What Is Osteoarthritis?
Osteoarthritis occurs when the protective cartilage that cushions the ends of the bones wears down over time. It is the most common form of arthritis, affecting nearly 16 percent of adults in the United States. Individuals with osteoarthritis can usually manage their symptoms, but damage to their joints cannot be reversed.
The most common symptoms of osteoarthritis are:
- Pain in the affected joint
- Stiffness in the affected joint
- Loss of flexibility due to decreased range of motion
- A grating sensation with movement
- Popping and crackling in the affected joint
- Bone spurs
- Swelling caused by soft tissue inflammation
While the direct cause of osteoarthritis is well known, there are a number of different factors that can lead to the cartilage degeneration that causes osteoarthritis. Some of the most common risk factors include older age, joint injuries, obesity, repeated stress on the joint, and certain metabolic diseases like diabetes. Due to these risk factors, it is not surprising that veterans are more likely to develop osteoarthritis than the general population. Many veterans, during the course of their military service, experience joint injuries and repeated stress on their joints because of the physical nature of many military activities. This can lead to the development of osteoarthritis while in the military or later in the veteran’s life. If a veteran can prove to the VA that his or her osteoarthritis is a result of his or her military service, he or she is eligible for VA disability benefits.
How The VA Rates Osteoarthritis
Under 38 CFR § 4.71a, the VA rates osteoarthritis depending on the severity of the condition. Degenerative osteoarthritis 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 (DC 5200 etc.). However, when the limitation of motion of the specific joint or joints involved is non compensable under the appropriate diagnostic codes, the VA will apply a rating of 10 percent to each major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5003:
Diagnostic Code 5003: Degenerative arthritis, other than post-traumatic
- 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
Below is an example of a disability rating schedule for limitation of motion of the elbow joint. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion.
Diagnostic Code 5206: Forearm, limitation of flexion
|Flexion limited to 45°||50||40|
|Flexion limited to 55°||40||30|
|Flexion limited to 70°||30||20|
|Flexion limited to 90°||20||20|
|Flexion limited to 100°||10||10|
|Flexion limited to 110°||0||0|
Diagnostic Code 5207: Forearm, limitation of extension
|Extension limited to 110°||50||40|
|Extension limited to 100°||40||30|
|Extension limited to 90°||30||20|
|Extension limited to 75°||20||20|
|Extension limited to 60°||10||10|
|Extension limited to 45°||10||10|
Getting Help With Your Osteoarthritis Claim
If you are a veteran with osteoarthritis and are looking for assistance with your VA disability claim, please contact our office today for a free case evaluation.