Expansion of Diagnosis

[Mediman14]

Can someone explain to me why VAC includes different diagnosis into 1 diagnosis? In my situation, I developed a Labral Tear in my hip,( favourable decision from VAC),
it was surgical repaired, after the surgery I developed Osteoarthritis and because of that, now I have chronic pain. VAC decided to include OA with the Labral Tear.
From anyone's experience with VAC, does this sound right? Can I still submit a claim for chronic pain?

 

[blackberet17]

The labral tear is the primary condition, following which you developed osteoarthritis.  The two would be combined by VAC for assessment purposes, as it would be difficult to separate the pain symptoms and limitations you would be suffering due to both conditions.

What VAC would do is expand the diagnosis of the labral tear right (or left) hip to include the osteoarthritis, and may also add the fact it was operated, to read something like "labral tear right hip (operated) with osteoarthritis).

VAC may also simply go with "osteoarthritis right hip", or keep the two separated, i.e., "labral tear right hip (operated)", and "osteoarthritis right hip".

Just a couple of possibilities. In the end, as noted above, the two conditions would most likely be combined for assessment (%) purposes.

Totally! Submit your claim for chronic pain.

 

[Mediman14]

The labral tear is the primary condition, following which you developed osteoarthritis.  The two would be combined by VAC for assessment purposes, as it would be difficult to separate the pain symptoms and limitations you would be suffering due to both conditions.

What VAC would do is expand the diagnosis of the labral tear right (or left) hip to include the osteoarthritis, and may also add the fact it was operated, to read something like "labral tear right hip (operated) with

VAC may also simply go with "osteoarthritis right hip", or keep the two separated, i.e., "labral tear right hip (operated)", and "osteoarthritis right hip".

Just a couple of possibilities. In the end, as noted above, the two conditions would most likely be combined for assessment (%) purposes.

Totally! Submit your claim for chronic pain.

Because this new to me, is this normal procedure for VAC, should I be appealing this? A ex vac clerk had told me before that it should be "1 claim for 1 condition and 1 assessment for each condition, not to be combined" Does this sound accurate? Should I be asking for another Medical assessment by an VAC Physician? I guess VAC would probably combined the chronic pain in with the original diagnosis as well!

 

[blackberet17]

It is true, one application for each condition. However, because the symptoms (pain, physical limitations, etc.) related to one condition in a specific body part are difficult to separate from the symptoms related to another condition, but in the same body part, those two conditions can be combined for assessment purposes.

For example, an ACL tear in the left knee and an MCL tear in the left knee. Those are two separate conditions, but they are affecting the same body part, causing symptoms (range of motion limitations, pain, knee laxity, etc.) which are difficult to look at and go hey, those two symptoms are because of the ACL and this other symptom is because of the MCL.

Hip conditions are assessed under Table 17.10 - Loss of Function - Lower Limb - Hip, of the 2006 ToD, whereas the chronic pain could/would be assessed under Table 19/7 - Other Impairment - Chronic Pain.