Determining a military disability rating for arthritis can be
frustrating, to say the least. I’m just going to get this out of the way right
off the bat: It totally makes me feel like this guy.
There are all sorts of tricky rules in the VASRD that must be
considered when rating arthritis. And having other conditions affecting a joint
in addition to arthritis just complicates things even more. If you are a disabled American veteran with arthritis, I will do my best to help you understand how your arthritis
should be rated.
First rule that you must understand:
All joints will only receive ONE rating for the overall condition of that
joint, regardless of the number of conditions that affect it. So, if you have
arthritis and a meniscus condition in your knee, you can only receive a rating
for one of the two conditions, whichever gives the higher rating. So, if your
arthritis gives a higher rating than the meniscus condition, then it is rated,
and the other is ignored. Only one rating per joint.
There are a couple of conditions that are
an exception to this rule, but if you have one of these conditions, our
discussion about that condition on our site will clearly say that you can rate
it in addition to other conditions that affect that joint. If it doesn’t
clearly state this, then it doesn’t apply. Only one rating for the entire
joint.
Now that we understand that, let’s jump
into arthritis. The VASRD rates two main types of arthritis: Degenerative Arthritis
(code 5003), and
Rheumatoid Arthritis (code 5002). All other types of arthritis or similar conditions are rated analogously as
degenerative or rheumatoid, whichever is the most similar.
If your condition is Rheumatoid Arthritis or
is rated as Rheumatoid Arthritis, it’s your lucky day! The ratings for Rheumatoid Arthritis are
fairly straightforward. No serious complications or confusion for you. Just
follow the instructions on our site, and you’ll be pretty good to go. Woo-hoo!
All right, Degenerative Arthritis… Let’s
start off with assuming that only ONE joint has arthritis in the entire body.
The key to Degenerative Arthritis is that if there is any limited motion AT ALL
in the affected joint, then the condition MUST be rated on limited motion of
that joint. So, if you have arthritis in your knee, and you cannot bend it all
the way, then it is rated once on limited motion of the knee, code 5260. That is the
one and only rating, and you are done.
Now if you have trouble both bending and straightening your knee
all the way (they are two different codes for the knee), then you would pick
the code that would give you the higher rating. So if the inability to bend
gives a higher rating than the inability to straighten, then that is what is
rated, and you are done.
Side
Note: Because limited motion is so vital to rating arthritis, it is essential
that your physicians record the exact range of motion measurements for your
affected joints. If these measurements aren’t properly recorded, you will not
receive the correct ratings you deserve. Physicians often don't know how
things are rated, and so they may not realize this. Be proactive to make sure
this is done. It is vital for both your DoD Disability and your VA Disability.
Now, if you don’t have limited motion, then
your condition is rated as Degenerative Arthritis under code 5003. Here is the most confusing part of rating
Degenerative Arthritis: all joints in the body that are rated as Degenerative
Arthritis are combined, and only one rating given for all the joints. (If you
just screamed “What the heck?!” – don’t worry, I did too.)
So let’s jump to having multiple joints
with Degenerative Arthritis. This will best be explained by using an example.
Joe has four joints that have Degenerative Arthritis or conditions that are rated as Degenerative Arthritis, his right elbow, his right wrist, his left
knee, and his left ankle. All the conditions must first be rated on limited
motion if there is any, and if they have limited motion, then they can each be
rated SEPARATELY. So, both his elbow and his ankle do not have any limited
motion, but his wrist and knee do. So, he receives one rating for limited motion of the wrist, and a second for limited motion of the knee. These both are finished.
Since his elbow and ankle do not have any
limited motion, then they are both rated as Degenerative Arthritis under code 5003. Under this
code, these joints will be combined, so they will only receive ONE rating for
both of them. Carefully read how code 5003 works, and this should make sense.
Ultimately, Joe will only have a total of
three ratings for his four conditions, instead of four separate ratings.
That’s it. Hopefully that didn’t just
create more questions than it answered. Carefully read our discussions of Degenerative Arthritis and Rheumatoid Arthritis, and hopefully this will make sense to you. Rating arthritis is second only to
rating TBI in its complexity, so take it slow.
Hopefully I have been able to help!
All right, Degenerative Arthritis… Let’s
start off with assuming that only ONE joint has arthritis in the entire body.
The key to Degenerative Arthritis is that if there is any limited motion AT ALL
in the affected joint, then the condition MUST be rated on limited motion of
that joint. So, if you have arthritis in your knee, and you cannot bend it all
the way, then it is rated once on limited motion of the knee, code 5260. That is the
one and only rating, and you are done.