VASRD Schedule of ratings—musculoskeletal system Acute, Subacute, or Chronic Diseases

Jason Perry

Benevolent Leader
Site Founder
Staff Member
PEB Forum Veteran
Registered Member
§4.71a Schedule of ratings—musculoskeletal system.



Acute, Subacute, or Chronic Diseases

Rating
5000 Osteomyelitis, acute, subacute, or chronic:

Of the pelvis, vertebrae, or extending into major joints,
or with multiple localization or with long history of
intractability and debility, anemia, amyloid liver
changes, or other continuous constitutional symptoms.......................... 100
Frequent episodes, with constitutional symptoms.......................................... 60
With definite involucrum or sequestrum, with or without
discharging sinus............................................................................................. 30
With discharging sinus or other evidence of active infection
within the past 5 years..................................................................................... 20
Inactive, following repeated episodes, without evidence of
active infection in past 5 years....................................................................... 10

Note (1): A rating of 10 percent, as an exception to the amputation rule, is to be assigned in any case of active osteomyelitis where the amputation rating for the affected part is no percent. This 10 percent rating and the other partial ratings of 30 percent or less are to be combined with ratings for ankylosis, limited motion, nonunion or malunion, shortening, etc., subject, of course, to the amputation rule. The 60 percent rating, as it is based on constitutional symptoms, is not subject to the amputation rule. A rating for osteomyelitis will not be applied following cure by removal or radical resection of the affected bone.

Note (2): The 20 percent rating on the basis of activity within the past 5 years is not assignable following the initial infection of active osteomyelitis with no subsequent reactivation. The prerequisite for this historical rating is an established recurrent osteomyelitis. To qualify for the 10 percent rating, 2 or more episodes following the initial infection are required. This 20 percent rating or the 10 percent rating, when applicable, will be assigned once only to cover disability at all sites of previously active infection with a future ending date in the case of the 20 percent rating.

5001 Bones and joints, tuberculosis of, active or inactive:

Active.................................................................................................................... 100
Inactive: See §§ 4.88c and 4.89

5002 Arthritis rheumatoid (atrophic) as an active process

With constitutional manifestations associated with
active joint involvement, totally incapacitating.......................................... 100

5002 Arthritis rheumatoid (atrophic) as an active process (cont.)

Less than criteria for 100% but with weight loss and anemia
productive of severe impairment of health or severely
incapacitating exacerbations occurring 4 or more times a year
or a lesser number over prolonged periods.................................................. 60
Symptom combinations productive of definite impairment of
health objectively supported by examination findings or
incapacitating exacerbations occurring 3 or more times a year................ 40
One or two exacerbations a year in a well-established diagnosis............... 20

For chronic residuals:

For residuals such as limitation of motion or ankylosis, favorable or unfavor­able, rate under the appropriate diagnostic codes for the specific joints involved. Where, however, the limitation of motion of the specific joint or joints involved is noncompensable under the codes a rating of 10 percent is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5002. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion.

Note: The ratings for the active process will not be combined with the residual ratings for limitation of motion or ankylosis. Assign the higher evaluation.

5003 Arthritis, degenerative (hypertrophic or osteoarthritis):

Degenerative arthritis established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved (DC 5200 etc.). When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 pct is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. In the absence of limitation of motion, rate as below:

With X-ray evidence of involvement of 2 or more major joints
or 2 or more minor joint groups, with occasional incapacitating
exacerbations.................................................................................................... 20
With X-ray evidence of involvement of 2 or more major joints
or 2 or more minor joint groups....................................................................... 10

Note (1): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be combined with ratings based on limitation of motion.

Note(2): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be utilized in rating conditions listed under diagnostic code 5013 to 5024, inclusive.

5004 Arthritis, gonorrheal.

5005 Arthritis, pneumococcic.

5006 Arthritis, typhoid.

5007 Arthritis, syphilitic.

5008 Arthritis, streptococcic.

5009 Arthritis, other types (specify).

With the types of arthritis, diagnostic codes 5004 through 5009, rate the
disability as rheumatoid arthritis.

5010 Arthritis, due to trauma, substantiated by X-ray findings:

Rate as arthritis, degenerative.

5011 Bones, caisson disease of:

Rate as arthritis, cord involvement, or deafness, depending on the severity of disabling manifestations.

5012 Bones, new growths of, malignant........................................................................ 100

Note: The 100 percent rating will be continued for 1 year following the cessation of surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure. At this point, if there has been no local recurrence or metastases, the rating will be made on residuals.

5013 Osteoporosis, with joint manifestations.
5014 Osteomalacia.
5015 Bones, new growths of, benign.
5016 Osteitis deformans.
5017 Gout.
5018 Hydrarthrosis, intermittent.
5019 Bursitis.
5020 Synovitis.
5021 Myositis.
5022 Periostitis.
5023 Myositis ossificans.
5024 Tenosynovitis.

The diseases under diagnostic codes 5013 through 5024 Will be rated on limita­tion of motion of affected parts, as arthritis, degenerative, except gout which will be rated under diagnostic code 5002.

5025 Fibromyalgia (fibrositis, primary fibromyalgia syndrome)

With widespread musculoskeletal pain and tender points, with or without associated fatigue, sleep disturbance, stiffness, paresthesias, headache, irritable bowel symptoms, depression, anxiety, or Raynaud’s-like symptoms:
That are constant, or nearly so, and refractory to therapy.......................... 40
That are episodic, with exacerbations often precipitated by
environmental or emotional stress or by overexertion, but that
are present more than one-third of the time............................................ 20
That require continuous medication for control.......................................... 10
Note: Widespread pain means pain in both the left and right sides of the body, that is both above and below the waist, and that affects both the axial skeleton (i.e., cervical spine, anterior chest, thoracic spine, or low back) and the extremities.
 
O

owen86

Guest
VASRD Schedule of ratings—musculoskeletal system Acute, Subacute, or Chronic Dise

The 20 percent rating on the basis of activity within the past 5 years is not assignable following the initial infection of active osteomyelitis with no subsequent reactivation. The prerequisite for this historical rating is an established recurrent osteomyelitis. To qualify for the 10 percent rating, 2 or more episodes following the initial infection are required. This 20 percent rating or the 10 percent rating, when applicable, will be assigned once only to cover disability at all sites of previously active infection with a future ending date in the case of the 20 percent rating.

I'm rather curious about the number of years mentioned. Could you please elaborate why the basis is 5 years?
 

Jason Perry

Benevolent Leader
Site Founder
Staff Member
PEB Forum Veteran
Registered Member
VASRD Schedule of ratings—musculoskeletal system Acute, Subacute, or Chronic Dise

I'm rather curious about the number of years mentioned. Could you please elaborate why the basis is 5 years?

Do you mean the authority for this statement? Look at Note (2) to the osteomyelitis rating (DC 5000), that sets out the rule. If you are asking why that is, off the top of my head, I don't know. It is likely something that they commented on in the Federal Register when the VA made the rule. I can find this information (if it exists), but would not be inclined to hunt this down unless there was some need for the information (that is, what I quoted is the rule...doesn't do any good to challenge the rule based on disagreement in the VAST majority of cases...unless I am missing something about your question).
 

boxkicker

PEB Forum Regular Member
Jason,

I was wondering if you could please explain how the VA computes the combined disability rating. I'm currently at 90% (used to be 70). I'm on TDRL for fibromyalgia (40%), then the rest of my disabilities are: Major Depressive Disorder (30%), Tinnitus (10%), Migraines (used to be 0%, but was increased to 50%), and plantar fasciitis (used to be 0%, now increased to 10%). I just don't get it how they compute my overall disability rating to 90%, when the 0% ratings (migraines and plantar fasciitis) was increased to 50% and 10%?

Thank you in advance.
 

moneyblind

PEB Forum Regular Member
PEB Forum Veteran
Jason,

I was wondering if you could please explain how the VA computes the combined disability rating. I'm currently at 90% (used to be 70). I'm on TDRL for fibromyalgia (40%), then the rest of my disabilities are: Major Depressive Disorder (30%), Tinnitus (10%), Migraines (used to be 0%, but was increased to 50%), and plantar fasciitis (used to be 0%, now increased to 10%). I just don't get it how they compute my overall disability rating to 90%, when the 0% ratings (migraines and plantar fasciitis) was increased to 50% and 10%?

Thank you in advance.

The VA uses "VA Math"; It is based off of the remaining ability versus the added disabilities; The best way I have heard it explained was by TSgt Twitch;

Think of it like a football field, You start at one end at 0% disabled.

50% disabled moves you to the 50 yard line (50% of the remaining 100)
40% disabled moves you to the 70 yard line (40% of the remaining 50)
30% disabled moves you to the 79 yard line (30% of the remaining 30)
10% disabled moves you to the 81 yard line (10% of the remaining 21)
10% disabled moves you to the 83 yard line (10% of the remaining 19)

According to the 5 numbers you gave me, you actually should be calculating at 80% and not 90%; I have verified my calculations against the VA ratings table and 2 calculators, both listed below.

http://www.benefits.va.gov/compensation/rates-index.asp
http://www.vvaarizona.org/combined_disability.php
http://www.hadit.com/service_connected_disabilities_rating_calculator.php
 
data-matched-content-ui-type="image_stacked" data-matched-content-rows-num="3" data-matched-content-columns-num="1" data-ad-format="autorelaxed">
Top