Hip Replacement Question

TSgt Twitch

PEB Forum Veteran
#21
5054 Hip replacement (prosthesis).
Prosthetic replacement of the head of the femur or of the acetabulum:
For 1 year following implantation of prosthesis 100
Following implantation of prosthesis with painful motion or weakness such as to require the use of crutches1 90
Markedly severe residual weakness, pain or limitation of motion following implantation of prosthesis 70
Moderately severe residuals of weakness, pain or limitation of motion50
Minimum rating 30
 

cjhuck77

Registered Member
#22
So I just received my findings from the VA.
Had left hip replaced April 2012, and right hip has DJD and is now bone on bone, Total Hip replacement is inevitable.
DoD rated me at 20%, 10% each hip, they only rated me under codes 5052. (0%) 5053(10%).

The VA rated me 90% because all my other claims.

I'm extremely frustrated because now instead of being medically retired I'm being sep'd with severance pay. I've emailed a JAG to see what my options are, but what else do I need to do? I've seen code 5054 talked about for hip replacements, is it possible they overlooked that? Thanks!
 

TSgt Twitch

PEB Forum Veteran
#23
Yes its very possible if you had a hip replacement, for them to miss code it. A hip replacement is 30% minimum.

My guess is you did not have a traditional THA, instead you had a BHR? better known as resurfacing? very easy fix, happens a lot I am afraid. I am 50% for my THR and 10% for my FAI hip, which was repaired femoral/acetab plasties and re anchor/repair of labrum.

A BHR is a prostethic, but they sometimes over look that fact. If you had a traditional THA, then they should not have missed it, but if your narsum or C/P was worded incorrectly maybe? if you had it done by a civilian and it never made it to your C-file etc etc. lots of reasons, but no real excuses' except ignorance and laziness by the raters, which is what I am about to be fighting next week.
 

kenlc

Registered Member
#24
My VA rating came back this week for a hip resurfacing and I was awarded 30% for it. I will eventually have to get the right hip replaced or resurfaced as well. I am a 38 year old Army Reservist with almost 17 years. I am hoping the Army uses the 30% as well so that I am classified as medically retired vs separated. I'm not sure how all of the benefits work just yet but I am looking forward to a new chapter in my life. The MEB is completed, the PEB is waiting on this information. Hopefully, I can close out this chapter soon. Overall, the process from my C&P to now has been just over 6 months and it has gone very smoothly.

My breakdown:

surgical scars, left hip
0% Service-Connected

right hip osteoarthritis with impingement syndrome, extension of the thigh
0% Service-Connected
right hip osteoarthritis with impingement syndrome, impariment of the thigh
10% Service-Connected
right hip osteoarthritis with impingement syndrome, flexion of the thigh
0% Service-Connected
left hip osteoarthritist status post left total hip resurfacing
30% Service-Connected
lumbar strain secondary to bilateral hip osteoarthritis (also claimed as lower back pain)
20% Service-Connected
left knee iliotibial (IT) band syndrome, secondary to bilateral hip osteoarthritis (also claimed as left leg condition)
0% Service-Connected
lright knee iliotibial (IT) band syndrome, secondary to bilateral hip osteoarthritis (also claimed as right leg condition)
0% Service-Connected
 

TSgt Twitch

PEB Forum Veteran
#25
My VA rating came back this week for a hip resurfacing and I was awarded 30% for it. I will eventually have to get the right hip replaced or resurfaced as well. I am a 38 year old Army Reservist with almost 17 years. I am hoping the Army uses the 30% as well so that I am classified as medically retired vs separated. I'm not sure how all of the benefits work just yet but I am looking forward to a new chapter in my life. The MEB is completed, the PEB is waiting on this information. Hopefully, I can close out this chapter soon. Overall, the process from my C&P to now has been just over 6 months and it has gone very smoothly.

My breakdown:

surgical scars, left hip
0% Service-Connected

right hip osteoarthritis with impingement syndrome, extension of the thigh
0% Service-Connected
right hip osteoarthritis with impingement syndrome, impariment of the thigh
10% Service-Connected
right hip osteoarthritis with impingement syndrome, flexion of the thigh
0% Service-Connected
left hip osteoarthritist status post left total hip resurfacing
30% Service-Connected
lumbar strain secondary to bilateral hip osteoarthritis (also claimed as lower back pain)
20% Service-Connected
left knee iliotibial (IT) band syndrome, secondary to bilateral hip osteoarthritis (also claimed as left leg condition)
0% Service-Connected
lright knee iliotibial (IT) band syndrome, secondary to bilateral hip osteoarthritis (also claimed as right leg condition)
0% Service-Connected
the importance that we need to know to make sure your ratign is appropriate is, did they use code 5054 or another code. if 5054 they have you rated for the prosthetic, any other code and they have you based on range of motion or arthritis etc. if you are rated under 5054 and have any residuals of pain etc beyind normal "aches" then you should be 50%, getting beyond 50% is pretty tricky though.
 

kenlc

Registered Member
#26
Good point. My AB8 is now on Ebenefits and I can view my ratings through the backdoor method of creating a new claim but I havn't gotten my brown envelop yet. I update once I recieve it.
 

kenlc

Registered Member
#27
Tsgt Switch,

I did receive my brown envelope this morning. I received 30% for the artificial prosthetic (5054). Thanks for bringing this to my attention. It could have had a negative effect on the PEB had it not been rated as such.
 

stevehanes

Registered Member
#28
I'm active National Guard AGR. I tore the
cartilage last year in one hip, dealing with it for a year until I could get it diagnosised. I wound up finding out both hips were shot. Which resulted in a bilateral hip replacement. How do ya think this process will go. My meb was just submitted. Thanks
 
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