New Qualifying Tariff Inclusion after Tribunal

soldiergo

Clanker
Hi All,
I have found myself in technical AFCS situation and would appreciate advice and suggestions please.

I went to tribunal to fight for a higher award for my osteoarthritis injury in July 2019. The contention of Veterans UK was that because my injury is caused by trauma, the table 9, item 2, level 9 tariff was not applicable.

The tribunal panel agreed with Veterans UK and stated that to get table 9, item 2, level 9, the injury has to be caused by a disease not trauma and my case was dismissed because my osteoarthritis is caused by trauma injury to my knee. The tribunal used the tariff table that was in force when i applied.

I have now seen the 2019 tariff table that has inserted Table 9, item (F53)2B, Level 9 which is now for arthritis caused by trauma. Can I request a review on this or how do i go about it?
Thanks
 
Have you had any surgery to the knee?
 
What level have you been awarded?
 
[F532B 9Septic, rheumatoid or post traumatic arthritis requiring arthrodesis, osteotomy or total joint replacement.]

[F622513Radiologically confirmed osteoarthritis of hip, knee, ankle, back, shoulder, elbow or wrist (caused by repetitive or attrition injury) causing permanent significant functional limitation or restriction.]

It looks like you have a fair argument as you have had surgery that falls into the level 9 descriptor.

The issue might be the evidence that was available to veterans UK at the time of the decision.

Approach TRBL for help, make sure you have evidence of your arthritis (which you clearly have, as you have received an award) as well as evidence of surgery.

There is no mention of disease or trauma for level 9, the wording of the level 13 award indicates trauma, but that doesn’t exclude level 9 from being trauma.

If TRBL can’t or won’t help, approach a solicitor to seek a Judicial Review, you have to do it quickly though as there is a time limit for JR.
 
I was med-discharged in July 19 for my knee of which i had a couple of arthroscopy's and eventually an Osteotomy. I also was awarded Table 9, Item 25, Level 13 - Radiologically confirmed osteoarthritis of hip, knee, ankle, shoulder, elbow or wrist (caused by repetitive or attrition injury)) causing permanent significant functional limitation or restriction. (£6180.00). This new tariff seems to describe my circumstance perfectly and I will certainly be preceding to tribunal with this new tariff. I only received my decision on my first appeal (where i was awarded nothing due to not claiming within 7 years) in Nov 19 so you would like to think they had this update by then! Thank you both for the helpful info!
My other question for Soldiergo is were you medically discharged also? If so, what Tier did they award you? I have been awarded a Tier 1 and feel that doesn't represent the damage that has been done. The loss of career, future earnings and also how it has impacted daily life, health and new career prospects. I'd be interested to hear your experience and thoughts of others.
 

soldiergo

Clanker
I was med-discharged in July 19 for my knee of which i had a couple of arthroscopy's and eventually an Osteotomy. I also was awarded Table 9, Item 25, Level 13 - Radiologically confirmed osteoarthritis of hip, knee, ankle, shoulder, elbow or wrist (caused by repetitive or attrition injury)) causing permanent significant functional limitation or restriction. (£6180.00). This new tariff seems to describe my circumstance perfectly and I will certainly be preceding to tribunal with this new tariff. I only received my decision on my first appeal (where i was awarded nothing due to not claiming within 7 years) in Nov 19 so you would like to think they had this update by then! Thank you both for the helpful info!
My other question for Soldiergo is were you medically discharged also? If so, what Tier did they award you? I have been awarded a Tier 1 and feel that doesn't represent the damage that has been done. The loss of career, future earnings and also how it has impacted daily life, health and new career prospects. I'd be interested to hear your experience and thoughts of others.
Yes I was medically discharged with tiger 1 pension. I asked for tier 2 after discharge with further medical evidence and was awarded tier 2 pension
 
Can i nudge this topic please and see how people have experienced claims involving the osteotomy lvl 9 descriptor ?
Vetsuk sound like they are frequently awarding the item 27 instead of the 2B.
 
Can i nudge this topic please and see how people have experienced claims involving the osteotomy lvl 9 descriptor ?
Vetsuk sound like they are frequently awarding the item 27 instead of the 2B.
So an update from me... I received my recent appeal in the post this week after many months of bothering them. At one point they asked to see my hospital notes and sent me a consent form... At this stage if they havent seen my hospital notes what may i ask have their previous decisions been made on??!
So the decision was basically upholding their original decision of a Table 9, Item 25, Level 13 descriptor....

"Article7(4)(d) of the AFCS Order 2019 defines "post-traumatic arthritis"-"Post traumatic arthritis is arthritis which is secondary to a significant traumatic injury which was documented in the medical recordsat the time it occured."
This implies that there must have been a traumatic injury that was capable of leading by itself to the development of secondary osteoarthritis and was of sufficient severity that it would have been documented in medical records.
In effect a traumatic injury is a single serious injury, capable of causing significant disablement on its own, rather than one of many minor injuries which may have worsened the osteoarthritis through their cumulative effect.

.... Ican find no specific traumatic incident which occured post April 2005 as to cause Post-Traumatic Arthritis.

Accordingly, I advise the previous decision by the Secretary of State that the Osteoarthritis in the appalents knee was worsened by repetitive or attrition injury and so the descriptor in the tariff that best describes it is Item 25 (Table 9)


What are peoples thoughts on this? Personally I feel aggrieved that they think I can end up with the same injury and condition as someone else that had one single significant incident but if it is attritional then somehow it deserves less? With 1200 parachute descents, a decade of inter services rugby and years of tabbing with weight, my life belonged to the service and now my body is ruined... The Level 13 (£6000) is a slap in the face if you ask me. I intend to take it to tribunal but I am keen to hear thoughts and experience from other members. Will the Legion represent me with vigor and be active in fighting it or am i better off finding private representation? In the past Ive heard stories of people not meeting with RBL representitive until the day and them feel possibly not holding enough cards?? thoughts are very welcome!

Oh yeah... Merry Christmas to all!
 

Mosquito

Clanker
A tricky one.

1. Do you have a full copy of your service medical records? If not, ask for them and inform the tribunal that you cannot take any next step until you receive and review them.

2. Are there any injuries detailed in your medical records, which relate to the same area as your arthritis?

3. If such injuries are in your medical records but Vets UK/the tribunal have rejected their significance, then can you justifiably argue why those injuries were physically traumatic and significant?

4. If so, I'd look for a leading expert in the field of post-traumatic arthritis and ask their opinion. You may have to pay a fair whack for their opinion but it could be worth it. The other option is to politely state to the tribunal that there appears to be a lack of clarity in the regulations regarding your situation (notably that the AFCS regulations appear to not define the word "traumatic") and ask the Tribunal to commission specialist medical advice under section 24, "Medical examinations and commissioning of medical evidence etc." of The Tribunal Procedure (First-tier Tribunal) (War Pensions and Armed Forces Compensation Chamber) Rules 2008. I don't know how frequently they request such specialist evidence (if ever!).

I'd also be tempted to submit a Subject Access Request to Veterans UK for a copy of every document that they hold on you. You never know, there could be something useful in there.
 
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Hi all, chipping in as I can relate to the above comments.
Brief summary:
- Traumatic knee injury sustained Jun 2010 in Afghanistan.
- Keyhole (arthroscopic) in 2014 following 3rd tour of Afghanistan.
- AFCS claim submitted following diagnosis of arthritis in knee compartment and ligament damage.
- Awarded £6000 (Table 9, Item 27, level 13) in Aug 2015
- Continuous issues, failed MPFL reconstruction and then a HTO (High Tibial Osteotomy).
- MD (P8) in Aug 2019.
- Service Termination Review (STR) submitted day after discharge to review the original award as I believe it was no longer proportionate and the initial injury was directly linked to the subsequent invasive surgeries.
- AFCS rejected, asked for reconsideration then finally appeals tribunal.
- Attended my tribunal a few days ago and the panel overwhelmingly agreed that initial injury was linked and the descriptor did not fit merit the full extent of events - judge prescribed table 9, Item 2b, level 9.

Quezzies:
- Next correspondence?
- Already in receipt of GIP band D (30%) from a linked injury to the initial injury mentioned above, as per policy; if 2b is confirmed then I will also receive a GIP at 30%, combining both should be calculated at the above band, band C (50%) or have I misinterpreted the policy?
- Finally, if the above is true; I will be eligible for AFIP. When is this backdated to? Day after discharge or any other date?

TIA everyone
 
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