Leg Length Discrepancy (LLD), AFCS, Tribunal, Med Discharge

Piloneer

Swinger
Hello all,

On Friday I had a first tier tribunal for hip OA which was rejected. This AFCS claim has been ongoing for 3 years since 2016 when it was first discovered along with FAI hip impingement R Hip.

On Tuesday I was recommend for MD under QR 9.386 for a separate injury I sustained over a year ago but could have been caused by the damage to my hips over time.

In 2015 I was measured for a leg length discrepancy, my left shorter by 1.5cm. I did not have a LLD test on my pre-medical examination (joined 2007) as per JSP 346 which was in place at the time. The pre-entry medical (FMED 4) is also missing (despite Vets UK asking for it while collecting evidence) so there is no evidence of it ever being conducted either.

JSP 346, Ch 3, Leaflet 3-12: Musculoskeletal and connective tissue disorders, paragraph 34 states the following regarding LLD.

"Those with a discrepancy of 1.5-2.5 cm who are able to achieve activity comparable with military service for a minimum of 3 months should be referred for further assessment."

My LLD detected in 2015 was not detected in 2007 when I entered service and I wasn't sent for further assessment at any point in my career. In 2015 I was just given orthotics to correct it. However, by this time, I had served 8 years. As a result I had hip pain recorded in 2013, an x-ray showing osteophytic lipping and arthritic changes and again in 2016, by which time it was worse. I attended the Hip and Groin course at DMRC Headley Court in 2017 but my LLD wasn't discussed. I also sustained a bucket handle meniscal tear in my left knee in 2011 which, in my opinion, could have been a result of my unknown LLD.

Unfortunately I didn't present the evidence from JSP 346 or any of the above at the tribunal on Friday because I was shattered from my trip to Colchester on Tuesday and the build up to my FMB (not to mention the difficult year I have had recovering from a bad pilon fracture).

Yesterday I decided I needed so legal advice because I am clearly not capable to representing myself at the moment. I'm going to appeal the tribunal result and I've instructed Slater + Gordon to look into this. My reasons..... the first tier tribunal took 40 mins (instead of the usual 15 mins) to decide my case.... they said it was a very close decision. If they'd had that evidence I think it could have gone in my favour.
 
It is a weird one, seems to have shit loads of history...........but however then does not present it due to being "tired" and only then decides may need legal advice???? Absolutely bonkers, I would have thought that would be the first port of call if you reckon you have a case and let the rest sort itself out. I don't think pitching up to a tribunal or any formal meeting and saying "Well I have this stuff but I have not got it here cos I am a bit tired!" is going to go well.
I would think the board would have been happy they all put their Tenalady's on that morning.
 

Piloneer

Swinger
It is a weird one, seems to have shit loads of history...........but however then does not present it due to being "tired" and only then decides may need legal advice???? Absolutely bonkers, I would have thought that would be the first port of call if you reckon you have a case and let the rest sort itself out. I don't think pitching up to a tribunal or any formal meeting and saying "Well I have this stuff but I have not got it here cos I am a bit tired!" is going to go well.
I would think the board would have been happy they all put their Tenalady's on that morning.
I did ask RBL for help but they didn’t think my case was strong enough.

I didn’t tell them I was tired. It’s more of a mental health issue I’ve been suffering the last 14 months since falling off a ladder and shattering my tibia, learning to walk again and finding out I’ll be losing my job.

They brought up the LLD as the reason for saying it wasn’t due to service, not me. I had no idea until the day after how much a LLD can affect you. And if the Army have failed to conduct a test to measure for that, to avoid said issues, they are in the wrong, not me for being affected by that. They have a duty of care to look after their most valuable assets.
 
Sorry but it sounds like you are fishing for compo that will not be coming your way.
I agree totally if your injuries/condition were cause by service. Fine but as it's not, you have no grounds.
These people are professionals and have heard every line written in the book of bollocks.
Lets be fair it is not up to the Army to conduct tests, it is up to you to declare any condition that may effect your ability to carry out your role.
I am an ex union man and generally would always back the man and not the employer, however you have really not helped yourself in this matter and will/have end up with the square root of **** all.
Like I said in my first post, should of sought legal advice first. It seems you have forked yourself up to be honest.
 

Piloneer

Swinger
Sorry but it sounds like you are fishing for compo that will not be coming your way.
I agree totally if your injuries/condition were cause by service. Fine but as it's not, you have no grounds.
These people are professionals and have heard every line written in the book of bollocks.
Lets be fair it is not up to the Army to conduct tests, it is up to you to declare any condition that may effect your ability to carry out your role.
I am an ex union man and generally would always back the man and not the employer, however you have really not helped yourself in this matter and will/have end up with the square root of **** all.
Like I said in my first post, should of sought legal advice first. It seems you have forked yourself up to be honest.
Not fishing for compo at all. If I’d won the tribunal I’d have left it at that.

I have OA at the age of 37 when most people don’t get it till their 50-60s. I had no knowledge of a leg length discrepancy. It states that pre-medical examinations should measure leg length because a discrepancy can cause musculoskeletal injuries. I didn’t have a test and I have a musculoskeletal injury at an early age.

The facts are clear and this needs highlighting to avoid these issues for others in the future.

I did seek advice, from the RBL, who like me didn’t notice this. I only noticed it when the tribunal gave it as a reason why I wasn’t going to receive an award under the AFCS. As a result they actually highlighted a larger issue of medical negligence which is actually at the root of the problem!
 
The question I have is why should the Army be testing for LLD?
 

Piloneer

Swinger
The question I have is why should the Army be the testing for LLD?
I’ve done a bit of research and.....

londonpodiatry.com/podiatry/conditions/hip-back-pain

JSP 346, Chapter 3, Leaflet 3-12 (attached) mentions LLD as a pre-entry condition to look out for. If it’s not being tested for it should be. It’s a simple test and if missed can lead to many avoidable issues with the lower limbs. A simple fix with orthotics early on may prevent injuries otherwise sustained without them.
 

Attachments

I’ve done a bit of research and.....

londonpodiatry.com/podiatry/conditions/hip-back-pain

JSP 346, Chapter 3, Leaflet 3-12 (attached) mentions LLD as a pre-entry condition to look out for. If it’s not being tested for it should be. It’s a simple test and if missed can lead to many avoidable issues with the lower limbs. A simple fix with orthotics early on may prevent injuries otherwise sustained without them.
Got you. I asked because there must a be million different conditions the human body can be subject to, a medical is only going to check those that it deems reasonable, but as it is laid down in policy, you have a point to argue.

im certainly no expert, but isnt one leg shorter than the other in all humans? What are the tolerances for this? 1.5cm doesn’t sound much, but then it could be massive. Is it really something the Army should be aware of?
 

Piloneer

Swinger
Got you. I asked because there must a be million different conditions the human body can be subject to, a medical is only going to check those that it deems reasonable, but as it is laid down in policy, you have a point to argue.

im certainly no expert, but isnt one leg shorter than the other in all humans? What are the tolerances for this? 1.5cm doesn’t sound much, but then it could be massive. Is it really something the Army should be aware of?
“Leg length discrepancy

3.12.34. If noted, a candidate with a discrepancy of <1.5cm may be graded L2 provided the functional assessment is normal. Those with a discrepancy of 1.5-2.5 cm who are able to achieve activity comparable with military service for a minimum of 3 months should be referred for further assessment. Those with a discrepancy of >2.5 cm should be graded L8.”

It’s in policy and although 1.5cm doesn’t sound much, it states further assessment is required. I’m guessing for a reason. A simple LLD test can be performed in a matter of minutes in an office environment.

No doubt my plight will lead to nowhere, but I may aswell try for others sakes!
 
“Leg length discrepancy

3.12.34. If noted, a candidate with a discrepancy of <1.5cm may be graded L2 provided the functional assessment is normal. Those with a discrepancy of 1.5-2.5 cm who are able to achieve activity comparable with military service for a minimum of 3 months should be referred for further assessment. Those with a discrepancy of >2.5 cm should be graded L8.”

It’s in policy and although 1.5cm doesn’t sound much, it states further assessment is required. I’m guessing for a reason. A simple LLD test can be performed in a matter of minutes in an office environment.

No doubt my plight will lead to nowhere, but I may aswell try for others sakes!
Certainly a difficult one.
 
Didn't Mommy and Daddy show you enough attention when you were a child?
I was not being abusive to you so there is no need for it in return, I was just stating that I think you have gone around your claim in the wrong way and as such you have lost the tribunal.
I only stated that it may have (ie would have) been better to seek legal representation from the outset and not to pitch up to a tribunal having not brought all the evidence which you clearly have a lot of and would of more than likely swung the decision.
You just simply do not go into things like a tribunal without having all the evidence well prepared and in order, generally an ace up your sleeve and definitely not without a professional to represent yourself.
Ta for the insult, I will place it with all the others in it's respective pit.
 

Piloneer

Swinger
I was not being abusive to you so there is no need for it in return, I was just stating that I think you have gone around your claim in the wrong way and as such you have lost the tribunal.
I only stated that it may have (ie would have) been better to seek legal representation from the outset and not to pitch up to a tribunal having not brought all the evidence which you clearly have a lot of and would of more than likely swung the decision.
You just simply do not go into things like a tribunal without having all the evidence well prepared and in order, generally an ace up your sleeve and definitely not without a professional to represent yourself.
Ta for the insult, I will place it with all the others in it's respective pit.
So when you said there was negligence you weren’t referring to me being negligent? It sounded like a rather sarcastic comment. Unhelpful too. Like your first comment suggesting what I said was bollocks and I’ve messed it all up.

I’m not sure you’re particularly understanding of my situation, which is fair enough, you’re not living it.

The fact I’ve been suffering a mental health condition the last 12 months alongside my physical injury (which is a life changing disability) hasn’t helped me and I’ve been off the ball.

Yes I was out of my depth. I should have been represented by a solicitor but a lot recommended RBL who said I had no chance, so I went anyway to try my luck. Turns out I was very close, not miles away from the mark as RBL stated.

Perhaps I’ll fall at the first hurdle with the solicitor and I’m too late. Maybe not. I’ve nothing to lose at this point. Once I’ve exhausted every avenue I’ll call it a day and not until. We’re trained to just keep going sometimes even if we’re already beaten. That’s what I’ve been doing for the last 14 months..... and I’ll continue to fight until the end.

I apologise if I came across rude, but so did you. If I got that wrong, again I apologise.
 
Did you fall off the ladder and injure yourself at work or in your own time?
 

Piloneer

Swinger
Did you fall off the ladder and injure yourself at work or in your own time?
The ladder was my own time in 2018 and I do not have a claim in for that because I’m not eligible, which I accept. My bad! I was doing something for the wife and didn’t fall that far but the mechanism caused a pilon fracture, unfortunately the worst type of closed fracture which is a life changing injury.....

But the claim I’m still fighting was from 2016 for OA in both hips which I am sure was predominantly caused by service because I didn’t have OA before I joined. But when they cited my leg length discrepancy was the reason I didn’t win the tribunal..... well, I investigated that further the day after and they didn’t test for it despite it being something they should look out for in the pre-entry med according to JSP 345 policy at the time. Now, if they’re going to follow policy why can’t I? That’s what I reckon anyrate!

Appreciate the help btw dinger..... I’m just a little miffed by it all!
 
The ladder was my own time in 2018 and I do not have a claim in for that because I’m not eligible, which I accept. My bad! I was doing something for the wife and didn’t fall that far but the mechanism caused a pilon fracture, unfortunately the worst type of closed fracture which is a life changing injury.....

But the claim I’m still fighting was from 2016 for OA in both hips which I am sure was predominantly caused by service because I didn’t have OA before I joined. But when they cited my leg length discrepancy was the reason I didn’t win the tribunal..... well, I investigated that further the day after and they didn’t test for it despite it being something they should look out for in the pre-entry med according to JSP 345 policy at the time. Now, if they’re going to follow policy why can’t I? That’s what I reckon anyrate!

Appreciate the help btw dinger..... I’m just a little miffed by it all!
Got you, that’s why they are looking for you to prove causation, I’m guessing their opinion is that you would suffer hip OA even if you had not served, therefore service is not a defining factor.

Is LLD an exacerbating factor for hip OA?
 

Piloneer

Swinger
Did you fall off the ladder and injure yourself at work or in your own time?
The ladder was my own time in 2018 and I do not have a claim in for that because I’m not eligible, which I accept. My bad! I was doing something for the wife and didn’t fall that far but the mechanism caused a pilon fracture, unfortunately the worst type of closed fracture which is a life changing injury.....

But the claim I’m still fighting was from 2016 for OA in both hips which I am sure was predominantly caused by service because I didn’t have OA before I joined. But when they cited my leg length discrepancy was the reason I didn’t win the tribunal..... well, I investigated that further the day after and they didn’t test for it despite it being something they should look out for in the pre-entry med according to JSP 345 policy at the time. Now, if they’re going to follow policy why can’t I? That’s what I reckon anyrate!

Appreciate the help btw dinger..... I’m just a little miffed by it all!
Got you, that’s why they are looking for you to prove causation, I’m guessing their opinion is that you would suffer hip OA even if you had not served, therefore service is not a defining factor.

Is LLD an exacerbating factor for hip OA?
True, I get that. It’s just at the age of 37 I didn’t think I’d be arthritic. No family history of arthritis at an early age.

According to the research I’ve done, yes, LLD does have an affect on your lower limbs, especially at knee and hip joints and can cause degeneration, which is exactly what I have.

In a day when soldiers from the NI days are being harassed..... I’m going to be standing up for something I believe is right.
 
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