How should the VA evaluate a veteran's service arthritis?

How should the VA evaluate a veteran's service arthritis?

One of the most common medical conditions that military veterans want to associate with service is arthritis of the knees.

It should come as no surprise, then, that one of the most common mistakes the VA makes is failing to properly assess knee arthritis.

Here is a general summary of how you can review the VA's assessment to ensure that it is correctly assessing and evaluating your service-connected arthritis of the knee.

Before you begin, it is important to understand that the VA is generally not permitted to “pyramidate” reviews. A “pyramid rating” occurs when the VA evaluates the same disability under multiple – and sometimes different – ​​diagnoses. Read the regulation at 38 CFR § 4.14 to learn more about pyramid valuations.

Arthritis is different. If a military veteran has arthritis related to the knees, that veteran may be eligible for up to 3 evaluations for the same condition. The key word is “power” – what’s important is that the VA evaluates and evaluates the unique way arthritis manifests itself in your knees.

Here are three (3) factors that the VA should examine to see how to evaluate arthritis of the knees in military veterans.

1) Loss of function. Loss of function is a limitation in the range of motion of the knee. The VA evaluator should focus on what the military veteran's medical records say about his or her ability to perform the normal working movements of the knee with "excursion, speed, strength, coordination and endurance." This aspect of arthritis of the knee is typically evaluated under diagnosis codes 5000-5010 - (Diagnosis codes and their criteria can be found at 38 CFR Part 4.)

2) Instability. Instability is the knee's inability to perform the "support" role it does - an inability to keep you upright and balanced. If this limitation is present in your knee arthritis, the VA examiner should evaluate it using three (3) criteria under diagnosis code 5257:

a) easy (corresponds to an additional rating of 10%)

b) moderate (which corresponds to an additional rating of 20%)

c) difficult (which corresponds to an additional rating of 30%)

3. Pain. The most common and recognizable manifestation of arthritis is pain. The VA typically does not consider pain when determining the proper rating for an illness or condition. Arthritis is a little different; Even if there is no loss of function, the VA examiner may assign a pain rating if there is evidence that the military veteran is affected by pain when using the knee with normal, daily, repeated use and/or if the pain limits range of motion.

Confused? Do not worry. The VA examiner probably is too.

I have seen many false and bizarre reviews and ratings of service related knee arthritis pain.

In fact, I recently looked at a claim in which the VA examiner classified arthritis as sciatica. Sciatica is a condition that affects the nerves of the spinal cord; While sciatica pain can affect the legs up to the knees, there was no diagnosis for the condition in the C-file - the examiner simply never figured out that arthritis and sciatica are two completely different conditions.

One caveat: The above explanation is simplistic and may not be the correct analysis under the circumstances of your case. Every case is different, every military veteran's medical situation is unique.

If you are a military veteran with service-connected arthritis of the knee, it is strongly recommended that you present your arthritis evaluation decision - and code sheet - to an attorney or VSO representative who is familiar with proper arthritis evaluation.

If you don't know what the VA code sheet is, it's even more important that you have it turned on to have someone review your rating to make sure you're receiving all the benefits you're entitled to.

Inspired by Christopher Attig