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C&P test procedure for knee exam

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OldJoe

Question

What are the different ways examiners can measure RoM of knee extension?

Just got results back from C&P finally (after 5 years) got my left knee connected (just need right knee now).  Nurse practitioner couldn't get my knee to extend enough in the seated position to get a reading (essentially 0°) next did the flexion test from the lying down position, no problem bringing thigh up to flexion.  Straightening it was a different story, struggled to get it to lay flat (0°-135° flexion, normal range).

Raters denied me RoM for the lousy extension?  I though extension was done from the sitting position.  A previous C&P measured me from the seated position I wrote down what he said; 52° and 60° degrees (right and left knees). If I am correct that is easily 50% for each knee.

What am I missing here?  Is there some special procedure the they have to go through to test.  I  though they were supposed to pick the results that favors the vet.  Not cherry pick testing methods that gives the VA the advantage.  Or am I  totally off base in interpretation of the evaluation?

Unfortunately anxiety is getting the worst of me right now (just put in for increase).  And have been diagnosed with  Functional Neurological Disorder (conversion disorder),  last night while putting the dog out I hobbled with my cain quite literally dragging my right leg (couldn't get it to work).

Comments, questions, advice...  I  really could use some help right now.

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I am not the most versed here by any means but I have found the info from this source to be pretty solid. Have a look at these, maybe they can help? I'll provide link too.

http://www.militarydisabilitymadeeasy.org/kneeandleg.html#limo

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Thanks for the quick reply (makes me feel a bit less anxious).

That seems to be what I think is the position (seated) the measurement should be taken from. 

I am wondering if there are any other methods in which they can measure extension, and if they can pick whichever method favors them if the first method fails to achieve results.

Unfortunately with the VA basically outsourcing all their C&Ps it is hard to get them in a timely manner.  

That site was such a great site until the new owner made a pay site out of it.

Edited by OldJoe
make post less vague.
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Forgive me if my replies seem a bit off.  My anxiety has really had an uptick recently and it has affected me mentally and  physically.  This information helps ,me get myself back under control and helps me plan my next move.

Edited by OldJoe
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On 12/20/2020 at 1:54 PM, OldJoe said:

Forgive me if my replies seem a bit off.  My anxiety has really had an uptick recently and it has affected me mentally and  physically.  This information helps ,me get myself back under control and helps me plan my next move.

I fully understand that, no worries. Takes me awhile a lot of the times to send off a solid, coherent post on here LOL. Anxiety sucks..

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Looking through web site print offs of the old military disability made easy.  Looking at knees (at different ways to proceed) I went with muscle groups.  What was weird is it went full circle to how to classify knee flexion (and hip) code 5314.  The description was "think of a hurdler raising  his leg to jump over a hurdle".  It lists code 5252 for the muscle groups or use the knee code 5261, which is the code for rating the knee based on extension. 

But this section deals with muscles???  Somebody want to give some insight?  I think I remember it saying some where to use the one that favors the vet (but that was somewhere/time over the past 5 years)

 

Also, the stability portion of rating knees (they gave me the standard 10%), can someone explain code 5257?  When they say mention buckling is that buckling sideways (that would be SO PAINFUL) or my assumption that means as your walking along your knee up and decides to flex on its own.  I have had this happen enough times that I don't leave the house without a can and I use the cane most of the time while in the house.

Also, I have been diagnosed with functional neurological disorder (conversion) that affects...(you guessed it) my lower extremities (thought it was because of the joints).  When I first got this diagnosis I really didn't believe it at first but thought at this point I will take anything that might help my case.  This past weekend made me a firm believer; while having a serious anxiety attack I basically lose the usage of my right leg (can use say ~30 lbs hunk of useless meat) and I could barely hobble.  I nearly fell three times going to get a pen and paper to write down what was happening so I could accurately describe it later.

I know I have to be careful when having this write up so it can be used to rate my legs and not affect my receiving an increase for anxiety and depression (which I just put in for).  Even without having an anxiety attack my legs simply don't want to work right and I have pain, sometimes more sometimes less depending on all the factors that can apply, not just anxiety.

Insight and suggestions welcome...

Edited by OldJoe
Hiccup with computer while typing
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Update: 

With the how convoluted my claim has gotten I honestly don't know which way is up anymore I am fairly certain I can get more for my claim but am at wits end, not to mention the anxiety isn't helping matters.

The last Dr I had hoped would help me turned out to be a VA shill (not only works at the orthopedic center but also at the VA)...  Kept telling that's not how it works, that there are people out there that have the same condition and no pain, that there are no studies proving left knee causes right knee failure, and how he has an injury that he isn't taking compensation for an injury he had while in the service.  He wouldn't even look at my records that showed progression from when I left the service, to my first C&P. 

First C&P Bilateral Knee arthralgia;  just through it back in my face stating that all it meant was knee pain.   Um... I kinda knew that already, and that alone is enough to get 10% and connect my knee (if he wanted to)  The diagnosis was shortly after I had left the military though they didn't get me in until after a year, so no presumptive conditions.  I have a claim at the CAVC level and assuming that no news is good news, it is still winding its way through the system.  If I win that, then my date of separation will become the effective date for my back and I would like to hope for my knees as well.

 

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