Posted on Feb 22, 2019
Sgt Douglas Dietrich
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In Roper v. Nicholson, gives guidance in combining Primary and secondary conditions. In this ruling and in 38 CFR 4.25 "Unless otherwise provided" you will use 4.25. Please note Secondary and Bilateral together as in my case my Primary Condition (Right Knee) has caused several secondary conditions that are bilateral and non-bilateral. 38 CFR 3.310 states that all of these conditions become part of the Primary condition, which will become one rating when all said and done. I also point out that 38 CFR 4.16 is an exception to the rule in 4.25, which 4.26 is also.

Right Knee 60, combined with Secondary Bilateral Planter Fasciitis 50, results in 80, combined with secondary bilateral Left hip 10, results 82, combined with Secondary Bilateral low back sciatica 10, results 84, combined with Secondary Bilateral Right Heel spur 10, results 86, bilateral factor 8.6, results 94.6 rounded to 95 rounded to 100%, one orthopedic condition, Right Knee. First qualifier for Special Monthly Compensation "S". Now utilizing 4.25 combined table, Secondary to the Right knee, Sleep Apnea 50%, 20% Diabetes, 60% New rating for Right Knee to be combined with the rest of disabilities. Bilateral Left Knee 10, Left Ankle 10, Right Ankle 10, Left Wrist 10, Right Wrist 10, non bilateral 20% upper back, 10% tinnitus. Mine Bilateral Secondary, Secondary, and regular disabilities come to two separate and distinct ratings in accordance with those regulations. 100% Orthopedic rating for the Right Knee, then the additional disabilities are over 60% for the second qualifier for SMC "S".
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