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In this Pop-up Video, I talk about several topics, including how to figure out if you got an adequate VA disability rating for knee pain.  What’s a “pop up” video?

I will randomly “pop up” – LIVE – on You Tube or Facebook and talk to whoever’s listening for 5 or 10 minutes about VA claims and appeals.

In this Facebook LIVE Popup, we talked about:

* 3 most important factors in achieving a VA disability rating for knee pain
* Service connecting sleep apnea with no in-service diagnosis
* Proving Secondary service connection

And a couple more topics, too.

VA Disability Ratings for Knee Pain, Functional Loss, Limitations on Range of Motion and Instability.

In summary of what you will see in this video, there are 3 things that you want to make sure your VA C&P examiner considers when you are trying to make sure you got the correct VA disability rating for knee pain, or a disability of the knee such as arthritis.

The over-arching principle of the process for establishing a VA disability rating for knee pain is that you can get more than one rating for knee pain. This is an exception to the rule against pyramid ratings.

Here are three aspects to consider in ensuring you get the most accurate VA disability rating for knee pain

VA disability ratings for service-connected knee disabilities include multiple facets, and often separate ratings for pain, functional loss, limitations on range of motion and instability.

The over-arching principle of the process for establishing a VA disability rating for knee pain is that you can get more than one rating for knee pain. This is an exception to the rule against pyramid ratings.

As such, veterans want to make sure their VA C&P examiner or private medical experts consider four facets of your knee disability to ensure you get the correct VA disability rating for your service-connected knee pain.

Focus on these four facets to maximize your VA disability rating for knee pain. Here are the four facets:

#1: Functional Loss. The core focus of the knee rating is on the inability of the veteran to perform the normal working movements of the body with normal Excursion (movement of something along a path or through an angle), Strength, Speed, Coordination and Endurance. 

That acronym – ESSCE – can help you make sure your VA examiner or your private medical examiner covers all aspects of your knee disability. It is essential that the examination on which ratings are based adequately portray the anatomical damage, and the functional loss, with respect to the ESSCE elements.

One point worth noting: a proper VA disability rating for your knee based on functional loss will observe where in the range of motion the functional loss begins to occur.

When we talk about “functional loss,” however, we are talking about more than just the functional ability of the knee joint to perform its role in the body – the ESSCE factors.

There is a component of “functional loss” that includes the anatomy of the knee, and the presence of all components of the knee. According to 38 C.F.R. §4.40, the “functional loss may be due to absence of part, or all, of the necessary bones, joints and muscles, or associated structures, or to deformity, adhesions, defective innervation, or other pathology, or it may be due to pain, supported by adequate pathology and evidenced by the visible behavior of the claimant undertaking the motion.”

#2: Range of Motion. The most basic rating measures limitations of “flexion” and “extension”. You should get a separate VA disability rating for a limitation on the range of motion of your knee. Here are some examples:

  • Knee Flexion is the bending motion of your knee.VA disability ratings for knee flexion limitations reach to 30 percent.
  • Knee Extension is the straightening motion of your knee. VA disability ratings for knee extension limitations reach to 50 percent. Overextension of the knee can reach up to a 30 percent rating, when coupled with dislocation.
  • Limitations on BOTH knee flexion and knee extension:  separate VA disability ratings for each limitation

#3: Instability in the Knee Joint.

  • VA rating for knee instability is measured by the need for bracing and the impact on daily life activities.
  • This rating can be combined with a rating for pain

#4: Pain

  • Even if your knee pain has NO impact on the knees range of motion, you can get the minimum 10% VA disability rating for knee pain alone when accompanied with a diagnosis (pain alone is a disability, but it must relate to a functional impairment of earning capacity).
  • Pain, like functional loss, is measured by its impact on the range of motion. Tell your doctor where in the knee range of motion you are experiencing pain.

Other factors to consider in getting the proper VA disability ratings for knee pain, instability, functional loss and range of motion:

#5: Repetitive Use. In establishing VA disability ratings for knee pain, instability, range of motion limitation or functional loss, the C&P examiner should not do a once-and-done measurement.

  • Establishing the proper rating requires repetitive use testing – at least 3 repetitions – to simulate the operation of the knee joint in its daily use.

#7: Flareups. If you have flareups of knee pain, or flareups of any kind related to your knee injury, tell the C&P examiner.

  • Be detailed in your descriptions: the VA C&P Examiner is supposed to estimate the impact of flareups on your range of motion even if you are not experiencing a flareup during the exam.
  • It is a cop-out – and remandable error – for the BVA to endorse a VA knee rating when the C&P examiner said he could not assign a rating based on flareups because he did not personally witness the flareup.
  • Share detailed information with the C&P examiner, and bolster it later with lay evidence, demonstrating the frequency, nature and duration of your flareups.

#7: Appeal BVA Decisions establishing VA Disability Ratings for Knee injuries.

IMPORTANT NOTE: This post is meant to be a general guide for factors to consider when determining if your VA Disability rating for knee pain is proper or adequate. It is NOT meant to be an exhaustive list of all of the possible ways to rate a VA knee disability. There are many other ratings – some separate and some combined – which could apply to any given knee condition. To name just a few: dislocation/removal of the meniscus, total knee replacements, partial knee replacements, frozen knee joint and amputations of the leg.


The above video was recorded November 6, 2018, live on Facebook.

A word of caution as you watch this video: the older the video, the older the information. While some things in VA law never change, other things can change quicker than you think. I work hard to keep every post and video on this site up-to-date, but I’m only human.

In the arena of VA disability ratings for knee pain, the rating process is likely to get more and more sophisticated, opening new opportunities for increased VA disability ratings for knee conditions.

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