Possible ratings for hip?

seanegalloway

Registered Member
Hello, I am new to this forum and was wondering if anyone could give me any insight on my potential rating for my hip. I am in the IDES process and its all moving pretty quick. Thanks for anything you can give me.

LEFT HIP
[] All Normal [X] Abnormal or outside of normal range [] Unable to test [] Not indicated If “Unable to test” or “Not indicated,” please explain:
Flexion (0-125 degrees) 0 to 20 degrees Extension (0-30 degrees) 0 to 10 degrees Abduction (0-45 degrees) 0 to 25 degrees Adduction (0-25 degrees) 0 to 10 degrees External Rotation (0-60 degrees) 0 to 30 degrees Internal Rotation (0-40 degrees) 0 to 20 degrees
Is adduction limited such that the Veteran cannot cross legs? [X] Yes [] No
If ROM is outside of "normal" range, but is normal for the Veteran (for reasons other than a hip condition, such as age, body habitus, neurologic disease), please describe:
If abnormal, does the range of motion itself contribute to a functional loss? [X] Yes [] No If yes, please explain: This degree of loss of ROM, especially flexion, significantly interferes with most weight bearing activities.
Description of Pain (select the best response): [] No pain noted on exam [] Pain noted on exam on rest/non-movement [] Pain noted on exam but does not result in/cause functional loss [X] Pain noted on examination and causes functional loss If noted on examination, which ROM exhibited pain (select all that apply): [X] Flexion [X] Extension [X] Abduction [X] Adduction [X] External rotation [X] Internal rotation
Is there objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue? [X] Yes [] No If yes, describe. Include location, severity, and relationship to condition(s). Location: Pubic bone and left adductor complex Severity: Moderate Relationship: Athletic Pubalgia
Is there evidence of pain with weight bearing? [X] Yes [] No
Is there objective evidence of crepitus? [] Yes [X] No
LEFT HIP
Is the Veteran able to perform repetitive-use testing with at least three repetitions? [] Yes [X] No If yes, perform repetitive-use testing.
If no, provide reason: Unable to perform repetitive-use testing with at least three repetitions as it is too painful.
LEFT HIP
Is the Veteran being examined immediately after repetitive use over time? [] Yes [X] No If the examination is not being conducted immediately after repetitive use over time: [X] The examination is medically consistent with the Veteran’s statements describing functional loss with repetitive use over time. [] The examination is medically inconsistent with the Veteran’s statements describing functional loss with repetitive use over time. (please explain) [] The examination is neither medically consistent or inconsistent with the Veteran’s statements describing functional loss with repetitive use over time. If the examination is medically inconsistent with the Veteran’s statements of functional loss, please explain:
Does pain, weakness, fatigability or incoordination significantly limit functional ability with repeated use over a period of time? [X] Yes [] No [] Unable to say without mere speculation If unable to say without mere speculation, please explain:
Select all factors that cause this functional loss: [] N/A [X] Pain [] Fatigue [] Weakness [] Lack of endurance [] Incoordination
Are you able to describe in terms of Range of Motion? [X] Yes [] No If no, please describe:
Flexion (0-125 degrees): 0 to 20 degrees Extension (0-30 degrees): 0 to 10 degrees Abduction (0-45 degrees): 0 to 25 degrees Adduction (0-25 degrees): 0 to 10 degrees Is post-test adduction limited such that the Veteran cannot cross legs? [X] Yes [] No External Rotation (0-60 degrees): 0 to 30 degrees Internal Rotation (0-40 degrees): 0 to 20 degrees
LEFT HIP
Is the examination being conducted during a flare up? [] Yes [X] No If the examination is not being conducted during a flare up: [X] The examination is medically consistent with the Veteran’s statements describing functional loss during flare up. [] The examination is medically inconsistent with the Veteran’s statements describing functional loss during flare up. (please explain) [] The examination is neither medically consistent or inconsistent with the Veteran’s statements describing functional loss during flare up. If the examination is medically inconsistent with the Veteran’s statements of functional loss, please explain:
Does pain, weakness, fatigability or incoordination significantly limit functional ability with flare ups? [X] Yes [] No [] Unable to say without mere speculation If unable to say without mere speculation, please explain:
Select all factors that cause this functional loss: [] N/A [X] Pain [] Fatigue [] Weakness [] Lack of endurance [] Incoordination
Are you able to describe in terms of Range of Motion? [X] Yes [] No If no, please describe:
Flexion (0-125 degrees): 0 to 20 degrees Extension (0-30 degrees): 0 to 10 degrees Abduction (0-45 degrees): 0 to 25 degrees
Adduction (0-25 degrees): 0 to 10 degrees Is post-test adduction limited such that the Veteran cannot cross legs? [X] Yes [] No External Rotation (0-60 degrees): 0 to 30 degrees Internal Rotation (0-40 degrees): 0 to 20 degrees

LEFT SIDE In addition to those addressed above, are there additional contributing factors of disability? Please select all that apply and describe: [] None [X] Less movement than normal (due to ankylosis, limitation or blocking, adhesions, tendon-tie-ups, contracted scars, etc.) [] More movement than normal (from flail joints, resections, nonunion of fractures, relaxation of ligaments, etc.) [] Weakened movement (due to muscle injury, disease or injury of peripheral nerves, divided or lengthened tendons, etc.) [] Swelling [] Deformity [] Atrophy of disuse [] Instability of station [X] Disturbance of locomotion [X] Interference with sitting [X] Interference with standing [] Other, describe: Please describe additional contributing factors of disability: The hip pain does interfere with running and walking, he has pain with sitting and has to keep the leg somewhat straightened, and the loss of ROM itself does interfere with activities as noted above.
LEFT HIP Flexion/ Extension
Rate Strength
Is there a reduction in muscle strength?
If yes, is the reduction entirely due to the claimed condition in the Diagnosis section?
If no (the reduction is not entirely due to the claimed condition), provide rationale:
Flexion 4 /5 [X] Yes [] No [X] Yes [] NoExtension 4 /5 Abduction 4 /5
4B. Does the Veteran have muscle atrophy? [] Yes [X] No If yes, is the muscle atrophy due to the claimed condition in the diagnosis section? [] Yes [] No If no, provide rationale:
For any muscle atrophy due to a diagnosis listed in Section 1, indicate side and specific location of atrophy, providing measurements in centimeters of normal side and corresponding atrophied side, measured at maximum muscle bulk. Location of muscle atrophy: [] Right lower extremity (specify location of measurement such as "10cm above or below elbow”):
Circumference of more normal side: cm Circumference of atrophied side: cm [] Left lower extremity (specify location of measurement such as "10cm above or below elbow"):
Circumference of more normal side: cm Circumference of atrophied side: cm
4C. Comments, if any: The loss of strength noted on the measurements is more from giveaway due to pain and not due to actual loss of muscular function.
SECTION XII - FUNCTIONALIMPACT NOTE: Provide the impact of only the diagnosed condition(s), without consideration of the impact of other medical conditions or factors, such as age.
12. Regardless of the Veteran’s current employment status, do the condition(s) listed in the diagnosis section impact his or her ability to perform any type of occupational task (such as standing, walking, lifting, sitting, etc.)? [X] Yes [] No If yes, describe the functional impact of each condition, providing one or more examples: The hip pain can significantly interfere with the veteran's ability to walk, climb, squat and run. Any work activities that required such activities would likely be difficult for this veteran.
SECTION XIII - REMARKS 13. Remarks, if any: The condition of Athletic Pubalgia is an inflammation of the insertion of the muscles at the site of the pubic bone. The hip flexors are involved. Any movement of the leg causes pain as it engages these muscles and bone structures, all of which are inflamed. The rotator cuff in the shoulder is nothing but muscle and frequently causes a significant loss of range of motion. There is no other evidence to warrant any additional diagnoses than those already provided for the claimed left hip pain / injury (meb/referred); right hip condition; muscle spasm of the legs at this time.
Correia Criteria – Left Hip A. Is there objective evidence of pain when the left hip is used in non-weight bearing? [] Yes [X] No objective evidence of pain on non-weight bearing.
B. Perform passive range of motion for the left hip and provide the ROM values or select “Same as active ROM.” [] Same as active ROM.
Hip and Thigh Conditions Disability Benefits Questionnaire VA Form 21-0960M-8
[] Cannot be performed or is not medically appropriate [X] Different than active ROM. Flexion (0-125 degrees): 0 to 40 degrees Extension (0-30 degrees): 0 to 15 degrees Abduction (0-45 degrees): 0 to 25 degrees Adduction (0-25 degrees): 0 to 10 degrees External Rotation (0-60 degrees): 0 to 35 degrees Internal Rotation (0-40 degrees): 0 to 30 degrees
C. If objective evidence of pain is present on passive ROM, please specify the plane(s) of ROM (flexion, extension, etc.) involved below, state same as active ROM, or state no objective evidence of pain present. [] No objective evidence of pain on passive range of motion testing [X] Same as active ROM. [] Pain was present only on passive ROM or pain was different on passive ROM and in the following planes: Plane(s) involved:
 
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