Going to IPEB

A

ANguyen

PEB Forum Regular Member
Registered Member
I need help just received findings from the IPED and was rated 20% from CRPS, Osteoarthritis, Right Knee, ALC reconstructions x2. I elected to go to FPED because of disagreement of rating. I checked the documents from my PEBLO guy and it shows no evaluation from the Pain Management clinic I have been seeing for a year and half. They only review evaluation from Orthopedics, PT and Sleep study. I was told when going to the MEB they must review all medical documents regarding my leg. I need some help so I can prove they did not follow AFI. I check everywhere on how they rate, AFI's or documents and can't find anything that can help my case. I need info to help me bring my rating to 30%.
 
Yes you and me have the same, I have bi-lateral Osteoarthritis and a cyst in both knees. Basically the PEB went what is off the Regulation, unfortunely 20% is the max for knees unless you have impairments. Did they give you PDRL or TDRL.

Check out AR 635-40 and the VASRD for information on this.
I have bad knees and a bulding disk as failing conditions. The PEB only rates off of failing conditions, so looks like you will get severence and VA. You can also apply for social security. I am not sure what the AFI is for the Air Force but will do some research and get back to you. If you were diagnosed with sleep apnia, VA gives 50%
 
I don't think they gave a PDRL or TDRL., as for the knee I have going to the pain management clinic to and elected to get neurostimulator implanted in my back to lessen the pain caused by my nerves. That I can't walk, I have to use a cane because of my locking and constant grinding. Plus I have to continue to take medication to lessen pain. I have been diagnosed with sleep apnia and currently using the CPAP machine. I am really glad someone out there is helping me.
 
Thats correct, its a severance and VA pays the difference off their ratings.
 
Oh also they said originally the rating was at 10% but felt generous and gave me 20% instead. Is that the correct rating and how do figure it out, I am kinda a noob to process.
 
These are the most common "knee" diagnostic codes:

The Knee and Leg​
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

5257 Knee, other impairment of:

Recurrent subluxation or lateral instability:
Severe............................................................................................................ 30
Moderate........................................................................................................ 20
Slight ............................................................................................................. 10

5258 Cartilage, semilunar, dislocated, with frequent episodes of
“locking,” pain, and effusion into the joint........................................................ 20

5259 Cartilage, semilunar, removal of, symptomatic...................................................... 10

5260 Leg, limitation of flexion of:

Flexion limited to 15°............................................................................................ 30
Flexion limited to 30°............................................................................................ 20
Flexion limited to 45°............................................................................................ 10
Flexion limited to 60°.............................................................................................. 0

5261 Leg, limitation of extension of:

Extension limited to 45°....................................................................................... 50
Extension limited to 30°....................................................................................... 40
Extension limited to 20°....................................................................................... 30
Extension limited to 15°....................................................................................... 20
Extension limited to 10°....................................................................................... 10
Extension limited to 5°............................................................................................ 0

5262 Tibia and fibula, impairment of:

Nonunion of, with loose motion, requiring brace............................................ 40

Malunion of:

With marked knee or ankle disability........................................................ 30
With moderate knee or ankle disability.................................................... 20
With slight knee or ankle disability........................................................... 10

You have to look at if there is also nerve damage or other bases for disabilities...it is not very common to get above 20% for a knee disability, but it can happen.
 
do you know if once your out they pay for your house while you go to school?
 
There are allowances based on Improved GI Bill...this is separate issue from disability benefits.
 
also i have nerve damage, but its based on complex regional pain syndrome... what is the best way to get it up to 30 % will the formal board lower my percentage if i fight it?
 
This has to be addressed prior to the NARSUM, there are test such as EMG that is conducted. Your MEB rep or PCM would of asked for a referrel if they feel this is the case. Adding to the MEB after you sign the NARSUM makes it difficult. They will only allow the appeal of what you agreed up on the NARSUM. You should take your questions to JAG who represents MEB. You can also find out if you have a local American Legion Rep in your area.
 
how do you calculate the 20 % severance pay? im a e5, and do you know how long it takes to get the severance pay?
 
smacinnes40 said:
This has to be addressed prior to the NARSUM, there are test such as EMG that is conducted. Your MEB rep or PCM would of asked for a referrel if they feel this is the case. Adding to the MEB after you sign the NARSUM makes it difficult. They will only allow the appeal of what you agreed up on the NARSUM. You should take your questions to JAG who represents MEB. You can also find out if you have a local American Legion Rep in your area.
Click to expand...

You can appeal anything you like. Of course, having a longer history and documentation of the condition helps prove your case. But there is no rule limiting what you can appeal.

MEB Outreach counsel and other services similar programs are a good idea. However, the vast majority have never argued in front of a PEB (and it is almost certain they have never handled appeals post-PEB), so just be aware of the level of experience out there. It is a good idea though to consult with knowledgeable attorneys. As for American Legion or other VSO's, most organizations do not practice at PEBs. While they may be good and competent at VA specific issues, I would be wary about using someone with no/limited experience with PEBs.
 
Jason said:
These are the most common "knee" diagnostic codes:

The Knee and Leg​
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

5257 Knee, other impairment of:

Recurrent subluxation or lateral instability:
Severe............................................................................................................ 30
Moderate........................................................................................................ 20
Slight ............................................................................................................. 10

5258 Cartilage, semilunar, dislocated, with frequent episodes of
“locking,” pain, and effusion into the joint........................................................ 20

5259 Cartilage, semilunar, removal of, symptomatic...................................................... 10

5260 Leg, limitation of flexion of:

Flexion limited to 15°............................................................................................ 30
Flexion limited to 30°............................................................................................ 20
Flexion limited to 45°............................................................................................ 10
Flexion limited to 60°.............................................................................................. 0

5261 Leg, limitation of extension of:

Extension limited to 45°....................................................................................... 50
Extension limited to 30°....................................................................................... 40
Extension limited to 20°....................................................................................... 30
Extension limited to 15°....................................................................................... 20
Extension limited to 10°....................................................................................... 10
Extension limited to 5°............................................................................................ 0

5262 Tibia and fibula, impairment of:

Nonunion of, with loose motion, requiring brace............................................ 40

Malunion of:

With marked knee or ankle disability........................................................ 30
With moderate knee or ankle disability.................................................... 20
With slight knee or ankle disability........................................................... 10

You have to look at if there is also nerve damage or other bases for disabilities...it is not very common to get above 20% for a knee disability, but it can happen.
Click to expand...
I had three PEB proceeding that gave me a code of 5299/5255 Post ACL reconstruction with residual instability 30%. I then had a final PEB that gave me a code of 5003 severe degenerative arthritis 20%. At the same time the VA gave me a code of 5259/5257 Post ACL reconstruction with internal cartilage derangement 30%. I don't understand why they had different codes for the same injury.
 
im getting representation with the texas vetrans commission.... and all of them are prior military
 
Jason, TimMC and smacinnes40 thanks for info, my only thing is I don't think they rated me correctly. My leg locks up and gives way thats why I have to use a cane. The doctors have diagnose these to include nerve damage. The Pain Clinic states I do have nerve damage but they can't exactly locate which nerve so they diagnosed it as CRPS. They said my nerves are flaring up constantly and taking a nerve blocker is the best way to calm it down. I had already did the dye test and they still could not find which nerve is flaring up.
 
smacinnes40 said:
This has to be addressed prior to the NARSUM, there are test such as EMG that is conducted. Your MEB rep or PCM would of asked for a referrel if they feel this is the case. Adding to the MEB after you sign the NARSUM makes it difficult. They will only allow the appeal of what you agreed up on the NARSUM. You should take your questions to JAG who represents MEB. You can also find out if you have a local American Legion Rep in your area.
Click to expand...

The VA scheduled an EMG for me as a C&P exam. I would have to say, not fun at all and can be extremely painful if the doc doing the test is overly aggressive.
 
Agree with usafaviator. The nerve test is extremely painful. Basically a needle that goes in the affected area and conducts a current. I have 5x knee surgeries as a result of an emergent (total) knee joint dislocation with redisual peroneal nerve damage and foot drop.

Reply back if you have any updates on this as we have similar cases and any information is useful.
 
my legs acts up alot sometimes feels like it goes numb and i have to move it alot cause feels like i have no sensation. i did the nerve test and it was no fun at all. They discovered that my nerves were fine but no real answer as to why my legs go numb. Sometimes when laying in bed it bothers me cause i have to move my leg when it feels like it is getting numb, kind of wierd feeling. Good luck hopefully you can get help with it. I am taking different meds now to assist with my restless leg syndrome.
 
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