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In this article, we’ll explore how to get a VA rating for rheumatoid arthritis (RA).
Rheumatoid arthritis is more than just a joint condition; it’s a debilitating autoimmune disease that can severely impact your work, life, and social functioning.
If you’re a veteran suffering from RA, understanding how the VA rates this condition is crucial for securing the benefits you’ve earned for serving our country.
We’ll break down the VA rating system for RA, explain what evidence you need, and give you insider tips and strategies to maximize your chances of a successful VA claim.
Let’s begin!
Table of Contents
Summary of Key Points
- Understanding VA Ratings for Rheumatoid Arthritis (RA): The VA rates rheumatoid arthritis from 10% to 100% with breaks at 20%, 40%, and 60%, depending on the frequency, severity, and duration of incapacitating episodes.
- Criteria for Service Connection: To get service connected VA disability benefits, veterans must prove a current medical diagnosis, in-service occurrence or aggravation, and a “nexus” between their RA and military service.
- Important Evidence: Important documentation includes medical records, lay statements (personal statements and buddy letters), and nexus letters from healthcare providers.
- Secondary Conditions: RA can lead to secondary conditions like osteoporosis, cardiovascular issues, lung conditions, and more, which may also be eligible for VA compensation.
What is Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects the joints.
It occurs when the immune system mistakenly attacks the body’s own tissues, particularly the synovium—the lining of the membranes that surround the joints.
This leads to inflammation that can cause joint pain, swelling, stiffness, and eventual joint damage.
Key characteristics of RA include:
- Symmetrical Joint Involvement: RA typically affects joints on both sides of the body, such as both wrists, both knees, or both hands.
- Chronic Pain and Swelling: Persistent pain and swelling in the joints can lead to reduced mobility and function.
- Systemic Impact: RA can also affect other parts of the body, including the skin, eyes, lungs, heart, and blood vessels.
RA often progresses in a pattern of flares and remissions, where symptoms can worsen and then improve.
Early diagnosis and treatment are crucial to managing the disease and preventing severe joint damage and disability.
Treatment options may include medications, physical therapy, and sometimes surgery to repair or replace damaged joints.
What are the Signs and Symptoms of Rheumatoid Arthritis?
The signs and symptoms of rheumatoid arthritis (RA) can vary in severity and may develop gradually or suddenly.
Common signs and symptoms of RA in veterans include:
- Joint Pain and Tenderness: Persistent pain and tenderness in joints, often symmetrically on both sides of the body.
- Swelling and Redness: Joints may appear swollen, red, and warm to the touch.
- Stiffness: Joint stiffness, especially in the morning or after periods of inactivity, lasting for an hour or more.
- Fatigue: Persistent tiredness and a general feeling of being unwell.
- Joint Deformities: Over time, chronic inflammation can lead to joint deformities and loss of function.
- Reduced Range of Motion: Difficulty moving joints through their full range of motion.
- Firm Lumps under the Skin: These nodules, known as rheumatoid nodules, typically develop around pressure points, such as the elbows.
- Systemic Symptoms: RA can affect other parts of the body, leading to symptoms like fever, weight loss, and anemia.
Early detection and treatment are crucial to managing RA effectively and preventing long-term joint damage.
How does the VA Rate Rheumatoid Arthritis?
The VA rates rheumatoid arthritis under Diagnostic Code (DC) 5002, based on the severity of symptoms and impact on a veteran’s work, life, and social functioning.
VA disability ratings for rheumatoid arthritis range from 10% to 100% as follows:
- 100%: Incapacitating episodes that occur four or more times a year, or less frequent episodes but severely limiting daily activities.
- 60%: Less frequent incapacitating episodes, but still causing significant health impairment.
- 40%: Symptom combinations producing definite health impairment and occasional incapacitating episodes.
- 20%: One or two exacerbations a year with a well-established diagnosis.
- 10%: In accordance with the painful motion principle, if the veteran has pain upon flexion or extension, assign the minimum compensable rating of 10 percent.
Note (#1): Examples of conditions rated using this diagnostic code include, but are not limited to, rheumatoid arthritis, psoriatic arthritis, and spondyloarthropathies.
Note (#2): For chronic residuals, rate under diagnostic code 5003.
Note (#3): The ratings for the active process will not be combined with the residual ratings for limitation of motion, ankylosis, or diagnostic code 5003. Instead, assign the higher evaluation.
For more information, refer to 38 CFR § 4.71a.
How to Prove Service Connection for Rheumatoid Arthritis
To prove service connection for rheumatoid arthritis (RA), a veteran must establish three key elements:
#1. Current Diagnosis: Provide medical evidence of a current diagnosis of rheumatoid arthritis. This can include medical records, doctor’s notes, and test results.
#2. In-Service Occurrence or Aggravation: Demonstrate that the RA began or was aggravated during military service. This can be shown through:
- Service medical records documenting symptoms, diagnosis, or treatment of RA. At a minimum, you must have a current diagnosis in VA medical records or private medical records.
- Statements from service members, family, or friends who witnessed the symptoms during service. This is optional and not required.
- Evidence of conditions or exposures during service that could have triggered or worsened RA, such as stress, infections, or injuries.
#3. Nexus Between Service and Current Condition: Provide medical evidence linking the current RA to the in-service occurrence or aggravation. This can include:
- A medical opinion from a healthcare provider stating that it is “at least as likely as not” (a 50/50 probability) that the RA is related to military service.
- Continuity of symptomatology, which means showing continuous symptoms from the time of service to the present.
Supporting Documentation:
- Medical Records: Both service and post-service medical records detailing the diagnosis and treatment of RA.
- Lay Statements: Personal statements or “buddy statements” from fellow service members, family, or friends detailing the onset and continuity of symptoms.
- Nexus Letters: A detailed letter from a medical professional explaining the connection between the RA and service.
By gathering and presenting this evidence, a veteran can strengthen their claim for service connection for rheumatoid arthritis.
Are There VA Secondary Conditions to Rheumatoid Arthritis?
Yes, rheumatoid arthritis (RA) can lead to several secondary conditions that may be eligible for VA disability compensation.
Some common secondary conditions to RA include:
- Osteoporosis: Chronic inflammation and the use of corticosteroids to manage RA can lead to decreased bone density.
- Cardiovascular Issues: RA increases the risk of heart disease, including coronary artery disease and heart attacks.
- Lung Conditions: RA can cause inflammation and scarring of the lung tissues, leading to conditions like interstitial lung disease.
- Anemia: Chronic inflammation from RA can result in anemia, characterized by a deficiency of red blood cells.
- Peripheral Neuropathy: Inflammation from RA can damage nerves, causing numbness, tingling, and pain in the extremities.
- Sjogren’s Syndrome: An autoimmune disorder that often accompanies RA, causing dry eyes and dry mouth.
- Depression and Anxiety: Chronic pain and disability from RA can lead to mental health conditions such as depression and anxiety.
- Gastrointestinal Issues: Medications used to treat RA, such as NSAIDs and corticosteroids, can cause gastrointestinal problems like ulcers and gastritis.
- Eye Conditions: RA can lead to inflammation in parts of the eye, causing conditions like uveitis or scleritis.
- Infections: The immunosuppressive medications used to treat RA can increase the risk of infections.
To establish a secondary service connection for these conditions, a veteran must provide medical evidence showing that the secondary condition is caused or aggravated by the primary service-connected RA.
This typically involves:
- A current diagnosis of the secondary condition.
- Medical records linking the secondary condition to RA.
- A nexus letter from a medical professional supporting the connection between the two conditions (primary and secondary).
By demonstrating this link, veterans might be eligible to receive additional compensation for a secondary condition.
About the Author
Brian Reese
Brian Reese is a world-renowned VA disability benefits expert and the #1 bestselling author of VA Claim Secrets and You Deserve It. Motivated by his own frustration with the VA claim process, Brian founded VA Claims Insider to help disabled veterans secure their VA disability compensation faster, regardless of their past struggles with the VA. Since 2013, he has positively impacted the lives of over 10 million military, veterans, and their families.
A former active-duty Air Force officer, Brian has extensive experience leading diverse teams in challenging international environments, including a combat tour in Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy and earned his MBA from Oklahoma State University’s Spears School of Business, where he was a National Honor Scholar, ranking in the top 1% of his class.
