To assign arthritis disability ratings, the VA categorizes the condition as either rheumatoid arthritis or degenerative arthritis and then assesses the extent of the veteran’s symptoms.
Summary
- Arthritis, particularly osteoarthritis and rheumatoid arthritis, is a common service-connected disability among veterans.
- Securing VA disability benefits for arthritis requires proving a direct, presumptive, or secondary service connection.
- Degenerative arthritis is typically rated based on the range of motion, with a 10-20% rating depending on severity, while rheumatoid arthritis VA ratings range from 10-100% based on the frequency and impact of flare-ups.
- Veterans with severe arthritis affecting employability may qualify for Total Disability Based on Individual Unemployability (TDIU).
Arthritis stands as a leading cause of disability in the U.S. For veterans, the impact of arthritis can be particularly significant, often linked to the physical demands of military service. The Department of Veterans Affairs (VA) recognizes this challenge, offering disability benefits to veterans grappling with arthritis.
However, establishing a connection between the condition and military service is crucial for securing these benefits. Understanding an arthritis VA disability rating can be complex, but it is essential for veterans seeking to obtain the compensation they rightfully deserve.
When trying to understand how the VA determines an arthritis VA rating, the expertise of a veteran disability claim appeals lawyer becomes invaluable. VA-accredited attorneys can guide you through the process of filing claims, ensuring that all necessary documentation and evidence are in place to maximize the likelihood of a successful outcome.
By securing the appropriate compensation, you can better manage your condition and improve your quality of life. Discuss your case with Bartlett Legal Group to learn more. You can schedule a free consultation with us by calling (850) 332-6434 or filling out a contact form.
Understanding Arthritis and Its Different Types
Arthritis is a persistent inflammatory condition and a major contributor to chronic pain and disability. According to the Centers for Disease Control and Prevention (CDC), arthritis is a condition affecting over 52 million American adults.
Recent CDC research findings also reveal that U.S. military veterans experience higher arthritis prevalence than nonveterans, with 35.2% of veterans, approximately 6.8 million, reporting a diagnosis.
Arthritis primarily manifests in two forms: degenerative arthritis and rheumatoid arthritis. While these conditions share some common traits, they also possess distinct differences that make accurate identification crucial.
Understanding precisely which type of arthritis you have is essential, as it significantly influences the VA rating you might receive. Your arthritis VA rating determines the benefits and support you qualify for. Therefore, it is imperative to undergo a comprehensive examination and secure thorough documentation of your condition.
Degenerative Arthritis
Degenerative arthritis, commonly referred to as osteoarthritis, is recognized by the American Academy of Orthopedic Surgeons as a prevalent reason for discharge from active military service.
This physical condition stands as a leading service-connected disability for which veterans are often awarded compensation. Osteoarthritis occurs when the protective cartilage that cushions the ends of bones gradually wears down, a natural process that results in discomfort and restricted mobility.
Individuals affected by this condition typically experience pain, stiffness, and limitations in movement, accompanied by a noticeable grinding or clicking sensation as the joint is moved. These symptoms underscore the importance of addressing degenerative arthritis, particularly for veterans seeking to maintain their quality of life and access necessary support.
Rheumatoid Arthritis
Rheumatoid arthritis is a chronic autoimmune disorder where the body’s immune system mistakenly targets its own joints, leading to significant inflammation and swelling. This inflammatory process results in persistent pain and discomfort around the affected joints.
Key symptoms include enduring joint pain, tenderness, or swelling lasting for six weeks or more, morning stiffness persisting for at least half an hour, and additional issues such as fatigue, decreased appetite, and a mild fever.
If left untreated, rheumatoid arthritis can cause severe damage to the joints and bones. Consequently, this may compromise joint stability and greatly reduce mobility. Early detection and intervention are crucial to prevent these debilitating outcomes and maintain quality of life for veterans with an arthritis VA rating.
Establishing Service Connections for Arthritis
VA disability claims for arthritis can be established through three primary service connections: direct, presumptive, and secondary. Given arthritis’s progressive nature, a specific injury or event isn’t necessary to establish a service connection.
Direct Service Connection
This path is more straightforward if you have documented your joint pain throughout your military service and beyond. Having a comprehensive record of medical documentation that shows the presence of arthritis can significantly ease the rating process.
Even if a specific incident isn’t recorded, the cumulative impact of joint overuse during service can contribute to arthritis development. A physician can often link your service history with your arthritis, supporting a direct service connection claim.
Presumptive Service Connection
Both rheumatoid and degenerative arthritis fall under the category of chronic diseases eligible for presumptive service connection. Veterans may qualify for a 10% VA disability rating if they exhibit arthritic symptoms within a year following discharge.
This can be particularly advantageous for veterans who lack documented incidents of joint injuries during their service.
Secondary Service Connection
Arthritis can also qualify as a secondary condition stemming from another service-related injury. According to federal regulations, if arthritis develops as a direct consequence of a service-connected injury, such as a knee injury, it can be claimed as a secondary service connection.
Additionally, arthritis itself can lead to secondary conditions, such as depression. If such conditions are acknowledged by the VA as related, they, too, can be claimed as a secondary service connection.
Timely action is crucial, as delaying your claim can complicate the process. The sooner you file after noticing symptoms, particularly if they arise close to your discharge, the easier it is to establish a service connection. Each connection type offers a pathway to securing the support you need to manage arthritis effectively.
Arthritis VA Disability Rating
Both degenerative and rheumatoid arthritis are evaluated under the musculoskeletal system conditions by the VA. The determination of your disability rating depends on the range of motion and pain levels associated with your joints. To ensure accuracy, your physician should use a goniometer to measure the precise range of motion for each joint.
This is crucial because the VA initially assesses the range of motion to determine your arthritis VA rating. In some instances, you may have complete motion, which the VA evaluates according to the degenerative arthritis criteria.
How Rating Percentages Correspond With Arthritis Symptoms
The VA employs a percentage-based system for arthritis disability ratings, with rheumatoid arthritis assessed under Diagnostic Code 5002 and degenerative arthritis under Diagnostic Code 5003.
The ratings span from 10% to 100%. It’s important to note that you cannot receive an additional rating for limited range of motion alongside the ratings for either degenerative or rheumatoid arthritis.
These ratings significantly influence your arthritis claim and the disability benefits you are entitled to receive. Therefore, thorough documentation and accurate measurement are critical in the evaluation process for both types of arthritis.
Criteria for VA Disability Ratings for Degenerative Arthritis
The VA assesses degenerative arthritis primarily through the limited range of motion in various joints or joint groups, a condition frequently confirmed via X-ray imaging.
Even if arthritis is not visible on an X-ray, the VA grants an automatic 10% disability rating for each major or minor joint group affected by limited motion.
This is not cumulative with any rating under Diagnostic Code 5003, which specifically addresses degenerative arthritis. For a limited motion rating, the VA must verify physical symptoms such as swelling, muscle spasms, or pain through direct observation during an examination of the affected joint.
According to VA Diagnostic Code 5003, osteoarthritis disability ratings fall into two categories based on symptom severity:
- 10% Rating: Awarded to veterans with degenerative arthritis in two or more major joints or two or more groups of minor joints, as evidenced by X-rays.
- 20% Rating: Granted when the condition is accompanied by occasional episodes of intense incapacitation, also supported by X-ray findings.
The VA Evaluates Minor Joints and Major Joint Groups Separately at First
When filing for a disability rating, conditions in different body parts, like arthritis in the back and hands, are assessed separately as minor joint groups and then combined for an overall disability rating.
Similarly, arthritis in the knee and ankle are considered major joint groups. Therefore, the VA evaluates the major joints separately before combining ratings. Even if arthritis affects only one area, there is still potential for receiving a VA disability rating based on the condition’s impact.
The VA Offers Higher Disability Ratings for Rheumatoid Arthritis
The disability rating for rheumatoid arthritis can fluctuate over time, reflecting changes in the severity of the condition. This autoimmune disorder is assessed based on the minor or major joints involved. Then, the VA categorizes it as either an active condition or according to any lasting chronic effects.
The VA evaluates rheumatoid arthritis using Diagnostic Code 5002, following the following criteria:
- 100% Rating: This is the highest VA rating for arthritis, and it’s awarded when the condition leads to complete incapacitation, impacting multiple organs and body systems in addition to the joints.
- 60% Rating: Given for severe episodes occurring four or more times annually, often accompanied by symptoms such as anemia, weight loss, and a decline in overall health.
- 40% Rating: Assigned for three or more severe episodes each year, or when there is a medically confirmed health impairment affecting daily life.
- 20% Rating: Applied for one to two severe episodes per year with a well-established diagnosis.
The Process of Rating Rheumatoid Arthritis for VA Disability
Residual symptoms, such as ankylosis or restricted joint movement, are evaluated separately and rated according to the specific joint’s condition. A 10% rating may be assigned for additional symptoms like muscle spasms, swelling, or pain during movement if they are distinct from other conditions recognized under Diagnostic Code 5002.
The VA disability rating you receive for rheumatoid arthritis directly impacts your disability benefits. As this chronic condition can deteriorate over time, you have the opportunity to adjust your veteran disability claim as your arthritis VA rating increases to reflect the progression of your condition.
How Veterans Can Get a Total Disability Rating (TDIU) for Arthritis
Arthritis can significantly hinder your ability to perform both physically demanding and sedentary work. Tasks such as prolonged standing and heavy lifting may become challenging. In the same vein, activities requiring fine motor skills, like handling calls or typing can also be difficult due to joint pain and stiffness.
If arthritis severely impacts your ability to work, you may qualify for other types of compensation such as Total Disability based on Individual Unemployability (TDIU).
Proving Eligibility for Additional VA Disability Compensation
Even if your osteoarthritis rating alone doesn’t meet TDIU requirements, you might still be eligible if the combined effects of multiple service-connected conditions, including arthritis, impede your employment capabilities.
To meet the criteria for TDIU disability benefits, you need to:
- Have a single disability rated at 40% or more, with a combined disability rating of at least 70%, or
- Have one service-connected condition rated at 60% or higher.
If you experience additional secondary conditions, such as depression or insomnia, alongside arthritis, which further complicates your working capacity, this may strengthen your case for TDIU eligibility.
Seek Disability Benefits for Arthritis With Our VA-Accredited Team Today
At Bartlett Legal Group, our dedicated team of VA-accredited veterans benefits attorneys advocates for vets to secure the highest possible VA rating for arthritis. We understand the challenges service-connected arthritis can bring.
Our team is here to provide the support you need as you pursue a VA disability claim. If you or your loved ones are struggling with arthritis related to military service, don’t wait any longer to seek the VA benefits you deserve.
Call us today at (850) 332-6434 or submit this contact form to schedule your free consultation. Let us assist you in navigating the VA claim process with compassion and expertise.
