Insiders, today we are discussing how the VA determines benefits for arthritis.
Arthritis is one of the most common conditions affecting those who have served in the military. In fact, the Center for Disease Control (CDC) estimates the rate of arthritis in veterans to be 25.6%, although other estimates have the rate as high as 35%. This is a higher rate than among the civilian population, and it is one of the leading causes of physical disability. Knowing how the VA determines benefits for arthritis can also help Veterans get their condition service-connected.
Arthritis especially tends to affect those who are overweight, as well as older men. It can develop later in life due to the overuse of joints or traumatic injuries that occurred during active duty.
Officially the word “arthritis” refers to joint inflammation, but it is also used to describe over 100 rheumatic diseases and other conditions affecting the joints, the tissues surrounding the joints, and other connective tissues. This broad spectrum of application means that those suffering from “arthritis” can experience a variety of symptoms in regards to location and severity.
Osteoarthritis (degenerative joint disease), is the most common form affecting veterans. In fact, the American Academy of Orthopedic Surgeons has cited it as the number one reason for disability discharge among service members.
Seeking Help with the VA
As with all claims submitted to the VA, it is required that there is a service-connection to the veteran’s arthritis. However, if your arthritis symptoms are at the degree of a 10 percent disability rating or more within the first year from discharge it is possible to obtain a presumptive service connection. This is important as it removes the need to present direct medical evidence linking arthritis to a particular event or injury.
Presumptive service connection is possible because the VA characterizes arthritis as a chronic disease under 38 CFR § 3.309.
If the symptoms of your arthritis come later, it may still be possible to establish a service-connection. Many veterans develop their arthritis later in life as the cartilage wears down. A doctor can determine if your service had a causal relationship with your arthritis by looking at your injuries or overuse of the joints. Thankfully, the in-service injury does not need to be traumatic to be considered connected.
Finally, it is also possible to receive a secondary service-connection if it is determined that an already service-connected condition is causing arthritis. It is also possible to establish a secondary service-connection under 38 CFR § 4.58, which states that if you have received an amputation or a leg shortening and arthritis appears later in life, it may be service-connected on a secondary basis (so long as the arthritis is attributed to those conditions).
VA Ratings for Arthritis
Degenerative arthritis can receive the following disability compensation ratings from the VA*:
- 10%- If two or more joint groups (major or minor) have arthritis but are never incapacitating
- 20%- If two or more joint groups (major or minor) have arthritis and are occasionally incapacitating
Rheumatoid arthritis can receive the following disability ratings from the VA:
- 20%- One or two incapacitating episodes per year
- 40%- If there is a definite decline in health; or, if incapacitating episodes occur 3 or more times per year
- 60%- If there is an overall decline in health but is short of complete incapacitation, significant weight loss or anemia; or, if there are 4 or more severe incapacitating episodes per year
- 100%- Completely incapacitated and bedridden, regardless of how many joints are affected.
Arthritis is one of the main disabilities facing today’s veterans and the VA has many resources and benefits available to you if you are suffering from arthritis.
Haven’t filed a claim yet or know that you are underrated? This is the link to get started, FAST.
*If you have already received a rating for Limited Motion of a joint, then you cannot receive a rating for arthritis in that joint.
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About the Author
VA Claims insider is an education-based coaching/consulting company. We’re here for disabled veterans exploring eligibility for increased VA disability benefits and who wish to learn more about that process. We also connect veterans with independent medical professionals in our referral network for medical examinations, disability evaluations, and credible Independent Medical Opinions & Nexus Statements (Medical Nexus Letters) for a wide range of disability conditions.