility for the award of DoVA disability compensation.

With that all said, your forthcoming bilateral knee replacement has an associated VASRD Code 5055; therefore, it seems that you shall retain military disability retirement by receiving at least a 30% minimum rating for each knee (without the bilateral factor included) as follows:

5055 Knee replacement (prosthesis).

Prosthetic replacement of knee joint:
For 1 year following implantation of prosthesis-------------------------------------------------------------------------- 100

With chronic residuals consisting of severe painful motion or weakness in the affected extremity--------------- 60

With intermediate degrees of residual weakness, pain or limitation of motion rate by analogy to diagnostic codes:
__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

__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

Minimum rating----------------------------------------------------------------------------------------------------------------- 30

Thus, possessing well-informed knowledge is truly a powerful equalizer.

Best Wishes!
 
jozzz123 said:
The question I have is this. I am getting both knees replaced after this is all complete and i am back home. I am being put on TDRL 60% DOD 80% VA. After I get my knees done does anyone think that my percentages will go down and taken off TDRL and just separated with compensation? I mean I am getting the knees done regardless, but if that means I loose retirement, I will need to make some more changes financially.
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How old are you?
 
Warrior644 said:
My initial question is "Did the DoD IDES PEB determine an unfitting condition for each knee?" If your answer is "no" then the DoVA shall rate your bilateral knee replacement as a military veteran. If your answer is "yes" then the DoD - Army shall perform a TDRL re-evaluation.

From my experiences and information received from a Regional VA Office representative, the DoVA usually are less likely to award disability compensation for the completion of an elective medical surgery. The Regional VA Office representative asked the question "What is the purpose of any medical surgery?" then she replied it's to make any medical condition better and the DoVA doesn't compensate for an improved medical condition.

To that extent, if there exist medical condition complications from a successful surgery, or additional medical condition complications as a direct result of a failed surgery then there exist a possibility for the award of DoVA disability compensation.

With that all said, your forthcoming bilateral knee replacement has an associated VASRD Code 5055; therefore, it seems that you shall retain military disability retirement by receiving at least a 30% minimum rating for each knee (without the bilateral factor included) as follows:

5055 Knee replacement (prosthesis).

Prosthetic replacement of knee joint:
For 1 year following implantation of prosthesis-------------------------------------------------------------------------- 100

With chronic residuals consisting of severe painful motion or weakness in the affected extremity--------------- 60

With intermediate degrees of residual weakness, pain or limitation of motion rate by analogy to diagnostic codes:
__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

__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

Minimum rating----------------------------------------------------------------------------------------------------------------- 30

Thus, possessing well-informed knowledge is truly a powerful equalizer.

Best Wishes!
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Well, here goes. I was found unfit for PTSD and my left knee, the right knee they said was OK. My ortho surgeon said I should have the surgery, and I agree if it will ease the pain. I am also suffering from nerve damage in both legs and my wrist now thanks to the cane I have to use on a daily basis just to get around. I have scaring on my face but in the 199 it says that it does not cover enough of my face for them to rate. I shall find out what the Order of the Purple Heart has to say about all of it. But thank you for all your help too. I really appreciate it.
 
trishnron said:
I am not a professional on this. But my thought process, I would think that they would go up! What are you on TDRL for? was it for both your knees? If you are going to prosthetic knees I would think the percentages would be higher but I know also it would depend on your ROM. But there is a minimum for prosthetics for the joints too.
Click to expand...


Well, here goes. I was found unfit for PTSD and my left knee, the right knee they said was OK. My ortho surgeon said I should have the surgery, and I agree if it will ease the pain. I am also suffering from nerve damage in both legs and my wrist now thanks to the cane I have to use on a daily basis just to get around. I have scaring on my face but in the 199 it says that it does not cover enough of my face for them to rate. I shall find out what the Order of the Purple Heart has to say about all of it. But thank you for all your help too. I really appreciate it.
 
Keep in mind a TDRL re-evaluation is not necessarily limited to only those conditions previously found unfitting. Others can be added, but your re-evaluation at the very least needs to address your full medical picture. Look at DoDi 1332.38 for more info.
 
pittpan2005 said:
Keep in mind a TDRL re-evaluation is not necessarily limited to only those conditions previously found unfitting. Others can be added, but your re-evaluation at the very least needs to address your full medical picture. Look at DoDi 1332.38 for more info.
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This is all true- but, remember that in order to get a condition that was not originally found unfitting at the PEB on TDRL review, you normally have to show the condition should have been found unfitting originally, or that a condition is related to an originally unfitting condition.
 
Jason Perry said:
This is all true- but, remember that in order to get a condition that was not originally found unfitting at the PEB on TDRL review, you normally have to show the condition should have been found unfitting originally, or that a condition is related to an originally unfitting condition.
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Jason,
I have not read through the updated DoDi (on my to do list). In regards to the TDRL reviews, have you found it easier adding conditions that were not addressed previously, or changing a condition that was addressed, not unfitting at the time, to unfitting?

Also, how is the PEB handling IDES re-evaluations if the VA has not reviewed or changed the SM's unfitting conditions ratings prior? Are they applying the most recent VA rating or is the PEB requesting the VA perform a review at the time of re-evaluation?

A few questions I expect to start seeing.
 
pittpan2005 said:
Jason, I have not read through the updated DoDi (on my to do list). In regards to the TDRL reviews, have you found it easier adding conditions that were not addressed previously, or changing a condition that was addressed, not unfitting at the time, to unfitting?
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Typically, it is quite hard to show additional conditions not originally found unfitting to be later found as such on TDRL review. It is usually rare to have a case where this is an issue. I can only think of one that I have had, but, I was successful in convincing the PEB that the original PEB was in error (I would not place much stock in this as to "probabilities" in other cases- the evidence in that case was very strong, almost irrefutable in my opinion). The vast majority of cases would be difficult to prove. (I think people would have better luck at later appeals, though).




Also, how is the PEB handling IDES re-evaluations if the VA has not reviewed or changed the SM's unfitting conditions ratings prior? Are they applying the most recent VA rating or is the PEB requesting the VA perform a review at the time of re-evaluation?
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I think you are asking about IDES cases. If so, I would say that I am greatly concerned that most of the cases I am seeing, the PEBs are ignoring the requirement under DTM 11-015 to have the VA rate TDRL cases and are just doing it themselves like it is a legacy case. Bad ju-ju, all the way around if you ask me. Bad for the member, because I think you get a worse outcome. Long term, bad for the military because I think this will be challenged and the military will be held to the consequence of the error. This means more costs in administrating the cases and fixing them when this eventually (in my opinion) happens.
 
jozzz123 said:
The question I have is this. I am getting both knees replaced after this is all complete and i am back home. I am being put on TDRL 60% DOD 80% VA. After I get my knees done does anyone think that my percentages will go down and taken off TDRL and just separated with compensation? I mean I am getting the knees done regardless, but if that means I loose retirement, I will need to make some more changes financially.
Click to expand...

How much time do you need to retire?
TDRL time goes towards time in service and counts towards retirement.
 
jozzz123 said:
Well, here goes. I was found unfit for PTSD and my left knee, the right knee they said was OK. My ortho surgeon said I should have the surgery, and I agree if it will ease the pain. I am also suffering from nerve damage in both legs and my wrist now thanks to the cane I have to use on a daily basis just to get around. I have scaring on my face but in the 199 it says that it does not cover enough of my face for them to rate. I shall find out what the Order of the Purple Heart has to say about all of it. But thank you for all your help too. I really appreciate it.
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Oh, you're probably an O.

Wouldn't your other knee be added as well? And you could get an EMG to get your wrist added also.

I would think the VA would rate the scaring.
 
AmyGallay said:
Oh, you're probably an O.

Wouldn't your other knee be added as well? And you could get an EMG to get your wrist added also.

I would think the VA would rate the scaring.
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O=Officer? No, E6.

I'm not sure why they didn't rate my right knee. Probably cause I didn't have all the documentation that I had for the left knee. Whats a EMG for my wrist? VA does rate scaring, they just said that mine didn't cover enough of my face to warrant rating. Now for my re-eval in 6 months. Can I just add everything else then? Or do you think I should appeal my 199 and try to get my other conditions unfitting and rated?
 
You said you had nerve damage in your wrist. An EMG is a nerve conduction test done by a neurologist to show you have nerve damage. You can't really add it for the wrist without it. It is for arms... You cannot add your scarring to your Dod rating, as that does not prevent you from doing your job. You need the EMG to prove the wrist. And you really can't guess a rating until after you see how your knees recover.
 
AmyGallay said:
You said you had nerve damage in your wrist. An EMG is a nerve conduction test done by a neurologist to show you have nerve damage. You can't really add it for the wrist without it. It is for arms... You cannot add your scarring to your Dod rating, as that does not prevent you from doing your job. You need the EMG to prove the wrist. And you really can't guess a rating until after you see how your knees recover.
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OK, Thank you
 
remember, even if your Dod rating lowers, your VA rating will stay about the same or higher if you develop more to claim. That would be some tax free money every month you can count on towards your budget.
 
AmyGallay said:
remember, even if your Dod rating lowers, your VA rating will stay about the same or higher if you develop more to claim. That would be some tax free money every month you can count on towards your budget.
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Sounds good, thanks
 
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