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!
No, the VA will only give you a single spine rating for your cervical spine. They will, however, rate your radiculopathy separately.
Greetings, I am currently rated 10% for cervical spine degenerative disc disease, I was also diagnosed with cervical facet arthropathy. Is it possible to get the facet athropathy secondary to cervical spine DDD (two separate ratings)? Also would Cervical Radiculopathy be a possible secondary condition to cervical degenerative disc disease (two separate ratings)
You can definitely claim it as secondary, but the VA will not rate it as a separate condition. They will simply include it in your overall cervical spine condition. If it causes significantly new or progressed symptoms, it could contribute to having your overall cervical spine condition increased.
Sir, I think I understand when you say the VA will only give you a single rating for the cervical spine as a whole, no matter how many diagnosed conditions you have. So with my recent diagnosis of moderate spinal canal stenosis I cant say that is secondary to my cervical degenerative disc disease (currently rated at 10%), correct?
The baseline issue is the fact that the VA will only you a single rating for the cervical spine as a whole, no matter how many diagnosed conditions you have (nerve conditions are rated separately). They will look at the overall symptoms and assign the highest rating they can based on those symptoms. So, you cannot receive a rating for degenerative disc disease and another for facet arthropathy. Only one.
All of these conditions are rated on the general rating formula which is baed on limited motion. If your motion is more limited, you may qualify for a higher rating on that alone.
Since you have multiple disc conditions, you could qualify for a rating under Intervertebral Disc Syndrome instead if that offers higher rating under incapacitating episodes.
Again, they will only give one overall rating, but if your symptoms do qualify for a higher rating, it is definitely worth applying for an increased evaluation.
I currently have a 10% rating for cervical spine degenerative disc disease. I recently had an MRI done of my cervical spine which indicated mild multilevel degenerative changes of the cervical spine, most pronounced at C4-C7. Specifically…
• C3/C4: Posterior disc osteophyte complex in contact with the anterior spinal cord. Bilateral facet arthropathy. Moderate spinal canal stenosis. Moderate-to-severe left and moderate right neuroforaminal narrowing.
• C4/C5: Symmetric posterior disc bulge. Bilateral facet arthropathy. Mild spinal canal stenosis. Moderate-to-severe right and moderate left neuroforaminal narrowing.
• C5/C6: Symmetric posterior disc bulge with superimposed focal central to right subarticular disc protrusion. Bilateral facet arthropathy. Mild spinal canal stenosis. Mild bilateral neuroforaminal narrowing.
• C6/C7: Symmetric posterior disc bulge. Bilateral facet arthropathy. Minimal spinal canal stenosis. Minimal bilateral neuroforaminal narrowing.
• C7/T1: Disc desiccation without posterior protrusion. No facet arthropathy. No spinal canal stenosis or neuroforaminal narrowing.
DOCTORS IMPRESSION: 1. Multilevel cervical degenerative disc disease, most pronounced at C3/C4 resulting in moderate spinal canal stenosis, moderate-to-severe left neuroforaminal narrowing, and moderate right neuroforaminal narrowing. Correlation for radicular symptoms. 2. C4/C5 degenerative disc disease resulting in moderate-to-severe right and moderate left neuroforaminal narrowing. Correlation for radicular symptoms. 3. Multilevel bilateral facet arthropathy.
My question to you is can I get a rating increase to my cervical spine degenerative disc disease rating due to the facet arthropathy in my cervical vertebrae? I did some research on a website called spine-health.com which stated "degenerative discs and osteoarthritis often occur hand in hand because the disc and facet joints are both part of the same three-joint complex. It is thought that degenerating discs can place undue stress on the facet joints, thus over time leading to degeneration and formation of osteoarthritis in the facet joints".
Also based on the MRI results listed above are there any conditions I could file for separately for example "Mild spinal canal stenosis, mild bilateral neuroforaminal narrowing"?
The cyst and the arthritis would all be rated together under code 5003, degenerative arthritis, on how they affect the motion of the knees. The presence of pain would qualify for a minimum 10% per knee.
This is the only rating that can be given for the cyst and arthritis, however, you may qualify for one more rating under code 5257 if instability is officially diagnosed.
Hello, I was awarded service connection at 0% for both my left and right knee in 2011. Both of my legs have recently begun swelling, the right leg occasionally and the left almost daily. I went to have the swelling checked and a large Baker's cyst was found behind my left knee as well as arthritis. I am overseas working and at a loss how to communicate with the doctors here. I want to file for an increase and wonder what rating codes this would be under. I have pain in both knees and they actually feel like they are on fire inside. My left knee occasionally gives out and I limp but that comes and goes. Can you please help me understand a bit more about what type of rating I should expect.
Yes, "arthrosis" is really a term describing the joint itself. Degenerative talonavicular arthrosis is really just degenerative arthritis of the talonavicular joint.
Yes, the arthritis can be granted secondary service-connection to the Chondromalacia Patella, but it is important to note that only a single rating can be given for the overall knee condition (unless instability is present–that can be rated separately). Thus, the VA could increase your current rating if the ratings for arthritis allow it, but you would not give a second separate rating for the arthritis.
Hello Sir, I was recently diagnosed with degenerative talonavicular arthrosis of my right foot. Does the VA look at and rate arthrosis the same as arthritis?
I was diagnosed with Chondromalacia Patella when I separated from the service in 1978. I received a 10% disability at separation for on one knee. Over the years my knees have become worst and was recently diagnosed with degenerative arthritis in both knees. I filed for compensation change but was denied because of range of motion was not enough. However, they rated my left knee with 10% as a result of Chondromalacia Patella.
Would I have a chance for additional disability rating if I filed the arthritis as a secondary cause of the Chondromalacia Patella?
Thanks in advance for your response.
It is usually rated on code 5242.
It's rated first on limited motion. If not enough, then arthritis. The painful motion principle does apply.
Sir, I was diagnosed with multilevel cervical facet arthropathy or as the VA calls it "cervical spondylosis." How does the VA rate this condition? Are ratings based on range of motion for example to get 10%, flexion measures more than 30° but less than 45°. Or would this condition fall under diagnostic code 5003: Degenerative arthritis and if there is pain on movement then it rates 10% because of the Painful Motion principle.
Hi Amber –
Yes, the examiner basically stated that in their opinion the synovial hypertrophy is SC while the arthritis is not. The rating authority could look at your case and disagree, but the examiner's opinion does hold weight.
As for the rating under code 5002, the VA will rate either by these rating requirements (which would rate you 20% for the 2 incapacitating episodes) or as limited motion, whichever gives you the higher rating. You cannot rate both. Since limited motion of the wrist is only rated 10% at the most, the 20% rating under 5002 is the more likely rating option.
Since last posting my question I have been to the VA for my C&P exam but I am still awaiting my rating.
I claimed synovial hypertrophy/proliferative synovium of bilateral wrists and also arthritis of bilateral fingers, hands, and wrists all secondary to amyopathic dermatomyositis (for which I am SC).
The examiner notated the following in regard to the synovial hypertrophy/proliferative synovium:
"a. The condition claimed is at least as likely as not (50% or greater probability) proximately due to or the result of the Veteran's service connected condition."
For the arthritis of bilat hands/fingers/wrists the examiner stated the following:
"b. The condition claimed is less likely than not (less than 50% probability) proximately due to or the result of the Veteran's service connected condition."
So I take this as they will grant SC for the synovial hypertrophy but not the arthritis?
Additionally, I have had four "flare ups" in less than a year, two of which I received prednisone for and two of which I did not. The examiner documented this as two incapacitating episodes as well as two non-incapacitating episodes. When examining my wrist the examiner also notated abnormal results for ROM. Right wrist: Palmar Flexion (0-80): 0 to 55 degree Dorsiflexion (0-70): 0 to 45 degree Ulnar Deviation (0-45): 0 to 25 degree Radial Deviation (0-20): 0 to 15 degree, and left wrist: Palmar Flexion (0-80): 0 to 60 degree Dorsiflexion (0-70): 0 to 40 degree Ulnar Deviation (0-45): 0 to 45 degree Radial Deviation (0-20): 0 to 20 degree.
Given this information, do you believe I will be rated under 5002 for wrist arthralgia (claimed as bilateral proliferative synovium/synovial hypertrophy) or will I be rated for limited ROM? Is it possible to be rated under 5002 for the arthralgia/flare ups as well as limited ROM? Thank you for your time!
Most spine conditions are inter-related as they cause further wear and tear on other parts of the spine. Never hurts to strengthen your case by getting a NEXUS letter from your physician, however.
Sir, I was recently diagnosed with multilevel cervical facet arthropathy or as the VA calls it "cervical spondylosis." Is there a possibility degenerative disc disease (DDD) causes or exasperates the condition of cervical spondylosis? I'm thinking about doing a secondary claim for the cervical spondylosis to the DDD.
Good question. Ultimately, yes, they may ask for the extra money they paid you to be returned. Often, however, they do not. It depends on what the authority decides at the time they make the correction. Since it was their error, they often will decide to let it slide, but they do have the legal right to request the funds be returned.
Sir, you sent me a reply to my question about Administrative Decision For Cue the VA initiated. Well I got a letter today stating THEY made a calculation error when I submitted a claim for two painful scars. For one scar they did a 10% as a secondary condition to my service connected ankle. Then a scar on my knee they rated a stand alone 10%. Well the regulations state "If there are 1 or 2 scars that are unstable or painful it is rated 10%." so they are taking 10% away from me.
My question to you is since this is an error made by the VA will I be required to pay back any money to the VA?
Thank you Sir
You are in a tough spot for your spondylosis. It is medically indicated that the ankle would cause this condition, so it makes sense that the VA denied it. However, without any symptoms present while you were active duty, it is highly unlikely that they will grant service-connection simply based on your posture during service. Chronic conditions must develop to at least 10% within 1 year of service to be considered at all. You can always try to submit a new claim, but it is likely to not be successful.
It is odd for the VA to open a CUE claim without you having requested it. Most often CUE claims are used to prove that the VA made a definite error that harmed the veteran's case that must be remedied. Rarely are they used to lower a veteran's ratings.
Sir, I got a bit of bad news today as the VA denied my claim for multilevel facet arthropathy or as they call it "cervical spondylosis". This claim was reviewed as a secondary condition to my service connected rating for lateral collateral ligament sprain with degenerative arthritis, left ankle. Basically I was trying to convince the VA that the pain issues with my neck was caused by my left ankle when walking ect. My question to you is should I open a new claim for the cervical spondylosis and not try to tie it to an existing secondary condition? I was an Air Force parachute specialist for 8 years and this job required a lot of standing at a table with my neck bent/hunched over looking down at the parachute equipment when packing. I figure doing an entire new claim and submit evidence this issue could possibly be exasperated from my time as a parachute specialist would be better than filing an appeal as a secondary condition for my ankle.
I also have a question about Administrative Decision For Cue. The VA opened this claim up and I'm not sure why because I did not make a request a Cue. From what I understand a “CUE claim,” is when a veteran asks the VA to revise a decision that is final. My question to you is could the VA be looking at one of my service connected disabilities and potentially give me an increased rating or could this be a possible downgrade in a rating where they are looking to take something away from me. This is making me very nervous.
Happy to help!
Yes, as long as they consider the arthropathy as service-connected, you have potential for getting headaches covered as secondary. In order to strengthen your case that your spine is the cause of the headaches, you'll need to get a NEXUS letter from your physician linking the conditions.
Thanks for all the help and advice you are giving us.
I have been diagnosed with multilevel facet arthropathy (aka facet joint osteoarthritis) in my upper neck and I'm in the process of getting a service connected rating from the VA. Since this condition had gotten somewhat worse I have been experiencing headaches. I'm thinking of filing a claim for headaches as a secondary condition to the facet joint osteoarthritis in my neck. Would the VA even consider this? I did some research online and read headaches can sometimes arise from problems in the neck, and degenerative conditions like osteoarthritis in the neck.
Synovial hypertrophy is closer to RA, and would be rated under 5002.
A NEXUS letter from your physician would strengthen your claim for the hypertrophy as a secondary condition.
It's never a waste of time to make sure the VA is aware of your full range of conditions.
Not at all. Chondromalacia patella is rated on either limited motion of the knee or a minimum 10% analogously under arthritis. Unless you also have instability, the only way to increase your rating is for your range of motion to significantly decrease.
I have a 60% rating for dermatomyositis (40% for Raynauds secondary to the DM). I've taken methotrexate for a few years. About 6 months ago I started to have severe pain and swelling in my hands and wrists. It would last for a few weeks and then disappear. This has happened about 3 times since that first occurrence. My rheumatologist ordered an U/S that showed mild synovial hypertrophy in each wrist. In addition to the methotrexate I'm now taking Plaquenil and Voltaren gel. I've started a secondary claim for arthritis and joint pain.
I'm wondering if the ultrasound and symptoms alone are enough for the VA to award secondary service connection? I'm also wondering with symptoms such as these if it's more likely I'm rated under 5002 or 5003? I'm really not sure what to expect and wondering if I'm wasting my time with this secondary claim. Any input would be great, thanks! -Amber
Dr. George P Johnson I have been officially diagnosed with chandramalicia patella I am receiving 10% on my VA for it but now I am gonna be in a knee brace and using a tens unit how much will my rating go up to due to having those items to use
Excellent question, and a tricky situation. Technically, you are correct that it should have been submitted as a secondary condition since arthritis was not present at all during service. Arthritis has now developed secondary to your shoulder condition.
However, a shoulder can only be given a single rating, so the VA would ultimately not rate the arthritis as a separate condition. They would just consider it along with your other condition and give you a single overall rating that reflects the overall condition of the shoulder. Thus, you would ultimately only receive an increased evaluation.
Because of this, it probably won't cause a problem that it was claimed this way. However, it is still very important to provide evidence that the arthritis is secondary along with the claim. As long as they have evidence that the shoulder condition worsened and caused arthritis, then it should still be processed correctly.
So… yes, the correct way is the one you suggested, but your claim should still process correctly. If it isn't too late to request the change, you can submit it as secondary, but if it would delay things too much, you will probably still be fine as is.
Just today I went in to apply for a shoulder increase. I told the Claims Rep that I now have arthritis in my shoulder (the one that is rated due to an injury while active duty and a surgery) .. He did not write "arthritis" he just submitted "left shoulder increase" .. Is this correct? or should I have a totally different one as arthritis due to service connected injury? Or will i tell the examiner when i have my evaluation?
The spine is very related, so it is possible for your DDD to cause your cervical spine problems. You would want to get a NEXUS letter from a specialist confirming this correlation.
The spine is rated as a whole, so if your symptoms are worse, your rating will most likely increase, regardless of the specific conditions at play. You can compare your current symptoms to the spinal ratings to determine what you currently qualify for:
Since your issues are mainly disc-related, they'll be rated under code 5243:
Painful motion only comes into play if the ankle doesn't qualify for any other rating. since you already have 10%, the pain is rated and won't allow for additional.
Yes, tendonitis would be rated as limited motion as well. Check out our range of motion rating info on our website. A 20% is the highest you can receive for a significantly limited ROM.
Dear DR Johnson,
I am currently a 50% disabled veteran. 10% for pain in my leg from back problems. 40% for ankylosing spondylosis and DDD.
I recently had a full spine MRI with these findings.
1. Normal MRI study of the cervical and thoracic spine. 2. L4-L5 disc protrusion and acute L5-S1 disc protrusion. Mild to moderate neural foraminal narrowing is present at L4-S1 levels 3. No sacroiliac joint fusion to suggest ankylosing spondylitis. I had earlier x-rays of my neck, that a neurologist told me I had arthritis in my neck. With me not having AS, but my back condition has became worse and more painful, plus I have problems with my neck, pain and numbness radiating down my right arm. My question is, did my DDD cause my arthritis in my neck- is there any kind of connection there? Also because of the no ankylosing spondylosis will my rating go down, even though my back symptoms have worsened. And I have the new neck problems. It does mention in my rating paperwork arthritis in my back as well. Thank you for your time and have a great day
Thanks for the quick reply, I currently have a rating of 10% for the lateral collateral ligament sprain with degenerative arthritis of the left ankle. I understand a joint condition can only be rated as degenerative arthritis if it does not have a limited enough range of motion. I'm trying to figure out of the conditions I have with my ankle what could give me a rating increase. What is the highest rating I can get for Achilles Tendonitis/Tenosynovitis and is that solely based on the range of motion of the ankle?
Also my ankle hurts when I move it so can I apply the painful motion principle to my already existing ankle rating to get an increase?
Since both conditions directly affect the use of the ankle, the VA will lump both conditions together and give you a single rating under the code that allows the higher rating. Because of the Pyramiding Principle, it is standard practice to only give a single body part a single rating unless there is also nerve damage (there are other exceptions, but not for the ankle).
Dr. Johnson, I currently have a service connected disability rating for a lateral collateral ligament sprain with degenerative arthritis of the left ankle. I'm thinking of filing a claim for Achilles Tendonitis, my question is will the VA rate Achilles Tendonitis as a separate stand alone condition separate from the issues I have with my ankle? Would this condition fall under diagnostic code 5024: Tenosynovitis (swelling of the tissues that surround the tendons) or would the VA group the Arthritis (diagnostic code 5003) and Achilles Tendonitis/Tenosynovitis together for final codes of 5024-5003?
The most common cause of epidural lipomatosis is steroid use. If you have used steroids as a treatment for a service-connected condition, then it could qualify that way.
Foot conditions could contribute to arthritis in the spine, but not really fat deposits. There is no significant medical evidence to correlate the build up of fat to abnormal gate.
Psoriatic arthritis is rated analogous to RA:
"Incapacitating episodes" for RA are periods where the condition is aggravated to the point that it is impossible for you to do your job or function well in daily life. The length of this period will depend on the specific of the condition, but it would have to be significant. Considering that you have not been medically separated because of the condition, it is unlikely that you have had many incapacitating episodes. It would make you unfit for duty.
Without knowing full details regarding incapacitating episodes, I'd assume that your condition would be rated on limited motion of the effected joints. At most, 20% for 1-2 incapacitating episodes/year.
Hello Dr. Johnson. I have recently been diagnosed with Epidural Lipomatosis. It is primarily in my L4-L-5-S1 region. I am a Gulf War Vet and am currently SC. 70% PTSD, 20% hearing loss, 10% tinnitus, 10% post right foot fx. Could I file this new diagnosis secondary to my right foot injury since the way I walked affects my back alignment. The pain issues in my foot have been ongoing for years. If you need additional information to reply, please let me know. Thank you.
Hello, My question relates to psoriatic arthritis. Is this analogous to RA or Degenerative Arthritis? Through X-rays that display "rat bites" on my distal joints and wrists to psoriatic sores on my hands and blood tests show positive results for the arthritic condition. I have been self medicating for 15 years with Ibprophen (about 1600mg a day) and the Corpsmen documented the white and red patches for years. The Rhumetologist, Epidemiologist have all determined that yes I have arthritis that exhibits psoriasis in most of the areas that are affected by arthritis. I am on methotrexate and REALLY thinking about the switch to Humira. I have 7 months until retirement (20 years). What is my disability for this type of arthritis? It affects daily life and job. Also, what is an "incapacitating episode"? And how long are they supposed to last?
Code 5237 is used for general back pain. Regardless of the code, however, most spine conditions are all rated on the same system: limited motion. You can get a rating higher than 20%, but only if your range of motion worsens.
I was rated 20% for my back issues that I've had for several years now. After many CP exams this is now what has been updated on ebenefits. Can you explain a bit more and also can they rate this together?
degenerative arthritis of the thoracolumbar spine (previously rated as strain, lumbosacral spine, with disc space narrowing DC5237
Okay thank you.
You can try, but there is a high likelihood that it would be denied. The presence of sleep issues while in service does not directly mean sleep apnea. Since it has been so many years, it is just as likely that the sleep apnea developed on its own and isn't connected. But depending on the quality of in service evidence, it could be enough. Worth a shot to apply.
I have a question. I have had sleep issues for years including while I was in. All the military and VA did was give me medication. Finally this year my doctor mentioned a sleep study because it's causing me to have more migraines (service-connected). If it is determined I have sleep apnea can I file a claim even though I've been out for 16 years since there's a history in my records.
Ok thank you Dr. Johnson have a good one take care.
There is precedent of connection there too, though it is impossible for me to opine on your case. Your physicians know your case and are better able to determine the causes, etc. You can claim the condition either way as long as you provide opinions from your physicians denoting the connection.
Ok thank you I had a visit with my Primary Care Doctor and she mention my Sleep Apnea maybe the cause. What do you think