Search VA regulations and diagnostic codes

Musculoskeletal Disabilities of the Extremities and Spine

V.iii.1.B.4.d. Separate Evaluations for Knee Instability and LOM A separate evaluation for knee instability may be assigned in addition to any evaluation(s) assigned based on limitation of knee motion. The Office of General Counsel has issued precedent opinions that an evaluation under [38 CFR…

Evaluating Disabilities

A claim for increase is received. The resultant examination shows no instability of the left knee but does show arthritis and pain related to the SC injury. In this situation, the 10-percent evaluation assigned under [38 CFR 4.71a, DC…

Effective Dates

Example 1: A Veteran claims SC for a knee condition with pain on March 21, 2015. There are no post-service treatment records submitted with the claim. Service treatment records (STRs) do show treatment for chronic knee pain and complaints of instability during service. The VA examination dated…

Schedule of ratings—musculoskeletal system.

| | Rating | | --- | --- | | 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 |…

Determining the Issues

V.ii.3.A.2.d. Considering an Unclaimed Primary Disability Associated With a Claimed Complication or Secondary Condition When a claim for SC for a disability is pending and subsequent development of the claim reveals that the claimed disability is caused by an unclaimed disability that may be…

Painful Motion and Functional Loss

V.iii.1.A.4.b. Compensable Limitation of One Motion With Pain in Another Motion _Situation_ : Evaluation of knee tenosynovitis with the following examination findings: · Flexion is limited to 45 degrees with pain at that point and no additional loss with repetitive motion. · Extension is…

Insufficient Examinations

Example: An examination requested in connection with a claim for a knee condition was not completed because “the claimed condition was not documented and diagnosed in the service treatment records on examiner review.” If the rating activity determines that such examination is needed, the…

Evidentiary Standards for Finding an Examination or Opinion Necessary

Example 1: The Veteran claimed SC for a knee disability. There was one complaint of knee pain in service with a negative separation examination. No other lay or medical evidence was submitted in support of the claim. Analysis: The Veteran’s current claim provided no medical evidence…

Applications for Benefits

Form 21-526EZ_](<http://www.vba.va.gov/pubs/forms/VBA-21-526ez-ARE.pdf>). Left knee condition can be accepted as a supplemental claim because the [_VA Form 20-0995_](<https://www.vba.va.gov/pubs/forms/VBA-20-0995-ARE.pdf>) is the prescribed form for supplemental claims, potentially new evidence was…

Claims for disability benefits.

(2) With respect to service-connected disability compensation, an issue for purposes of paragraph (c)(1) of this section is defined as entitlement to compensation for a particular disability. For example, if a decision adjudicates service-connected disability compensation for both a knee condition…

Other Temporary Total Evaluations

VIII.iv.8.D.2.a. Example 1: Staged Rating of Definite Period of Schedular Temporary Total Evaluation Facts: The determination involves a prospective increased rating for a knee replacement under [38 CFR 4.71a, DC…

Special Monthly Compensation (SMC)

Example: A Veteran is SC for amputation of bilateral feet, evaluated as 100-percent disabling. The Veteran underwent a total knee replacement. Following the temporary total evaluation assigned after knee replacement, the knee is evaluated as 60-percent disabling. SMC (l) is warranted for the…

Revision Based on Specific Types of Submissions, Including Supplemental Claims

X.ii.2.A.3.e. Example: Effective Date Assigned Under 38 CFR 3.2500(h)(2) Facts: VA issues a rating decision and corresponding decision notice on September 17, 2017, denying SC for right knee patellofemoral syndrome (PFS). A VA examination and medical opinion obtained in connection with the…

Reviewing Diagnoses

occupational tasks because the frequent episodes are so painful that the Veteran needs to cease all activity for several hours to obtain relief. _Result_ : A current disability is demonstrated under [38 U.S.C. 1110](<https://www.law.cornell.edu/uscode/text/38/1110>). Although the cephalgia is…

VI.ii.5.4.d. Election Is Required Between FEC and an Increased Rate of VA Compensation Following an On-the-Job Injury _Scenario_ : · A Veteran who is a Federal Government employee has a back disorder and a knee disorder that are each rated 10 percent disabling. · The Veteran reinjures his…

Screening Applications for Substantial Completeness and Notification Requirements

· Add left knee injury as a contention · affix the _MST_ special issue to the left knee contention, and · do _not_ · enter MST as a contention, or · take the actions in M21-1, Part II, Subpart iii, 1.C.2.b. Note: For the purpose of routing the claim for review by an MST claims processor in…

The joints.

§ 4.45. The joints. As regards the joints the factors of disability reside in reductions of their normal excursion of movements in different planes. Inquiry will be directed to these considerations: (a) Less movement than normal (due to ankylosis, limitation or blocking, adhesions, tendon-tie-up…

Direct Service Connection (SC) and Service Incurrence of an Injury

V.ii.2.A.1.e. Establishing Direct SC Based on Chronicity When a chronic disease listed under [38 CFR 3.309(a)](<http://www.ecfr.gov/cgi-bin/text-idx?SID=a88986ca8f9a29e8af73cdffa7bc08f9&node=se38.1.3_1309&rgn=div8>) is shown in service, consider all subsequent manifestations of the same chronic…

Award Adjustments Necessitated by a Veteran's Return to and Discharge From Active Duty

X.v.2.B.1.j. Proper Application of 38 CFR 3.31 The _reinstatement_ of compensation VA previously discontinued because a Veteran returned to active duty does _not_ constitute a new award of or increase in benefits. Therefore, the requirement in [38 CFR…

Developing Presumptive Service Connection (SC) Claims from Persian Gulf Veterans

VIII.ii.1.B.2.j. Example 1: Examination Is Unnecessary Because Claim Is Substantiated _Facts_ : A Veteran has qualifying service as defined in [38 U.S.C. 1117](<https://www.law.cornell.edu/uscode/text/38/1117>). The claims folder contains a competent medical assessment of CFS. The evidence…