In this article, we’re going to discuss your upcoming joint exam.
We’re going to cover shoulders, neck, back, knees, hips, and ankles.
If it’s a joint, this is for you.
Getting an accurate compensation and pension (C&P) exam is vital to ensuring you receive an accurate rating.
Unfortunately, the first thing you need to know about how all joints are rated is that the amount of pain you’re in doesn’t matter.
Whether your pain is a 2/10 or a 200/10, pain only entitles you to the minimum compensable rating for the applicable diagnostic code.
The minimum compensable rating for most joints is 10%. Some minor joints can be zero. For shoulders, it’s usually about 20%.
Now, pain is still important to mention; specifically, you should mention the limitations that pain causes you.
However, it’s important to note that the VA does not rate joints based on pain level.
So again, whether it’s a 2/10 or a 200/10, pain only gets you the minimum compensable rating.
I don’t agree with that either, but unfortunately, I don’t write the rating schedule (at least not yet).
So, how are joints rated?
Joints are rated primarily based on the limitation of motion for that joint. If you have full range of motion and severe pain, that’s still a 10% rating.
However, if you have no range of motion and no pain, that would be a much higher rating.
That’s why range of motion testing is key.
So here’s what you need to know.
First and foremost, make sure your examiner uses a goniometer.
A goniometer looks like a protractor that we used in school. It’s used to objectively measure your joint’s range of motion.
If your examiner does not use one, contact your case manager or attorney immediately.
Your examiner should test your range of motion in a few different ways.
Now, folks, there is a lot of bad advice about how to do these exams on the Internet right now.
One common myth is to just stop moving your joint as soon as it hurts, but that can lead to some very unsavory and unsatisfactory results.
Imagine if the examiner sees you sitting in a chair.
You’re at 90 degrees, back straight, feet flat like we all learned at boot camp.
But then when you start the examination, you refuse to move past 60 degrees because you saw this advice.
Your examiner might think you’re faking it, and they may not believe your description of your symptoms or your description of your flare-ups.
Instead of going to where it hurts, I tell my clients to go to where you have to stop.
See, the point of VA disability compensation is to compensate you for your loss of earnings potential due to your disabilities.
Every single day, we work through and push through some degree or amount of pain.
But at what point in that range of motion will you always generally stop due to pain, even if you’re at work?
That’s where you should be stopping.
Now, don’t push through the pain to the point of injury. Stop where you would normally stop due to pain.
Just don’t necessarily stop at the first sign of pain if that’s not how you’re going to be every single day.
Also, talk to your examiner about your flare-ups, even if you do not have one at the time. Explain what causes them, what helps, and what symptoms you have.
Offer to demonstrate how your range of motion changes during a flare-up, and describe any factors like stiffness or swelling that cause a worsened disability. And you should also note how often you experience these flare-ups.
Lastly, if the examiner asks you to push further and it causes pain, speak up.
Something as simple as, “If I bend anymore, I’ll be in pain for days,” or, “Please don’t push my shoulder that way. It’s going to hurt,” can help the examiner realize that they’re messing up.
You also need to be consistent.
Your exam begins the second you pull into the parking lot and ends when you drive out of the parking lot.
So, be mindful of your behavior both inside and outside the exam room.
If they see you hopping, skipping, and tap dancing to and from your car, but your demeanor inside that exam room is much different, they will absolutely note that.
To recap:
Also, keep in mind that if you take any pain medication frequently, including Motrin, you may want to consult with your medical provider about the possibility of tapering off your pain meds to ensure you receive a fair evaluation.
I’m not telling you not to take your medication. I’m saying to talk to your doctor and make that determination in conjunction with your physician.
If your physician says don’t stop, of course, don’t stop taking your meds.
And that’s it.
There’s no magic formula for a perfect exam, but following these steps will help you get an accurate one.
If you have any other questions or concerns, don’t hesitate to reach out to us at (480) 498-8998.
And if you’re not one of our clients yet but want some more information, feel free to give us a call. We’d love to talk to you.
