Orthopedic disability claims involve conditions affecting muscles or body joints. This may include any disabling conditions of the knees, ankles, elbows, shoulders or feet, but the most frequent orthopedic claim for VA disability involves low back pain. Orthopedic claims can be tricky because often the veteran is experiencing physical pain but there is not a medical diagnosis underlying that pain.

Until recently the VA took the position that to be eligible for disability payments veterans had to have a clear diagnosis of an injury and, regardless of how much pain a veteran was suffering, pain in and of itself was not a disability. But that has all changed. A federal court has ruled that pain, even without any underlying disability, may be a valid reason for awarding compensation. However, you still have to show the VA that there was an in-service event or injury that is the cause of your pain and provide medical proof linking your pain to that in-service incident.

Compensation and Pension exams are a critical component in your quest to win VA disability benefits. The C&P exam is an appointment that allows a VA doctor to evaluate your physical or psychological condition and determine the level of impairment caused by your disability. The C and P doctor will examine you, ask you questions, order lab work, and do standard tests to assess your situation. Their report is used by the VA to help approve or deny a disability. It is important to keep in mind that the VA almost always gives more weight to the evaluation of a C and P examiner than your own doctor, so you should take the C and P exam very seriously. 

Unfortunately, we have seen several cases where C and P doctors overlooked a crucial aspect of orthopedic conditions—flare-ups. Flare-ups are sudden and temporary increases in symptoms. Typically flare-ups will reoccur but they are unpredictable and happen without warning. Examiners have a duty to do all they reasonably can to become informed about your case. They should request pertinent information from you about the frequency, duration, severity, and loss of function during flare-ups. But they don’t always do this.

If you are not experiencing one of your flare-ups at the time of your exam, the doctor may overlook them. It is vital that you speak up and tell the doctor about flare-ups of your orthopedic disability if you experience them at any time. Tell the examiner how often you have flare-ups and if you have any functional limitations during the flare-ups. You should always be honest about your condition and its effects when speaking with the C and P doctor. Tell the examiner what you are feeling since pain and weakness should be considered when the VA assigns a disability rating.

At Cuddigan Law, we understand how critical it is for veterans to get the disability benefits they have rightfully earned. That’s why we provide a wealth of free information on our website to help veterans with their claims.  And you can contact us for a free evaluation of your situation.



Sean D. Cuddigan
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SSA and VA Disability Attorney in Omaha, Nebraska