Are you a military veteran who suffers from ongoing hip pain and decreased movement? It may be caused by Avascular Necrosis, so the VA has a rating for that condition.
Recent U.S. Census statistics show that there are 18.2 million American veterans. In this group, musculoskeletal problems rate as the leading cause of disabilities.
One severe condition, avascular necrosis (AVN), may result from trauma during military service. If you have AVN, you may qualify for an avascular necrosis (also called asceptic necrosis) VA disability rating. Keep reading to learn more about this VA disability rating.
In This Article About Avascular Necrosis VA Disability:
- What Is Avascular Necrosis?
- Common Causes of AVN
- Symptoms of AVN
- Understanding the VA Disability Rating System
- Avascular Necrosis VA Disability Rating
- Other Possible Secondary Conditions Related to AVN
- How to File for VA Disability
- What to Do If You Disagree with Your VA Disability Rating
- You Need Help Filing a VA Disability Claim or Appeal
What Is Avascular Necrosis?
Avascular necrosis (AVN) describes a condition that occurs when the bone loses its blood supply. This may result from a short-term or permanent situation. Without blood, the bone tissue doesn’t get oxygen causing it to die and collapse.
While this can happen in any part of the bone, it often affects the end of long bones. This causes them to lose their normal, smooth shape.
Now the bone doesn’t fit and moves correctly in the joint. This causes the joint’s surface to break down and collapse.
The femur (hip bone) is one example of a long bone that may develop AVN. This means that the hip joint is at risk of becoming damaged as well.
AVN can affect more than one bone at a time. This can cause significant pain and disability for the individual. If left untreated, the disease progresses causing more bone collapse and joint damage.
This disease is also called aseptic necrosis. Either name is correct as they both refer to a decrease or loss of blood supply to the bone.
Common Causes of AVN
There are several factors that can lead to the development of AVN. Examples include the following:
- Blood vessel blockage or damage
- Cancer treatments including radiation
- Injury to bones or joints
- Chronic medical conditions such as Gaucher’s disease and sickle cell anemia
- Prolonged use of medications such as corticosteroids
- Prolonged, excessive alcohol use
About one-fourth of people have no known cause for the blocked blood flow to the bone.
You can see how veterans would be susceptible to developing avascular necrosis after being discharged for a while. There are a lot of disabilities that are automatically presumed as service-connected if they show up in your first year as a civilian. AVN, unfortunately, might not show up that fast. An injury that occurred and healed while you were in the service could develop necrosis years later as you age.
Symptoms of AVN
Depending on the individual and the bone(s) involved, specific symptoms can vary. Some common problems experienced by patients with hip AVN include:
- Minimal pain in the hip at first
- Increasing pain over time as the bone starts collapsing
- Reduced hip movement due to pain
- Throbbing pain in the groin that’s worse when you put weight on the leg
- Pain in the buttocks, thigh, and knee
These symptoms may mimic other medical diseases or bone problems. Thus, it’s important to speak with your healthcare provider. Get a complete examination and have them document your diagnosis.
As the condition progresses, individuals often have pain even when lying down. AVN may occur on one or both sides and can lead to significant disability.
Understanding the VA Disability Rating System
The VA assigns disability ratings based on their determination of the condition’s severity. The rating ranges from zero to 100 percent in ten percent increments. The injury or illness must have a direct causal relationship to military service.
If you have more than one disabling disease or injury, the VA combines the ratings. For some veterans, this allows them to receive the highest VA disability ratings. Two 50% VA ratings don’t add up to 100% however, because of how VA Math works. You can learn more about this from this video about our VA disability calculator:
Here is a video of one of our Veterans Disability Lawyers teaching you how to use our VA Disability Combined Ratings Calculator.
It’s important to understand that an individual’s rating won’t exceed 100 percent. This is because no one can be more than 100 percent disabled.
Based on your VA rating, you’ll receive tax-free monetary compensation. Veterans can receive benefits for injuries or diseases that occurred during active duty. Some receive benefits if a pre-military condition became worse due to their service.
For other veterans, the disease or injury may not develop until after their service ends. A presumptive disability describes one example of this type of disability. It applies to veterans who served in specific locations or circumstances. One common example is Agent Orange exposure. All veterans who served in Vietnam have a presumptive exposure to this chemical.
Some VA disabilities may cause another illness or exacerbate an existing one. This situation describes a secondary disability. The secondary disability may or may not have a direct service connection.
Here one of our VA disability lawyers goes over the questions Woods and Woods, The Veteran’s Firm, is often asked about veterans’ disability claims and appeals.
Avascular Necrosis VA Disability Rating
The VA lists AVN under 38 C.F.R. § 4.71a, 5265 as aseptic necrosis of the femoral head. This rating group applies to leg and knee conditions. It assigns the disability rating as follows:
- The femoral head collapsed and there’s a constant need for walking support: 60% rating
- The femoral head collapsed and the veteran needs intermittent walking support: 40% rating
- Aseptic necroses without femoral head collapse: 10% rating
The VA will look at your hip mobility limitations and any other problems. This may lead to a secondary condition causing you to receive a higher rating. You may also qualify for SMC or even money to renovate your house to help you live a more normal life.
Here one of our VA disability lawyers talks about how SMC (Special Monthly Compensation) works to help you get more money for extra expenses related to your disabling condition every month.
Other Possible Secondary Conditions Related to AVN
Often, veterans with AVN also qualify for a VA disability rating for hip pain. This becomes a secondary disability coded under 38 CFR § 4.59. Some other possible related conditions may include the following.
Hip or trochanteric bursitis describes swelling in the hip bursa. The bursa is a fluid-filled sac in the greater trochanter of the hip joint. This swelling causes hip pain.
The VA disability rating for hip bursitis falls under 38 CFR § 4.71a, 5019. It’s based on the level of mobility limitation caused by bursitis.
Hip Labral Tear
The labrum is a ring of cartilage on the outside rim of your hip joint socket. It cushions the joint like a rubber gasket to hold the ball top of the femur in the hip socket.
Physical strain or repetitive motion may cause this type of injury. This activity is often part of combat or training. Femoral head AVN disfigurement can cause a tear in the labrum.
If you have this secondary condition, you may be eligible to get a VA disability rating for a torn labrum. You’ll find this rating described under 38 C.F.R. § 4.71a, 5253 as a hip labral tear.
AVN-related hip pain can cause a change in the way you walk. Limping puts extra strain on the other hip, knees, ankles, and feet. Another scenario involves a service-connected knee injury that causes new hip pain. This can result in a VA disability hip pain secondary to knee pain.
VA 38 CFR § 4.71a Schedule of Ratings for the Musculoskeletal System
Hip pain ratings depend on the severity of pain and underlying causes. The following summarizes the rating scale.
- Extreme ankylosis in which the foot can’t reach the ground and requires crutches: 90 percent
- Intermediate stiffening and immobility of the hip: 70 percent
- Hip flexion between 20 and 40 degrees with slight adduction or abduction: 60 percent
The rating may rely on X-ray findings. A 20 percent rating applies if there are two or more major or minor joints involved. This must also include intermittent incapacitating events.
The last rating applies to veterans with the same X-ray evidence. The difference is that they don’t have incapacitating episodes. In this case, they get a 10 percent rating.
If you have a hip replacement, you’ll receive a 100 percent disability for the first year. One year after surgery, the VA re-evaluates your disability rating for hip replacement.
They assign higher evaluation if you have ongoing complications. Examples may include pain, weakness, or limitation in your motion and mobility.
This evaluation compares the veteran’s mobility to normal parameters. They define normal as 125 degrees of hip flexion and 45 degrees of hip abduction.
In one case, the veteran had a decrease of 40 percent in hip flexion and 66 percent abduction. This person didn’t need crutches, so they weren’t eligible for a 90 percent rating. Thus, the VA gave them a 70 percent rating.
Another veteran who served from January 1951 to October 1953 appealed his rating. He had a diagnosis of avascular necrosis in his left hip as well as degenerative arthritis. The veteran had also undergone a hip replacement.
The Board of Veterans Appeals granted him a 90 percent disability rating. This was due to evidence of ongoing disability. It’s important to note that if surgery resolves the problem completely, you’ll receive a zero percent rating.
How to File for VA Disability
If you wish to file for VA disability, an important first step is to contact an expert. VA disability attorneys help veterans file their claims. They understand what the VA is looking for and make sure your application has all the key information. The call is free and we never charge you a dime unless we win your case.
You may file via the VA’s eBenefits online portal or by mail using the VA Form 21-526EZ. Before completing these applications you need to gather documents and evidence. This includes, but isn’t limited to the following.
- DD214 or equivalent separation or discharge documents
- Medical documents showing evidence of your condition
- Documentation that your injury or illness is directly related to your service
- Records for dependents such as marriage license and/or birth certificates
Some military members wish to file for benefits before separating. In this case, they may apply using the Benefits Delivery at Discharge program.
After collecting all your documents meet with your attorney. We will help you complete and submit the application. It may take several months before your receive a letter with the VA rating decision.
What to Do If You Disagree with Your VA Disability Rating
All veterans have the right to appeal their VA disability rating. Always consult with an experienced VA disability attorney like those at Woods and Woods to get the best results. There are several stages to the appeal process.
Request a Review of the Decision
You’ll need to file a Supplemental Claim VA Form 20-0995. You must also submit new, relevant evidence to support your appeal. This evidence will undergo review and a decision made.
Request a Higher-Level Review
If you still disagree with the decision, you may ask for a more senior reviewer to examine your case. You need to submit the Decision Review Request: Higher-Level Review VA Form 20-0996.
At this point, you aren’t allowed to present any new evidence. You must file this appeal within 365 days of the date on your decision letter.
You do have the right to speak with the reviewer or have your attorney speak on your behalf. The purpose is to tell them the reasons why you think they should change the decision. You may also describe errors you’ve identified.
This process often takes four to five months.
Board of Veteran’s Appeals (BVA)
The highest level of appeal is the BVA. You will definitely want to have an attorney representing you at this point. You now have 3 options for making this appeal.
First Option: Request a Direct Review
In this option, a Veterans Law Judge examines the previous evidence and decisions. You can’t present any new documents at this level. Be prepared that this option takes a year or more to complete.
Second Option: Submit More Evidence
You may submit a Decision Review Request: Board Appeal VA Form 10182. This option allows you to send more evidence. The BVA must receive your evidence within 90 days after they receive your form.
This option takes over a year to complete.
Third Option: Request a Hearing
Veterans have the right to request a hearing with the Veterans Law Judge. You may also submit new, relevant evidence at the hearing or within 90 days. Each hearing is transcribed and added to your appeal documentation.
Hearings take place virtually, via videoconference, or in person. You will not need to go to Washington, D.C for in-person hearings. This appeal process also takes over a year to complete.
You Need Help Filing a VA Disability Claim or Appeal
Are you a military veteran who’s been diagnosed with avascular necrosis? Do you wish to file for an avascular necrosis VA disability rating? Woods and Woods are VA-certified disability attorneys.
Our team includes Case Analysts, Case Managers, Doctors, Intake Managers, Psychologists, Support Staff, and Vocational Experts. Fill out our contact form or call us for a free legal consultation.
At Woods and Woods, the Veteran’s Firm, we’ve helped thousands of veterans with their VA disability applications and appeals. We’ve been adding staff and lawyers during the Covid pandemic to serve disabled veterans better in difficult times.
Call us today to discuss your VA disability appeal or your first application. The call is free and we won’t charge you a single fee until we win your case. We even pay for the postage for all of the documentation you send to our office. You can look for a VA disability attorney near you or call us and join the thousands of veterans living off of VA disability thanks to Woods and Woods.
Talk to Us About Your Claim: (866) 232-5777
The ratings are going to follow the same formula. The more disabling the condition, the higher your VA rating. The thing that you want to make sure you get right is your diagnosis. If you apply for something that is too hard to get a service-connection, the VA may deny your claim. Talk to one of our VA disability lawyers to see your best options for your case.
Depending on how long you’ve had your pain, you may be able to also get ratings for back problems, knee or hip pain on the other side of your body, PTSD, depression, and possibly the bilateral factor if both legs are affected.