The VA disability benefits for hip replacement patients are set at 100% initially, then vary depending on the condition of the veteran’s hip. This means the VA disability rating for hip replacement patients is one of the few total disability ratings that veterans can receive for a condition from which they may be able to fully recover.
For other veterans, a hip replacement VA disability rating can be combined with complementary conditions in the knee or hip to obtain a total disability rating even after the initial 100% rating has expired.
In this article about veterans hip replacement VA disability:
- Factors Influencing the VA Disability Rating for Hip Replacements
- Connecting a VA Disability Hip Replacement Claim to Your Service
- VA Disability Rating Hip Replacement Combinations
- Difficulties in Obtaining a VA Disability Rating for Hip Replacement
Factors Influencing the VA Disability Rating for Hip Replacements
Many veterans will be very familiar with the VA’s rating system by the time they receive a hip replacement. This is because the conditions leading to a hip replacement will likely be the basis of a VA disability claim.
For example, osteoarthritis occurs when overuse, age, or injury causes joints to wear down and become painful. This can be a common problem for veterans who had physically strenuous duties or jobs involving repetitive motion. Similarly, a combat injury or training accident can lead to a muscle or skeletal condition that allows bones or cartilage to wear down, resulting in hip osteoarthritis or a hip labral tear, respectively.
VA Disability Ratings for Hip Osteoarthritis and Other Hip Conditions
VA disability osteoarthritis hip ratings depend on the effect of arthritis on the hip’s range of motion (ROM). A hip that suffers from ankylosis (meaning the hip is frozen in place) is rated at 60%, 70%, or 90%. The rating depends on whether the hip is frozen in a position where it can support the veteran’s weight or prevents the foot from reaching the floor.
If the hip is not frozen, the hip condition is rated based on the limitation on ROM. The following measurements are taken to determine the ROM of the hip:
- Flexion: Forward motion of the leg at the hip – like taking a step forward.
- Extension: Backward motion of the leg at the hip – like taking a step backward.
- Adduction: Inward motion of the leg at the hip – like crossing legs.
- Abduction: Outward motion of the leg at the hip – like taking a step sideways.
- Rotation: Twisting of the leg at the hip to turn the foot outward.
Each of these motions is associated with a prescribed ROM. If your hip disability limits the ROM below the prescribed range, or pain is experienced as the leg is moved through the ROM, a disability rating is assigned to the hip condition based on the range.
What is the VA disability rating for a Hip Replacement?
The hip joint consists of a ball at the end of the leg’s femur that fits into a socket (acetabulum) in the hip’s pelvis. When a hip disability is treated using hip replacement, the ball, socket, or both the ball and socket are replaced by a prosthetic or artificial joint. The same VA disability rating table is used to rate a hip replacement regardless of which part of the joint is replaced.
The VA disability rating for hip replacement patients always begins with a total hip replacement disability rating for one year following the hip replacement surgery. That is, the VA always assigns a temporary rating of 100% disability for a hip replacement.
Bear in mind that the VA does not require that you have your hip replacement surgery at a VA hospital to qualify for disability benefit. However, if you did not receive a VA hospital hip replacement, you will need to file a claim within one year of surgery to receive the temporary 100% VA disability rating.
Re-Examination One Year After Surgery
The 100% disability rating expires a year after surgery. A new rating is then assigned based on the condition of the hip at an examination that takes place at least one year after surgery. Instead of reverting to the ROM measurements used to rate pre-surgery hip conditions, the VA provides a separate disability ratings table for post-surgery hip conditions.
All hip replacements are rated at least 30% disability irrespective of the effect on the veteran. Thus, if a veteran fully recovers from a hip replacement and is pain-free, a 30% disability rating is still assigned to them. This is one of the few instances where a veteran can fully recover from a disability and still receive disability benefits.
However, if the veteran experiences pain or ROM limitations one year after surgery, they can receive a higher VA rating. If pain, weakness, or limitation on ROM forces the veteran to use crutches or other mobility aids, a 90% disability rating is assigned. When “marked” pain, weakness, or limitation on ROM remains, a 70% disability rating is assigned. If the pain, weakness, or limitation on ROM is “moderate,” a 50% disability rating is assigned.
Difference Between “Marked” and “Moderate” Pain, Weakness, and Limitation on ROM
There is no bright line separating “marked” and “moderate” hip disabilities. However, cases discussed below from the Board of Veterans Appeals (BVA) look to a few factors.
The VA’s regulations include two illustrations that show a normal hip flexion of 125 degrees and a normal hip abduction of 45 degrees. One case compared the veteran’s ROM to these illustrations and justified a disability rating decision by pointing out that the veteran had a 40% reduction in flexion and 66% reduction in abduction. Because the veteran did not require crutches, the BVA could not assign a 90% disability rating. However, it considered the loss of motion “marked” and assigned the 70% disability rating.
In another case, the BVA considered factors including:
- Using “a cane for short distances” and “a walker for longer distances.”
- Falling several times.
- Stumbling and falling when standing after sitting for a long time.
- Inability to climb ladders or walk more than 50-75 yards without fatigue.
- Experiencing chronic hip pain.
- Hip extension of 105 degrees and hip abduction of 25 degrees.
Based on these factors, a 50% disability rating was assigned to the veteran.
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Connecting a VA Disability Hip Replacement Claim to Your Service
Every VA disability claim must include a service connection to be granted. For most musculoskeletal disabilities, like a hip condition, the easiest way to establish a service connection is through military medical records that show an in-service manifestation of the condition or worsening of a pre-existing condition.
In-Service Manifestation of the Condition
If your service records show complaints of, or treatment for, hip pain, they can form the basis of a service connection between the hip replacement surgery and your time in the military.
Similarly, if your service records show an injury or accident that affected your hip (even if it was not sustained in combat), a connection might exist between the hip replacement and your service. For example, a fall during training or a vehicle accident that resulted in hip pain, even if it was not severe enough for medical treatment at the time, might form the basis of a service connection.
Worsening of a Pre-Existing Condition
A service connection may also be established if you had a pre-existing hip condition that worsened due to your service. Again, this is most likely established using medical records from your time in the service and other service records that might point to an incident or injury that would have exacerbated the pre-existing condition.
If, for example, you had a documented pre-existing hip condition at the time you joined the service and you were involved in a vehicle rollover accident during your time in the military, you might be able to show that the accident worsened your hip condition.
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Secondary Service-Connected Hip Replacement
Another path to establishing a service connection is to tie the hip condition that necessitated the hip replacement to another service-connected disability.
For example, medications used to treat depression, thyroid conditions, epilepsy, and post-traumatic stress disorder (PTSD) can cause osteoporosis. It may, therefore, be possible to establish a hip replacement as a secondary service-connected disability if it was caused by the medication used to treat a service-connected disability like depression, thyroid conditions, traumatic brain injury (TBI), or PTSD.
Likewise, VA disability hip pain secondary to knee pain might allow a service-connected knee injury to form the basis of a secondary service connection to the hip replacement. Specifically, a knee disability can cause an irregular gait or limp that causes stress on the hip. Over time, the effects of this knee injury may result in osteoarthritis in the hip. If a physician can submit a nexus letter connecting the knee injury to the subsequent hip condition, the hip replacement to relieve the hip condition may be a secondary service-connected disability.
VA Disability Rating Hip Replacement Combinations
One way to increase your VA disability rating and keep a 100% disability rating after the one-year temporary rating expires is to combine disability ratings from multiple disabilities.
For example, bilateral hip pain VA disability ratings can be combined if both hips meet the VA’s rating criteria. A double hip replacement would allow a veteran to combine ratings using the VA disability calculator and obtain a higher overall disability rating. Two hips rated at 70% disability one year after surgery would give an overall disability rating of 90%.
Similarly, back conditions sometimes accompany hip conditions. When the back is unable to support the body’s weight properly, the hips may suffer extra stress – and vice versa. A back disability combined with a hip replacement will increase the overall VA disability rating for hip replacement and may even support a claim for a total disability rating of 100%.
Difficulties in Obtaining a VA Disability Rating for Hip Replacement
Since the 100% temporary rating after surgery is automatic, the most likely battle over a hip replacement VA disability rating will be the service connection. Particularly for older veterans, the VA may take the position that the hip replacement was necessitated by reasons other than the veteran’s service.
For example, a physically demanding job or accident that occurred after discharge from the military could be asserted to be the “real” cause of the hip disability. If there are no clear records from your time in the service showing complaints of hip pain, this type of denial becomes even more likely.
This is when a VA disability lawyer may be able to assist you in preparing the VA disability claim or requesting a review of a claim denial. VA lawyers have experience in both the law and procedure used by the VA to decide disability claims and can often help veterans when the VA denies a claim for disability.
The VA rates hip replacements at 100% for the first year after surgery because hip replacements can be difficult and can substantially affect a veteran’s quality of life. Contact a VA attorney at Woods and Woods today to discuss your VA disability benefits for your hip replacement claim.