Cancer and Tumors of the Musculoskeletal System

Topics:

Musculoskeletal Tumors
Musculoskeletal Cancers
Principles that Apply

Reminder: The VA will give a Military Disability Rating for each service-connected condition a service member has, but the DoD will only rate service-connected conditions that make a service member Unfit for Duty.

Cancer and tumors are made up of the growth of abnormal cells. These cells can be benign—they do not attack the good cells around them (tumors)—or they can be malignant—they attack the cells around them (cancers).

 


Musculoskeletal Tumors

Code 5328: Any tumor or lump that is not cancerous is rated based on its effect on the functioning of the body part. So if a benign tumor in the shoulder causes the shoulder to not move as well, then the condition is rated under limitation of motion of the shoulder. Likewise, if the tumor has been removed and a scar impacts the functioning of the body part, then it is rated as a scar.

Since this is coded 5328 but rated under a second code, the final code will be a hyphenated code, i.e. 5328-7805. The first code defines the condition, and the second code is the one the condition is actually rated under. See the Analogous Ratings page for more information.

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Musculoskeletal Cancers

Malignant cancers are divided into two groups. Carcinoma is a kind of cancer that is made up of epithelial cells. Epithelial tissue is present throughout the body. It lines the surfaces of organs and creates bodily fluids. The majority of the most common cancers are carcinomas, including lung cancer and breast cancer. Sarcoma is another kind of cancer that is made up of diseased cells of connective tissue, muscle or bone. It is the most common type of musculoskeletal cancer, but is rare in comparison to breast, skin, or colon cancer (carcinomas).

The VASRD splits cancers that originate in the musculoskeletal system into three groups: soft tissue sarcomas (Code 5329), bone cancer (Code 5012), and other muscle cancers (Code 5327).

Code 5329: Soft tissue sarcomas include muscle, fat, ligaments, and fibrous tissues. Examples include leiomyosarcoma, rhabdomyosarcoma, chondrosarcoma, Ewing’s sarcoma, and fibrosarcoma. A rating of 100% is given for active soft tissue sarcoma and remains in effect for the first 6 months following treatment. The condition will then be reevaluated. If it is no longer active, then it is rated on any lasting symptoms or complications. For example, if the lasting symptoms or complications affect the range of motion of the shoulder, it is rated under that symptom.

Soft tissue sarcoma of the blood vessels is rated under code 7123.

Code 5012: Osteosarcoma (sarcoma of the bones) is rated 100% while the cancer is active. This 100% rating remains in effect for the first 12 months following treatment. The condition will then be reevaluated. If it is no longer active, then it is rated on any lasting symptoms or complications. For example, if the cancer required the amputation of a limb, a common treatment for osteosarcoma, then that amputation is rated separately.

Please note that the bone cancer rated here only includes cancers that started in the bones and only affect the bones. This does not include bone marrow cancer, since that is a cancer of the blood (see The Blood page), nor cancers that begin elsewhere and then move to the bones, since these cancers do not originate in the bones themselves.

Code 5327: Any cancers, like leiomyoma, that affect the muscles that are NOT sarcomas are rated under this code. This code is not used very often since most muscle cancers are sarcomas and are thus rated under code 5329 (above). A rating of 100% is given while the cancer is active. This 100% rating will continue for the first 6 months following the last treatment. The condition will then be reevaluated. If it is no longer active, then it is rated on any lasting symptoms or complications. For example, if the lasting symptoms or complications affect the range of motion of the shoulder, it is rated under that symptom.

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Principles that Apply

Combined Ratings for Muscle Injuries: A rating for muscle cancer cannot be combined with a rating for any other muscle condition unless each condition affects completely different functions or muscle groups (i.e. a cancer condition in the arm makes it impossible to raise the arm above the head and another muscle condition in the arm limits the motion of the elbow). Please see the Musculoskeletal Principles page for more detailed information.

Pyramiding: A single condition can only be rated once!

Painful Motion: If pain is present with motion, then the minimum compensable rating (at least 10%) must be given.

Probative Value: If two exams record the condition differently, the exam with the most thorough data and performed by the most qualified person in that specialty will be the exam the rating is based on.

A Tie Goes to the Veteran: If there are two equally strong exams with conflicting information, or if the condition can be equally rated under two different codes, then the one that gives the highest rating will be assigned. Every conflict should be resolved in favor of the higher rating.

Hospital or Convalescent Ratings: Some conditions require periods of hospitalization or constant medical care (at-home nurse, etc.). Any condition that requires this is rated 100% during this intensive treatment. Once it ends, then the 100% rating will continue for a certain period. This period is 3 months unless another length (6 months, 1 year, etc.) is directly specified in the condition ratings. Some patients may need more time to recover than others, so the physician or Rating Authorities can lengthen this time period if they see fit.

Please see the Musculoskeletal Principles and the VASRD Principles pages for further guidance.

For cancer conditions that are not of the musculoskeletal system, please search by the organ or system they affect. Each page, besides those of the musculoskeletal system, has a section for cancers that affect those specific systems.

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