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Old 10-20-2010, 05:59 PM
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Question "The" VA, Grade IV Chondromalacia and/or Total Knee Replacement

*&^&% %^$%$ _+?>)_)()

I think they hope I'll just die or go away before they award a higher rating for grade IV chondromalacia or 4 other Service Connected disabilities.

Been fighting with these YAHOO's this time since Feb over re-evaluation(s) of both knees and prostate.

Some history; Have had three scopes on the right knee and four on the left. All seven were for medial meniscus tears/repairs, patellar debridement and femoral chondyle debridement.

Last go-round for left knee was June 2010. X-rays showed mild deteriation of joint line in both knees. Now have a 1" X 1" full thickness Grade IV on femoral chondyle of left knee. Doctor also states with his best medical opinion that is "more likely than not" that the right knee has followed suit with the left knee and is in at least the same or worse conditon.

Further states in his medical opinion that most definitely the left knee is a candidate for TKR and it is "more likely than not" that the right is also. So much that any further scopes on the right knee would be fruitless.

NOW, here's the part that gets me...........Both knees are rated at 10% after a re-eval in August. But both are in such a condition that necessitate replacement. If I have them replaced, the minimum disability rating is 30% each. 10% requires replacement surgery and 30% after corrective surgery???????????????????????

I've read and read and read the Diagnostic Codes till I've gone blind. I misplace my last denial back in 2001 about grade III warranting 10% and am 99% sure I remember reading that Grade IV warranted a higher rating, just can't remember what.

Right now I'm at the 40% mark with other ratings combined. Have read and chatted with several Vets who almost had to get congress involved to get to the 50% rating.

Anyone here have any info about grade IV rating(s). Not getting much help from MOPH. They just seemed to have initialled off on this last rating and said here it is.
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Old 10-20-2010, 07:18 PM
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Wait until they take over the rest of the medical syatem. You've seen what they can do with something like the Post Office. Imagine what they wil be able to do with the whole health care delievery system
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Old 10-20-2010, 07:50 PM
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I'm not sure what the big deal is about 40% vs 50% other than it pays more money monthly.

If you are service connected, then your co-pay didn't go up for scripts like the rest of the vets.

At 40%, I get all the medical treatment I want (there's some things I prefer to use an outside physician/facility for) and, though they bill my BC/BS for non-service connected treatment, (and BC/BS pays very, very little to them), I never have a co-pay.

I do pay $24 per month for a 90 day supply of prescription meds, but that's a lot cheaper than using my BC/BS plan.

Is there any other benefit other than a bit more money? Not saying you shouldn't get it, just wondering what benefit there is to it.

Bob

Last edited by straightshooter1; 10-20-2010 at 08:15 PM.
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Old 10-20-2010, 08:46 PM
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Quote:
Originally Posted by straightshooter1 View Post
I'm not sure what the big deal is about 40% vs 50% other than it pays more money monthly.

If you are service connected, then your co-pay didn't go up for scripts like the rest of the vets.

At 40%, I get all the medical treatment I want (there's some things I prefer to use an outside physician/facility for) and, though they bill my BC/BS for non-service connected treatment, (and BC/BS pays very, very little to them), I never have a co-pay.

I do pay $24 per month for a 90 day supply of prescription meds, but that's a lot cheaper than using my BC/BS plan.

Is there any other benefit other than a bit more money? Not saying you shouldn't get it, just wondering what benefit there is to it.

Bob
XXXXXXXXXXXXXX

I have Tri-Care Prime. I have a $3 co-pay for a month of generics.

I don't go to the VA for anything.


That "bit of money" is a bit more than a bit. ;-)

Concurrent Receipt Overview
Qualified disabled military retirees will now get paid both their full military retirement pay and their VA disability compensation. This recently passed law phases out (over 9 years) the VA disability offset, which means that military retirees with 20 or more years of service and a 50% (or higher) VA rated disability will no longer have their military retirement pay reduced by the amount of their VA disability compensation.

Concurrent Retirement and Disability Pay (CRDP) Overview - Military Benefits - Military.com
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Old 10-20-2010, 08:53 PM
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I see now.

Good luck, hopefully you will get someone to listen to you.

Bob
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