Our Disclaimer
This Knol is provided to you to describe general processes and procedures that occur during the application for disability compensation and pension and other benefits within the Department of Veterans Affairs System. Any author you find here is not providing you with legal advice. Any information provided by this Knol or any contributor to this Knol is not intended as and should not be construed as legal advice. You should always consult an attorney to help answer specific questions regarding how VA laws apply to you and/or your situation. The summaries provided here are incomplete, and the DVA laws and regulations are subject to change. We do not guarantee and we are not liable for the accuracy or completeness of any of the information provided, or any results or outcome as a result of the use of this information.The Joints
Your joints may have been injured during a traumatic event or may have become diseased through a normal process of aging and wear and tear. You may suffer from a combination of both of those.In their evaluation of your application for benefits due to joint complaints the VA will look at some specific factors; Is there more or less movement than is normal for that joint? Is the movement weaker than normal or is it uncoordinated? When the joint is moved, either passively (by the examiner) or actively (by the veteran) is there pain and how significant is the pain? Does use of the affected joint and limb cause excess fatigue due to pain or atrophied muscles? Is there swelling or deformity that is readily apparent at the joint?
Most joint complaints will be examined for all of the above issues with some joints requiring that the examiner make special notations and comments regarding signs or symptoms specific to that joint. If the joints of the fingers are a part of the complaint, the examiner will note signs of arthritis such as redness or heat of the surrounding tissue as well as the presence and severity of Heberden's Nodules on the distal interphalangeal (DIP) joints or make similar comments about Bouchard's Nodules on proximal interphalangeal (PIP) joints.
Most joint examinations must also include an accurate measurement by use of a goniometer. The goniometer is a very basic device that measures angles to determine the veterans ability to flex or bend the joint normally. In Title 38, Sec. 4.46 "Accurate measurement" we read that the VA tells examiners that; "The use of a goniometer in the measurement of limitation of motion is indispensable in examinations conducted within the Department of Veterans Affairs."
It is sometimes reported that during a joint examination an aggressive examiner will move the joint for the veteran and achieve a far greater angle of flexibility than would be possible were the veteran to attempt the maneuver independently. This may cause immediate or residual pain of varying severity and the veteran should use caution if the examiner wishes to record that as the measurement of flexibility. If a maneuver of that sort is likely to cause the veteran harm or undue pain and suffering or result in an unrealistic or inaccurate measurement, the veteran should politely but firmly decline to allow it.
Many ratings decisions seem to rely only on the report of the measurement of the goniometer and little else. The rater will see the C & P examination reort and determine that the limitation of flexion of the forearm is recorded as 45 degrees and that equals a rating of 40%, or the limitation is recorded as 55 degrees equalling a 30% rating and so on. All too often there is little comment or consideration given to the issues of coordination of the hand and arm, pain on motion, the ability to use the limb for practical activities of daily living or the strength of the affected limb.
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tstric1036
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no such thing as coinsidense
Gail Nobles
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Anonymous
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