Determining a military disability rating for arthritis can be frustrating, to say the least.
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!
If your condition is Degenerative Arthritis or is rated as Degenerative Arthritis (by far the most common), it is not your lucky day. You have to hang in there with me as I explain things step by step. Sorry.
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!