What Hip Conditions Qualify For VA Disability?
As reported in the VA’s most recent Annual Benefits Report, musculoskeletal disabilities are the most commonly claimed condition in the VA disability benefits system, making up 36.9 percent of all disability claims. Given the physicality required for many military occupations, this is not surprising. Due to their work, service members and veterans are naturally more likely to develop musculoskeletal conditions than those in the general population, and one of the most common sites of development for these types of conditions are the hips.
Some hip conditions which the VA has developed schedular disability rating criteria for include:
- Tuberculosis of the bones or joints
- Degenerative arthritis
- Flail joint
- Hip Subluxation
Each of these conditions are subject to VA disability compensation if the veteran developed the condition as a result of his or her military service. Due to the severe limitations these conditions can impose on veterans, such as impairing one’s ability to work or engage in everyday activities, having access to monetary compensation is incredibly important.
Getting Service Connected For A Hip Condition
The most important information veterans can provide when applying for service connection for their hip condition is their medical records. These medical records should hopefully include a doctor’s visit diagnosing the veteran with a hip condition in service, or at least a record of symptoms related to a hip issue in service, even if an official diagnosis was not given at that time. The veteran should also provide any private medical records he or she may have relating to their hip condition from the time of symptom onset to the present. Additional helpful evidence could include any service personnel records showing a relationship between the hip condition and an in-service event that could have caused or contributed to the development of the condition.
How The VA Rates Hip Conditions
Under 38 CFR § 4.71a, the VA evaluates conditions of the musculoskeletal system. The following diagnostic codes are used to determine the scheduler disability rating applied to conditions of the hip.
Diagnostic Code 5000: Osteomyelitis, acute, subacute, or chronic:
- 100 – Of the pelvis, vertebrae, or extending into major joints, or with multiple localization or with long history of intractability and debility, anemia, amyloid liver changes, or other continuous constitutional symptoms
- 60 – Frequent episodes, with constitutional symptoms
- 30 – With definite involucrum or sequestrum, with or without discharging sinus
- 20 – With discharging sinus or other evidence of active infection within the past 5 years
- 10 – Inactive, following repeated episodes, without evidence of active infection in past 5 years
Diagnostic Code 5001: Bones and joints, tuberculosis of, active or inactive:
- 100 – Active
- 100 – For 2 years after date of inactivity, following active tuberculosis, which was clinically identified during service or subsequently
- 50 – Thereafter, for 4 years, or in any event, to 6 years after date of inactivity
- 30 – Thereafter, for 5 years, or to 11 years after date of inactivity
- 0 – Thereafter, in the absence of a schedular compensable permanent residual
Diagnostic Code 5002: Multi-joint arthritis (except post-traumatic and gout), 2 or more joints, as an active process:
- 100 – With constitutional manifestations associated with active joint involvement, totally incapacitating
- 60 – Less than criteria for 100% but with weight loss and anemia productive of severe impairment of health or severely incapacitating exacerbations occurring 4 or more times a year or a lesser number over prolonged periods
- 40 – Symptom combinations productive of definite impairment of health objectively supported by examination findings or incapacitating exacerbations occurring 3 or more times a year
- 20 – One or two exacerbations a year in a well-established diagnosis
Diagnostic Code 5003: Degenerative arthritis, other than post-traumatic:
Degenerative arthritis established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. In the absence of limitation of motion, rate as below:
- 20 – With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations
- 10 – With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups
Diagnostic Code 5025: Fibromyalgia (fibrositis, primary fibromyalgia syndrome)
With widespread musculoskeletal pain and tender points, with or without associated fatigue, sleep disturbance, stiffness, paresthesias, headache, irritable bowel symptoms, depression, anxiety, or Raynaud’s-like symptoms:
- 40 – That are constant, or nearly so, and refractory to therapy
- 20 – That are episodic, with exacerbations often precipitated by environmental or emotional stress or by overexertion, but that are present more than one-third of the time
- 10 – That require continuous medication for control
Diagnostic Code 5250 Hip, ankylosis of:
- 90 – Unfavorable, extremely unfavorable ankylosis, the foot not reaching ground, crutches necessitated
- 70 – Intermediate
- 60 – Favorable, in flexion at an angle between 20° and 40°, and slight adduction or abduction
Diagnostic Code 5254: Hip, flail joint – 80
Diagnostic Code 5054: Hip, resurfacing or replacement (prosthesis):
- 100 – For 4 months following implantation of prosthesis or resurfacing
Prosthetic replacement of the head of the femur or of the acetabulum:
- 90 – Following implantation of prosthesis with painful motion or weakness such as to require the use of crutches
- 70 – Markedly severe residual weakness, pain or limitation of motion following implantation of prosthesis
- 50 – Moderately severe residuals of weakness, pain or limitation of motion
- 30 – Minimum evaluation, total replacement only
There are a number of other hip-related conditions which the VA will provide compensation for in addition to those listed above. For any veterans who do not see their condition listed here, please refer to 38 CFR § 4.71a to see if your condition is eligible for service connection.
Getting Help With Your VA Disability Claim
If you or someone you know is a veteran looking to get help with their hip-related claim, please contact us today. Our experienced veterans disability attorneys are ready to help you get the compensation you are entitled to because of your condition.