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Arthritis VA Rating

Posted on May 17, 2024 in

About one-third of veterans experience symptoms of arthritis. The U.S. Department of Veterans Affairs (the VA) recognizes arthritis as a disability. Eligible veterans can receive benefits for it, including monthly disability payments. Knee conditions are a common source of disability claims among veterans with arthritis.

Stone Rose Law helps veterans who suffer from arthritis and other service-connected disabilities make initial claims for veterans’ benefits and supplemental claims for veterans who already have a VA disability rating for arthritis. We can also help you to appeal if the VA has denied your initial or supplemental claim application.

To learn more about our services for veterans, or to set up an appointment with one of our VA disability attorneys, call us at (480) 498-8998.

What is Arthritis?

Arthritis is a medical term that describes joint inflammation. There are many kinds of arthritis with varying causes and symptoms, including gout, septic arthritis, reactive arthritis, psoriatic arthritis, and more.

The two service-related arthritis types that veterans are most likely to experience are Osteoarthritis (also known as degenerative arthritis) and rheumatoid arthritis.This does not mean that other kinds of arthritis cannot qualify you for VA disability benefits. The VA evaluates arthritis-related benefit claims on a case-by-case basis.

Osteoarthritis Causes and Symptoms

Osteoarthritis is the most likely type of arthritis you may suffer from because of military service. Its symptoms usually include joint stiffness, limited range of motion in the joint, and pain during movement.

Osteoarthritis is the result of the cartilage in your joints wearing down over time. It occurs most often in the knees, hips, spine, and hands, but it can affect any joint in your body. Although often associated with aging, the onset of osteoarthritis can be accelerated by repetitive joint use and overuse.

The degenerative origins of osteoarthritis are not unique to veterans, but veterans can be more susceptible to it if your military duties made you spend a lot of time carrying heavy loads on your back.

Rheumatoid Arthritis Causes and Symptoms

List of VA disability ratings for rheumatoid arthritis requirements.

Compared to osteoarthritis, rheumatoid arthritis does not come from overuse or repetitive use of a joint. Instead, rheumatoid arthritis is an autoimmune system disorder: your body’s immune system begins to attack the membranes that surround your joints. This causes inflammation of the joint.

Similar to osteoarthritis, rheumatoid arthritis include joint pain and stiffness, and limited range of joint motion.

The causes of rheumatoid arthritis can depend on your genetic history, hormonal factors, and your physical environment, especially if you are exposed to inhaling inorganic dust. 

For example, environmental factors like being in the proximity of blast effects and exposure to inhalants from activities like welding or equipment maintenance that can contribute to a military service connection for rheumatoid arthritis.

Additional Arthritis Symptoms

Aside from the common arthritis symptoms we describe above, some veterans who have arthritis report feeling a cracking sensation or a “pop” when moving the affected joint. In some cases, bone spurs can also form around the joint. Although these are not VA disabilities by themselves, the pain that bone spurs can cause you can be a ratable disability.

How to Claim Arthritis as a VA Service-Connected Condition

The VA makes monthly compensation and other benefits available to veterans when they can show that they have a service-connected arthritis condition. What benefits are available depends on your specific symptoms and their severity. The worse the symptoms and the greater your functional loss, the more likely it is the VA will provide you with more benefits.

Basic Elements of a VA Disability Benefits Claim

To receive VA approval of your arthritis disability claim, you must demonstrate the following three facts to the VA:

  1. You have a current medical diagnosis for arthritis.
  2. Your arthritis condition must have a present-day negative impact on your life, such as hindering your ability to work or interfering with your ability to perform ordinary daily life activities.
  3. A service connection, or “nexus” must exist between the onset of your arthritis condition, or if it was a pre-existing condition, then to a worsening or aggravation of that pre-existing condition. 

You can prove the first requirement through a diagnosis of arthritis from your doctor. 

If your arthritis symptoms already existed before your discharge from service and are ongoing, your military medical records of diagnosis and treatment can also support the diagnosis requirement.

You can demonstrate the effect of your arthritis condition on your life in multiple ways. 

  • You will need to undergo tests to measure your range of motion in the affected joint or joints. You will need to have x-rays taken of the affected joints. 
  • You may undergo a VA compensation and pension (C&P) examination by a VA examiner.
  • If you have supporting testimony from others, like family members, coworkers, or former comrades in service who were in position to know about how your arthritis condition began, these can be provided to the VA in the form of written statements.

Proving a Service Connection to Your Arthritis Condition

If your treating physician believes your arthritis condition arose or became worse because of your military service, then that person should prepare a written statement, also known as a nexus letter, that explains to the VA the doctor’s conclusion that a service connection exists.

The VA places considerable importance on having a nexus letter written by the doctor who has diagnosed you in your benefits application. 

Depending on your specific circumstances, your arthritis service connection can be direct, secondary, or presumptive. 

Direct Service Connection

The first thing to know about making a service connection to your arthritis condition is that you do not need to identify a specific event during your service that caused it. The VA recognizes that arthritis is a condition that often develops slowly and worsens over time.

The VA recognizes four kinds of direct service connection for arthritis:

  • A direct connection for degenerative arthritis.
  • A direct connection for degenerative arthritis with limited range of motion.
  • A direct connection for post-traumatic arthritis.
  • A direct connection for multi-joint arthritis.

We will cover how the VA rates arthritis disabilities below, but for now suffice it to say that most of the time these service-connected claims qualify for ratings of 10 or 20 percent. Still, a direct service connection for multi-joint arthritis, or arthritis with limited range of motion, can result in a rating as high as 100 percent or as low as 0 percent.

Presumptive Service Connection 

The VA considers osteoarthritis and rheumatoid arthritis chronic diseases and often assume that arthritis reported in disability claims are service-connected. This classification is particularly important for those who do not have enough documentation to support a disability claim.

The most common way to get a presumptive service connection for arthritis is if your arthritis symptoms appear within one year after your military discharge. If this happens and your symptoms would qualify for at least a 10 percent disability rating, you don’t need to prove that the arthritis is connected to your service. The VA will automatically assume the connection exists.

Another way to qualify is if you are a former prisoner of war who has developed arthritis to at least a 10 percent disability level at any time after you complete your military service.

Secondary Service Connection 

When you consider how often arthritis can arise from strenuous physical activities, injuries, or even exposure to certain contaminants in your military service environment, it should be no surprise that those same circumstances can lead to other disabilities. 

Most veteran applications to the VA for disability benefits include multiple disability claims. A secondary service connection can exist when one disability sets up a second disability to occur. 

For example, arthritis can have a secondary service connection if you get into a motor vehicle accident while in military service. Injuries to your hip and knees would be considered the primary service-connected disabilities. If you develop arthritis in any of these injured joints later on, then the arthritis condition is secondarily-connected with the primary disability.

Another example is if you develop arthritis later in life after undergoing a service-connected limb amputation.

Secondary conditions do not always have to be physically related to the underlying primary disability. 

Arthritis can also be a primary disability that can lead to a secondary condition. For example, if you suffer from arthritis and that condition causes you to be diagnosed with depression, the depression would be a VA-recognized secondary disability. 

Other kinds of VA-recognized disabling conditions that can be a secondary condition to arthritis are pain (like that caused by bone spurs), fibromyalgia, and insomnia.

The VA C&P Examination

C&P examinations are commonplace with arthritis disability claims. This examination, which is performed by a VA examiner, gives the VA the chance to learn more about the nature of your disability, how it arose, and its effects on your life.

A C&P examination for arthritis usually includes a review of your medical provider’s official diagnosis and other medical evidence followed by a physical examination and diagnostic motion testing. The examiner will be looking for existing x-rays, MRIs, or CT scans to show the existence of the arthritis condition. They may also arrange to have these tests done as part of the C&P exam. 

It is important to attend your C&P exam if the VA schedules one for you. This C&P exam report provides the VA with information important in deciding what VA disability rating to apply to you, and if you miss your C&P exam without good reason it could hurt your chances of receiving approval of your benefits application.

How the VA Rates Arthritis Disabilities

Once the VA completes its review of your disability benefits application, including the results of your C&P examination, it will first decide whether to approve or deny your application.

If it approves your claim, the next step will be for the VA to assign you disability ratings for the disabilities it has recognized, including your arthritis.

The VA uses the same diagnostic codes for arthritis disabilities as it does for musculoskeletal conditions. This means that a main consideration for the VA will be to see if you suffer from limited range of joint motion and how severe the limitation is.

If your limited range of motion does not qualify you for more than a 0 percent disability rating, then the VA will also consider the effects of osteoarthritis on you to see if you might qualify for a 10 or 20 percent disability that way.

Limited Range of Motion

The VA will first seek to verify limited range of motion by goniometer measurements and visual observation of symptoms like swelling, muscle spasms, or painful movement.

Specifically, the VA looks for:

  • Whether you have a greater or lesser range of motion than normal.
  • Whether your motions are weakened due to an injury to muscles, tendons, or ligaments, or because of nerve damage.
  • Whether you have trouble coordinating your movements, causing persistent instability.
  • Whether you experience pain when moving.

If your limitation of motion is not severe enough to rate more than a 0 percent disability rating, then the VA might still find a combined 10 percent disability rating if multiple joints are affected by a limited range of motion.

Major Joints and Minor Joint Groups

The VA distinguishes between major and minor joints based on their importance in your ability to move and perform life activities.

Major joints include your shoulders, elbows, wrists, hips, knees, and ankles.

Minor joint groups include joints within your hands and feet and the joints that run the length from your neck down through your upper back and into your lower back. Each individual joint in these groups receives its own disability rating, then the individual ratings are converted into a single combined rating (not simply summed up).

VA Ratings for Osteoarthritis 

If the VA does not assign you a disability rating based on limited range of motion, it will consider whether the existence of osteoarthritis that has been proven by x-ray images can qualify you for a disability rating.

The VA assigns ratings for osteoarthritis based on the kind of joint involved (major or minor), how many joints are affected, and whether you experience any flare-ups.

  • To receive a 10 percent disability rating, you must have two or more major joints or two or more groups of minor joints that are affected. Most VA ratings for osteoarthritis will be at this 10 percent level.
  • The same conditions above, coupled with the presence of occasional flare-ups, can qualify for a 20 percent rating.

Note: The VA will assign you a disability rating based on limited range of motion, or a rating for osteoarthritis, but not both. Also, if you already have at least a 10 percent disability rating for another condition that affects the same joint, then you will not qualify for the 10 or 20 percent osteoarthritis disability above. This is to avoid what the VA calls “pyramiding” of claims affecting the same body parts.

VA Ratings for Rheumatoid Arthritis

Rheumatoid arthritis can result in a much wider possibility of disability ratings, from 0 percent to 100 percent, with 100 percent being the highest VA rating for rheumatoid arthritis. although not all intermediate rating levels apply.

As with osteoarthritis, the VA will assign you a disability rating based on limited range of motion or the existence and symptoms of rheumatoid arthritis, but not both. Because rheumatoid arthritis carries the potential for higher disability ratings than osteoarthritis does, the VA will usually look to rheumatoid arthritis ratings first before range of motion.

For rheumatoid arthritis symptoms, the VA assigns the following disability ratings:

  • 100 percent disability rating: This applies if your arthritis symptoms result in your total disability, such as leaving you bedridden.
  • 60 percent disability rating: If you experience severe incapacitating episodes of rheumatoid arthritis at least four times a year or if your rheumatoid arthritis is causing you to experience symptoms like weight loss or anemia, then this rating applies.
  • 40 percent disability rating: If you suffer from definitive impairment of your overall health that is caused by rheumatoid arthritis, or if you experience three or more incapacitating episodes in one year, this rating applies to you.
  • 20 percent disability rating: If you have two or more incapacitating episodes of rheumatoid arthritis in a year, then this rating applies.

For symptoms that rate less than a 20 percent rheumatoid arthritis disability rating, the VA will consider range of motion in the affected joints, along with related symptoms of swelling, painful motion, and muscle spasms.

The Painful Motion Rule

If you have osteoarthritis or rheumatoid arthritis that causes you pain, like knee pain or hip pain when you are moving the affected joint, you might also qualify for an additional 10 percent disability rating for the pain. This is known as the VA “painful motion rule.”

The painful motion rule is subject to the VA prohibition on pyramiding claims, but as long as you are not receiving the same disability rating twice for the same joint, then you can possibly receive the 10 percent rating for pain on top of the rating for arthritis.

An experienced VA disability benefits lawyer can help you to know when the painful motion rule applies, and how to avoid claim pyramiding in your benefits application

Total Disability for Arthritis

In some cases, your arthritis condition can qualify you for 100 percent or total VA disability benefits. We cover two of these situations below.

Temporary Total Disability for Hospitalization and Convalescence

If your treatment for arthritis requires hospitalization, like for knee replacement surgery, then in some cases the VA will provide you with a temporary 100 percent disability rating during your time spent in the hospital and while you are recovering, under the following conditions:

  • You must be hospitalized for more than 21 days to receive the hospitalization total disability benefit.
  • For total disability benefits during convalescence after surgery, your post-surgery recovery must last for at least one month after being discharged from the hospital. Additionally, you must be experiencing severe residual effects during convalescence, like having to wear a cast that immobilizes you or otherwise make your convalescence take longer than usual.

Total Disability Based on Individual Unemployability (TDIU)

Sometimes arthritis by itself or in combination with other disabilities can be severe enough in its effects that it can prevent you from holding onto substantially gainful employment. If this happens, then you might qualify for 100 percent disability benefits through TDIU.

An arthritis disability can contribute to a TDIU claim in one of three ways. All three require you to be unable to obtain or keep substantially gainful employment:

  • If your arthritis disability rating is at least 60 percent.
  • If your arthritis disability rating is part of a combined disability rating of at least 70 percent, and one of the individual disabilities is at least 40 percent in its rating.
  • In some cases, if you cannot qualify under either of the two ways above, the VA can provide you with TDIU based on a review of your specific circumstances.

Do You Need Help with Your VA Disability Claim?

At Stone Rose Law, we are VA disability advocates for veterans disability claims of all kinds, including arthritis conditions. We are board-certified VA claims lawyers who serve on behalf of service members and veterans nationwide. Our VA accredited attorneys give you affordable, high-quality veterans appeals legal assistance.

Our veterans lawyers provide highly professional legal representation to military veterans, helping them through the VA process to receive all the veterans disability benefits they are entitled to. 

A Stone Rose disability lawyer can help you prepare your arthritis disability claim, monitor your claim status and consult with you before disability examinations—all at no cost to you.

If the VA denies your original claim, our VA benefits law firm will assign a VA disability appeals lawyer to help you pursue a VA appeal with the Board of Veterans Appeals while providing free representation on a contingency fee basis. 

This means you won’t pay your VA disability lawyer any fees unless we win your appeal. 

Call Us Today for Help With Your VA Arthritis Benefits Claim

For more information about how one of our VA disability lawyers can help you with your VA disability compensation claim or appeal, request a free assistance consultation at (480) 498-8998. 

If you already know one or more of your VA disability ratings and want an estimate on how much you might receive in monthly compensation benefits, see our VA Disability Benefits Calculator.

Or, if you prefer, you can reach us online to ask a question about veterans’ law, veterans’ disability benefits, or to set an appointment with one of our veterans’ lawyers for a free case evaluation.

Remember, the VA considers arthritis to be a progressive illness. This means that it is better to file your claim for a service-connected arthritis disability sooner rather than later, even if the symptoms do not seem to bother you much.

It is easier to prove a service connection to your arthritis disability soon after your disability, then file a supplemental claim to increase your benefits later on as the condition worsens, than to wait.