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Monday, March 24, 2014

Rating Ehlers-Danlos Syndrome (EDS) for Military Disability

We have run up against another tough condition to assign a Military Disability Rating to for military disability

Ehlers-Danlos Syndrome, or EDS, is a genetic condition that a person is born with. It is a condition where collagen is not produced correctly. Collagen is essential to the proper growth of the tissues. Without it, or if it is faulty, the tissues are more stretchy, causing them to have trouble keeping their shapes and perform their proper functions. The worst part about this is that any part of the body can be affected, including the joints, skin, muscles, ligaments, and organs. It is also has no cure.

So now that we know what it is, how to rate it. Because EDS is genetic, it technically cannot be rated since military disability is not given by either the DoD or the VA for any genetic conditions. This is because you would have had the condition regardless of whether or not you served in the military. This does not mean, though, that it cannot receive a rating and disability compensation in certain instances. 

First, all genetic conditions are treated like EPTS (existed prior to service) conditions. For it to qualify to receive disability, the EDS condition (and all other EPTS conditions) must have gotten significantly worse because of military service than it would have if you had not been in the military. Common causes could be demanding physical training, exposure to chemicals, etc.

For example, let’s say that Bob has EDS that mainly affects his joints. The doctors think that it would be reasonable to expect Bob to start having trouble controlling his joint movements by the time he turned 40 (this is extremely unrealistic, but I’m using it just for the sake of keeping the example as simple and straightforward as possible). Bob joined the military when he was 20, and had significant physical demands that caused him to start experiencing trouble controlling his joint movements when he was 30. The doctor’s think it is pretty logical to assume that he would not have begun having symptoms that early had he had a desk job with low physical demands. Thus, Bob’s EDS does qualify for rating since it was clearly made worse by his military service.

Remember, this example is very simplified. For the majority of cases, it will be much harder to determine whether or not an EDS condition was indeed worsened by service. Ultimately, this judgment is up to the physicians performing your exams and the Rating Authorities that determine your disability ratings. You can help your case, however, by getting as much definite proof as possible for both your physician’s and the Rating Authorities.

Alright, now that we know the condition can be rated, things get even more tricky when actually trying to rate it. Rating genetic conditions totally makes me feel like this guy.
If a genetic condition qualifies for rating, it can be rated, but only on how much it was worsened by military service. So, in Bob’s case the symptoms that he did have at age 30 would be compared to the symptoms he should have had at that age, and then the difference would be rated.

Let’s further the example by saying that the condition affected his right elbow. If at age 30 he should have been able to bend it all the way to 90°, but could only actually bend it to 60°, then it would be rated on the difference, 30° (90 – 60 = 30). That is how much the military worsened his condition, and thus, that is what they will compensate.

Do you feel like this guy yet?

That’s the basic rule for all genetic conditions and EPTS conditions, although very simplified.

Next we need to discuss the basics of rating EDS specifically.

Since EDS can cause so many different symptoms, it isn’t given just a single rating. Instead, each of the symptoms is rated separately. For example, let’s say Bob’s EDS causes limited motion in his elbow and affects the functioning of the liver. Both of these conditions are separately rated. He would get two ratings: one for the elbow and one for the liver. Just find the condition that most closely describes each symptom. But remember, for each of these conditions, they are only rated by how much worse military service made them.

That’s it. Just remember, if your symptoms would have been the same if you hadn't been in the military, they can’t be rated. Don't waste your time and effort trying to get a rating that simply won't be given.

Unfortunately, it’s impossible to determine exactly how your EDS condition will be rated. It is completely up to the Rating Authorities. There are so many ways to interpret things, that there isn’t really much you can do to help your case besides making sure the Rating Authorities have complete medical information about every symptom you have. In this post, I have simply outlined the laws and processes they are required to use when determining the ratings for your EDS. Hope this helps.

Find out more about your military disability and your military disability benefits on our site.

8 comments:

  1. I am currently looking at being tested for EDS. I show all the telltale signs, but would like to know if EDS will disqualify me from military service, if there are any regulations covering it, or if it's left to the discretion of the military providers.

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    1. Hi Steve -

      It all depends on your symptoms and their severity. If they aren't severe enough to inhibit you from performing your job or being deployed, they'll probably keep you on duty until they get worse. Once they make you unfit for duty, they will medically separate you at that time. So without knowing the severity of your symptoms, I can't determine whether or not they will immediately separate you.

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  2. I was free of symptoms until my stint in the army. During that time I developed multiple pelvic fractures for which I was ultimately medically discharged. During that time I also had neck pain, headaches, knee pain, elbow pain etc, for which I was evaluated, but received no diagnosis. I have been diagnosed with EDS, dysautonomia (a comorbidity which also showed itself first during my service)and other issues. Two years later I am now trying to file with the VA. Any suggestions or advice for me?

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    1. The key for you will be to show thorough proof of the development of your symptoms while in the military. Make sure to include every medical record you have regarding. I also recommend including your entrance medical exam showing a clean bill of health. This will prove that your condition worsened while on active duty. Any and all evidence you have of your conditions/symptoms while in the military will be by far the best thing you can submit to ensure a strong claim.

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  3. Hi - Posting this question on behalf of my husband. He has had 4 shoulder surgeries and one neck/spinal, all since being in the military. After his recent discectomy (June 16) he has now been referred back to the surgeon for neck pain she has suggested testing for Ehlers-Danlos Syndrome. They have already said they will be submitting the paperwork to medically retire him, I'm wondering if a diagnosis will help his case, sounds, from your post above, that it could actually dismiss some of his claim? He is 39 and at 21 years service. They have been testing him for years for different things to explain a lot of his symptoms and have not been able to identify anything, meanwhile they have continued to push him physically to pass physical tests, seems if he had received more consistent health care they could have discovered this earlier and lessened the impact on his joints etc... Does this have any merit to it?

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    1. If he is diagnosed with EDS, then that will definitely decrease the amount he would receive for his conditions since it is genetic and so technically ineligible. Military service is unquestionably tough on the body, however, and so in most cases, it can be prove that service made the condition worse, and so it is aggravated and eligible for some compensation. Again, however, it won't be the full amount he would be eligible for if he doesn't have EDS.

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  4. I'm a prior AD, now reservist. I am 12yrs in and currently deployed. I had been rated by the VA when I initially separated in 2007 receiving 30% for multiply claims. This past year the VA reevaluated me and increased my ratings to 50%, possibly going higher once I submit additional documentation. I am also a military dependant and was just diagnosed with EDS and am awaiting further testing to pin down my complete diagnosis. 2 Questions...

    1. If I cannot take a full of PT test any more and need to have a permanent aerobic waiver will that result in a MEB even though I have a low threat office job?

    2. Will the VA lower my disability rating now many of my injuries could be determined to be genetic?

    I don't double dip as my wages are balanced between the reserves and the VA, but I'm concerned that some how I got caught in catch 22...

    Suggestions or recommendations on how to proceed are welcome.

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    1. You might indeed be referred to the MEB for your conditions. It just depends on the circumstances. Usually, any conditions that disqualify you for deployment would make you Unfit for Duty, but depending your MOS and the demand for that MOS, they can keep you in on a waiver.

      Without knowing exactly what conditions you are rated for and your EDS circumstances, it's impossible for me to predict what the VA will do. In most cases, they rarely lower ratings. However, any symptom caused by EDS will be considered EPTS and so MAY be adjusted.

      Ultimately, since your conditions have already been rating, it's really difficult to know just what the VA will decide.

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