This review focuses on VA's June 1, 2023 decision continuing a 10% evaluation for left knee iliotibial band friction syndrome and reducing the evaluation for right knee internal derangement and proximal tibia exostosis from 20% to 10%, effective August 1, 2023. The broader reviewed record contains 16 current condition or rating entries.
Start with Part 1 for a plain-language explanation of the decision and the questions it raises. Part 2 contains the professional evidence record - exact facts, document names, page references, conflicts, and missing items that can make a conversation with an accredited attorney, claims agent, or VSO more productive.
Part 1 · Start here
The opening section identifies the target decision, its practical rating effect, the strongest record item to verify, the timing status, and five questions for an accredited representative.
Localized tenderness or pain over the tibial tubercle, patellar tendon, and inferior pole of the patella.
S-016 · C&P Exam · 03/13/2023No second verified comparison was located in the reviewed records.
Source record requires verificationThe standard one-year reference date appears passed. No later filing or decision event was located in the reviewed records.
This date is informational. Ask an accredited representative to verify the current procedural posture.How should the unresolved objective findings for the right knee be verified?
Does the calculated combined rating of 90% before and 90% after the decision match the authoritative codesheet?
After considering the actual compensation-payment effect, did the reduction require a proposal notice?
How should the eight examination checklist fields marked not located, conflicting, or unreadable be verified?
What is the current procedural posture after checking filings and decisions after June 1, 2024?
Initial active range of motion recorded flexion at 120 degrees and extension at 0 degrees. A listed diagnosis was associated with the claimed knee condition.
The examination records localized tenderness, disturbance of locomotion, less movement than normal, painful motion, and functional effects during flare-ups.
VA's stated result and rationale can be checked against the cited decision pages, earlier rating history, examination findings, and unresolved source items.
| Condition | Evaluation | Diagnostic code | Effective date | Source |
|---|---|---|---|---|
| Posttraumatic stress disorder with traumatic brain injury | 70% | 8045-9411 | 06/12/2018 | S-009 |
| Tension headaches | 50% | 8100 | 06/12/2018 | S-009 · p. 273 |
| Right knee internal derangement and proximal tibia exostosis | 20% before reviewed decision | 5260 | 04/19/2022 | S-009 |
| Tinnitus | 10% | 6260 | 09/07/2014 | S-009 |
| Left knee strain | 10% | 5260 | 06/12/2018 | S-009 · p. 274 |
| Right knee limitation of extension | 0% | 5261 | 04/19/2022 | S-009 · p. 274 |
| Traumatic brain injury | 0% | 8045 | 09/07/2014 | S-004 · p. 671 |
| Condition | Record status | Diagnostic code | Source |
|---|---|---|---|
| Back condition associated with left knee strain | Not service connected | 5237 | S-009 · p. 274 |
| Bilateral hearing loss | Not service connected | 6100 | S-012 · p. 228 |
| Vertigo associated with tinnitus | Not service connected | 6204 | S-012 · p. 228 |
| GERD associated with PTSD/TBI | Not service connected | 7399-7346 | S-012 · p. 229 |
| Depression | Denied | Not verified | Automated decision letter |
Part 2 · Source-backed detail
This section contains professionally organized record details, source documents, dates, and page references. It is designed to make a discussion with an accredited attorney, claims agent, or VSO more focused and productive.
Current-rating review
VA stated that the evidence did not show increased severity sufficient for a higher evaluation and that the 20% criteria for limitation of flexion or extension were not met.
Initial active range of motion recorded flexion at 120 degrees and extension at 0 degrees.
S-016 · C&P Exam · p. 83A listed diagnosis was associated with the claimed knee condition.
S-016 · C&P Exam · p. 81No flare-ups were reported for the left knee.
S-008 · Knee DBQ · p. 371The record states that left knee pain developed as well, possibly due to compensation for the right knee.
S-007 · CAPRILocalized tenderness or pain was recorded over the tibial tubercle, patellar tendon, and inferior pole of the patella.
S-016 · C&P ExamAdditional contributing factors included disturbance of locomotion and less movement than normal.
S-016 · C&P ExamFlexion was recorded at 120 degrees initially and estimated at 100 degrees during flare-ups; extension was 0 degrees.
S-016 · C&P ExamPain was noted on flexion and extension, with weight-bearing, active motion, and passive motion.
S-016 · C&P ExamVerify VA's stated outcome and rationale against the cited decision.
The extracted finding does not have a uniquely verified page reference.
The extracted finding does not have a uniquely verified page reference.
Your own VA record review
Receive a private, decision-focused report connecting what VA decided to the relevant evidence, conflicts, missing items, source documents, and page references in your records.
No subscription or account required. Secure PDF upload after payment. Your finished private report is delivered by email.
Current-rating review
VA assigned 10% based on painful motion and x-ray evidence of post-traumatic arthritis, stating that the 20% criteria for limitation of flexion or extension were not met.
Flare-ups were reported three to four times weekly, lasting all day, with swelling, heat, redness, and inability to bend or put pressure on the knee.
S-008 · Knee DBQ · p. 371During flare-ups at work, the veteran reported resting the knee at lunch and usually needing assistance.
S-008 · Knee DBQ · p. 371Pain was noted on flexion and extension, with weight-bearing, active motion, and passive motion.
S-016 · C&P ExamThe examiner stated that pain significantly limited functional ability during flare-ups.
S-016 · C&P ExamInitial active range of motion recorded flexion at 120 degrees and extension at 0 degrees.
S-016 · C&P Exam · p. 83Flexion was estimated at 100 degrees during flare-ups; extension remained 0 degrees.
S-016 · C&P ExamNo recurrent subluxation, persistent instability, ligament tear, or recurrent patellar instability was recorded.
S-016 · C&P ExamThe record states that repeated use over time did not significantly limit functional ability.
S-016 · C&P ExamVerify VA's stated outcome and rationale against the cited decision.
The extracted finding does not have a uniquely verified page reference.
The extracted finding does not have a uniquely verified page reference.
| Field | Earlier record | Later record | Review note |
|---|---|---|---|
| Examination date | 07/11/2022 S-008 · p. 371 | 03/13/2023 S-016 · p. 81 | Dates shown exactly as extracted. |
| Measurement | Initial active flexion 120° and extension 0°. S-016 · p. 83 | Not located in a later reviewed record. | Only one source-supported measurement entry was located. |
| Functional impact | During flare-ups at work, the veteran reported needing rest and assistance. S-008 · p. 371 | Not located in a later reviewed record. | Only one source-supported functional-impact entry was located. |
The available payment-effect status requires professional verification.
No exact monthly compensation is shown because all required inputs were not verified.
| Active motion measurements | Present |
| Passive motion measurements | Present |
| Weight-bearing findings | Present |
| Non-weight-bearing findings | Not located |
| Opposite-joint comparison | Not located |
| Observed repetitive-use testing | Present |
| Repeated-use-over-time estimate | Not located |
| Flare-up description | Present |
| Flare-up ROM estimate | Present |
| Pain onset | Present |
| Functional-loss description | Present |
| Rationale when estimate unavailable | Not located |
| Active motion measurements | Present |
| Passive motion measurements | Present |
| Weight-bearing findings | Present |
| Non-weight-bearing findings | Not located |
| Opposite-joint comparison | Not located |
| Observed repetitive-use testing | Not located |
| Repeated-use-over-time estimate | Present |
| Flare-up description | Present |
| Flare-up ROM estimate | Present |
| Pain onset | Present |
| Functional-loss description | Present |
| Rationale when estimate unavailable | Not located |
Verified diagnostic-code and measurement inputs were not both available. No schedule comparison is presented as a verified finding.
A smaller cited set reflects issue-relevance filtering across the documents that were processed. 158 documents were excluded from the cited set as unrelated to the two reviewed issues.
| Date | Record event | Source | Professional use |
|---|---|---|---|
| 02/03/2022 | Left knee pain reported as developing, possibly due to compensation for the right knee. | S-007 | Examination context |
| 07/11/2022 | Work impact during right-knee flare-ups was described. | S-008 · p. 371 | Work-impact evidence |
| 07/11/2022 | No flare-ups reported for the left knee. | S-008 · p. 371 | Reported history for comparison |
| 02/17/2023 | Current treatment referenced in the examination detail record. | S-015 | Treatment chronology |
| 03/13/2023 | Disturbance of locomotion and less movement than normal recorded. | S-016 | Functional-impact evidence |
| 03/13/2023 | Initial active flexion 120 degrees and extension 0 degrees. | S-016 · p. 83 | Range-of-motion evidence |
| 03/13/2023 | Diagnosis associated with the claimed knee condition listed. | S-016 · p. 81 | Diagnosis context |
| 03/13/2023 | Pain with flexion, extension, weight-bearing, active motion, and passive motion recorded. | S-016 | Symptom chronology |
| 03/13/2023 | Pain described as significantly limiting functional ability during flare-ups. | S-016 | Flare-up impact |
| 06/01/2023 | VA issued the reviewed decision addressing two issues. | S-017 · p. 52 | Outcomes and stated reasons |
| Date | Issue | Event and outcome | Source |
|---|---|---|---|
| 02/22/2023 | Right knee flexion and extension; left knee | Claims for increased evaluations filed | S-013 · p. 167 |
| 02/17/2023 | Right and left knee conditions | Additional disability claim entries located | S-014 · p. 189 |
| 11/01/2022 | Right knee flexion | Codesheet reflects increase from 10% to 20%, effective 04/19/2022 | S-012 |
| 11/01/2022 | Left knee | 10% evaluation confirmed and continued | S-011 · p. 226 |
| 10/18/2022 | Right knee limitation of extension | Service connection granted with 0% evaluation | S-010 · p. 258 |
| 10/18/2022 | Right knee flexion | Evaluation increased to 20% | S-010 |
| 10/18/2022 | Left knee | Increased-evaluation claim deferred for development | S-010 · p. 262 |
| 09/12/2018 | Right knee | Service connection reflected at 10% | S-006 · p. 603 |
| 09/12/2018 | Left knee | Service connection reflected at 10% | S-006 · p. 603 |
| 10/21/2014 | Left knee condition | Service connection denied | S-001 · p. 1110 |
Check VA's stated result and reason against the cited decision pages.
Check VA's stated result and reason against the cited decision pages and earlier rating history.
One or more extracted facts did not have a uniquely verified page reference and should be checked in the original PDF.
How should the unresolved objective findings for the right knee be verified?
Does the calculated combined rating of 90% before and 90% after the decision match the authoritative codesheet?
After considering the actual compensation-payment effect, did the reduction require a proposal notice?
How should the eight examination checklist fields marked not located, conflicting, or unreadable be verified?
What is the current procedural posture after checking filings and decisions after June 1, 2024?
Claim or decision history
Claim or decision history
Claim or decision history
Claim or decision history
Claim or decision history
Claim or decision history
Examination context
Lay evidence and occupational impact
Claim or decision history
Claim or decision history
Claim or decision history
Claim or decision history
Claim or decision history
Claim or decision history
Treatment or medication
Range of motion, diagnosis, objective findings, functional impact, flare-ups, and repeated-use findings
Target VA decision
Informational one-year reference date: June 1, 2024. The standard one-year reference date appears passed, and no later filing or decision event was located in the reviewed records. Ask an accredited representative to verify the current posture.
S-008 Knee DBQ · p. 371 · S-010 Automated Decision Letter · pp. 258, 262 · S-016 C&P Knee Examination · pp. 81, 83 · S-017 Rating Decision Narrative · p. 52
Send them this report and keep the original records available. The professional evidence section helps them move from a plain-language finding to the exact source page while they decide what is legally relevant.