Knee arthritis: 38 CFR
- Diagnostic Code: 5003, 5010
- Typical Rating Range: 10% to 60% (with 100% ratings possible for severe cases with significantly impaired functionality
- Factors Considered: Degree of pain; limitation of motion, extension, and flexion; joint instability
Knee arthritis is a painful, life-altering condition that affects many veterans. It occurs when the cartilage in the knee joint breaks down. It causes pain and inflammation and makes it difficult to move. If you have arthritis, your everyday tasks might feel like climbing a mountain
Your knee arthritis may qualify you for disability compensation and benefits from the VA. In this article, we will explain the facts about securing a VA rating for knee arthritis.
The VA rating for knee arthritis can vary from 10% to 60%, depending on the severity of your case. It will be considered more severe if both of your knees are affected.
The rating for your knee arthritis will be based on how it limits your range of motion. It will also take into account how much pain your arthritis causes.
For your knee arthritis to make you eligible for VA compensation, there must be a link between your arthritis and your military service.
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Types of Knee Arthritis
There are three different types of knee arthritis. The first is osteoarthritis (most common in veterans). The two other types include post-traumatic arthritis, which develops following a knee joint injury. Rheumatoid arthritis is the third type, and it is caused by a chronic autoimmune disease that damages the joints.
Certain rigors of military life can make veterans more prone to arthritis. These include things like intense physical training and the stress and strain of lifting heavy equipment. Sometimes, arthritis can be a secondary condition triggered by another service-related injury.
What is the VA Rating Process for Knee Arthritis?
The VA uses several diagnostic codes, depending on the type of arthritis you have, how severe it is, and what symptoms you are experiencing.
The two most common diagnostic codes for knee arthritis are 5003 and 5010.
Diagnostic code 5003 is used for degenerative knee arthritis that has been confirmed with an X-ray showing narrowing of the knee joint, loss of cartilage, and/or the formation of bone spurs. If this applies to you, your VA rating could be between 10% and 20%.
The other code, 5010, is specifically used for post-traumatic arthritis caused by an earlier injury. The rating for post-traumatic arthritis is similar to that of degenerative arthritis.
The VA will rate your arthritis based on the following:
Range of Motion (ROM)
This includes the degree to which you can bend your knee (flexion) and straighten your knee (extension). Your rating can range from 0% to 50%, depending on how limited your ROM is.
Pain
Even if you have good range of motion, you may be eligible for an additional 10% rating if it becomes obvious during your exam that moving your knee causes you a lot of pain.
How Do You Prove a Service Connection to Your Knee Arthritis?
In order to get a VA disability rating (or rating increase), your knee arthritis must be linked to your service. You can show the VA either a direct or secondary service connection to prove that your time in the military either caused or worsened your knee arthritis.
Direct Service Connection
A direct service connection means that your military service has caused or worsened your knee arthritis. Three main elements are required to prove this link.
- A current medical diagnosis of knee arthritis, usually supported by X-ray evidence.
- An in-service injury, illness, or event that caused or aggravated your condition.
- A medical link between your current diagnosis and your in-service injury, illness, or event. This link can be established with a “nexus letter” from a physician.
Secondary Service Connection
Your military service might not have directly caused your knee arthritis; in some cases, it could be a “secondary condition” caused (or worsened) by a service-connected disability.
For example, suppose you suffered an ankle injury during your service and have a VA rating. The ankle injury caused you to change the way you walk. Your altered gait put extra stress on your knees, causing arthritis.
If you suspect that your knee arthritis is secondary to a VA-rated disability, you can apply for a secondary service connection.
How to File Your VA Disability Claim
The quickest way to file your VA disability claim is online,1 but that route isn’t suitable for everyone.
If you can’t file your claim online, you can also submit a physical application via mail, fax, or in person at a VA regional office. To do this, you will need to print and complete form 21-526EZ.2
When you file, ensure you have all the supporting documents for your application.
You will need:
- Copies of medical records showing your diagnosis (and any treatment you have received)
- “Buddy letters” from fellow service members, friends, family, or others showing how your condition impacts your everyday life.
- A nexus letter from a medical provider showing the link between your knee arthritis and your service. (Contact VA Claims Academy for a template for this letter.)
- Optional: A personal statement describing the progression and scope of your arthritis. Your statement should also explain how you believe your arthritis is connected to your service and how the arthritis affects you on a daily basis.
Serving your country does not mean you have to live with residual injuries without financial help. The purpose of the VA is to make sure you get the compensation you deserve for injuries and illnesses related to your military service. VA Claims Academy can educate you on the process for getting a VA rating for knee pain and pave a straightforward path to your benefits.
1https://www.va.gov/disability/file-disability-claim-form-21-526ez/introduction
2https://www.va.gov/find-forms/about-form-21-526ez/