If you’re a veteran who suffers from joint pain or arthritis, you know how debilitating it is and the severe impact your condition can have on your daily life.
Countless veterans have disability ratings of only 50% or lower for these types of conditions when they might be eligible for significantly higher ratings — others have disability ratings of only 80% when they might be eligible for a 100% disability rating.
Arthritis and joint pain can worsen with time, warranting an increase to an existing VA disability rating. You may also have developed a secondary condition that should have been factored into the rating.
Increasing your VA disability rating for arthritis or joint pain can be challenging, but it’s not impossible.
Read on to learn more about the VA ratings for joint pain and arthritis and how you may be able to get a higher disability rating to receive the maximum compensation you’re entitled from the VA.
What You’ll Learn in This Article:
- VA Disability Rating for Rheumatoid Arthritis
- Total Disability / Individual Unemployability for Arthritis and Joint Pain Conditions (TDIU)
- VA Disability Rating for Arthritis in Hands
- VA Disability Ratings for Knee Joint Pain and Arthritis
- Can I Get a 100% Disability Rating for Joint Pain?
- How Can I Increase My VA Disability Rating for Joint Pain and Arthritis?
- Total Disability Rating for Joint Replacement Surgery
- Increasing Your VA Rating by Combining Multiple Disabilities
- Get Help With Increasing Your Joint Pain and Arthritis Disability Rating
VA Disability Rating for Rheumatoid Arthritis
VA disability ratings for rheumatoid arthritis start at 20% for one or two painful flareups per year. The disability rating increases based on how many flareups you experience annually and how they affect your daily life.
Three episodes of rheumatoid arthritis flareups each year can increase your disability rating to 40%. Four or more painful flareups can cause your disability rating to go up to 60%. Typically to get a 60% rating, you also need to demonstrate to the VA that you have other symptoms associated with the condition such as weight loss, anemia, and a decline in overall health. You can increase a 60% disability rating for rheumatoid arthritis by combining multiple disabilities, or by qualifying for TDIU to receive compensation equivalent to a 100% disability rating.
If multiple areas of the body are affected, you may be able to show that your rheumatoid arthritis condition is incapacitating, warranting a 100% disability rating.
When you go for your C&P exam, it’s important to inform the doctor of your flareups and how they affect you. Providing sufficient evidence of the pain you experience may be able to help significantly increase your rating.
Essentially, the difference in conditions between a veteran who receives a 60% rating and a 100% rating depends on whether rheumatoid arthritis causes them to be bedridden and completely incapable of doing chores, household tasks, their daily activities, and working.
Here are some tips on your C&P exam from one of our VA disability lawyers.
Total Disability / Individual Unemployability for Arthritis and Joint Pain Conditions (TDIU)
Even when conditions are completely debilitating, many veterans only have an 80% disability rating for arthritis and conditions related to joint pain. However, even without a 100% disability rating, you may be eligible for Total Disability Based on Individual Unemployability (TDIU) if you cannot carry out substantially gainful employment due to your arthritis or joint pain.
TDIU is the equivalent of a 100% disability rating, entitling you to the same amount of compensation each month. While your disability rating is meant to reflect how your condition affects your daily life, TDIU is intended to compensate you for the impact your service-related disability has on your employment.
Generally, you may be eligible for TDIU if you have one service-connected condition with a disability rating of 60%, or if you have two or more service-connected conditions with a combined rating of 70% or more and one of the conditions has at least a 40% disability rating.
VA Disability Rating for Arthritis in Hands
Joint pain and arthritis in the hands is a common condition faced by veterans. It can occur in or near the wrist, thumb, or fingers. Arthritis can also cause carpal tunnel syndrome, which can result in complete paralysis of the hand, warranting a disability rating of up to 70% for your dominant hand. You may be able to increase this rating if you also have symptoms of “trigger finger.” If you have lost the use of your hand and are can no longer work, you may be eligible for TDIU.
If you have joint pain or osteoarthritis in both hands, the rating for each disability can be combined for an increased rating. If arthritis has caused you to lose function in your hands, you may also be entitled to Special Monthly Compensation.
1. You have at least 1 service-connected disability rated at 60% or more disabling, or 2 or more service-connected disabilities—with at least 1 rated at 40% or more disabling and a combined rating of 70% or more—andTaken from https://www.va.gov/disability/eligibility/special-claims/unemployability/
2. You can’t hold down a steady job that supports you financially (known as substantially gainful employment) because of your service-connected disability. Odd jobs (marginal employment), don’t count.
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.
VA Disability Ratings for Knee Joint Pain and Arthritis
Knee pain is rated by the VA under various diagnostic codes depending on the condition causing the pain. A VA disability rating for knee tendonitis or joint pain may also be based on your range of motion during your VA disability knee exam.
While each condition that causes knee joint pain is assigned a rating based on its severity, your disability rating may be increased based on VA secondary conditions to knee pain.
VA disability for arthritis in the knee is generally determined through range of motion testing. However, if you have a satisfactory range of motion but there is still pain, the VA will look to X-ray evidence for evidence of arthritis and assign a 10% or 20% disability rating. Arthritis in the knees often gives rise to secondary conditions which can increase your rating.
You may also be able to increase a disability rating for knee pain by combining the VA’s bilateral factor. Depending on the combined rating of your disabilities, the bilateral factor can bump you up to a rating of 80% or more. The bilateral factor takes into consideration that a disability affecting both knees (or arms, legs, etc.) can result in further difficulties. It adds 10% to the combined disability rating.
Can I Get a 100% Disability Rating for Joint Pain?
Some joint pain conditions are rated higher by the VA than others. Generally, the difference between a veteran who receives a lower rating and one who receives a higher rating depends on how many painful episodes occur within one year and the impairments associated with them. For example, two veterans may have the same arthritic condition, but the veteran who has more flareups each year will receive a higher rating. The VA will also consider whether arthritis is an overall condition in the body — such as in the case of rheumatoid arthritis — or if it occurs in specific joints.
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Typically, the VA will look to medical evidence to determine your rating such as blood tests as well as X-rays and MRIs of the joints that are affected. It will also consider how much pain you experience and the effect of the condition on your everyday life.
Rheumatoid arthritis often worsens over time. It’s possible to increase a rating for rheumatoid arthritis to 100% when there is sufficient medical evidence that your condition has become completely incapacitating.
Veterans who have less than a 100% rating for joint pain or osteoarthritis may be able to increase their rating by having each joint considered individually. Each joint may receive a separate disability rating under different diagnostic codes that can make your rating closer to reaching 100% when combined. For example, if osteoarthritis is present in one joint, but another has a torn ACL, your disability rating will increase because each joint’s condition is evaluated separately. The same applies if you are assigned a 50% rating for degenerative disc disease in the spine — adding additional joint conditions to your combined rating may be able to get you to a rating of 80% or higher, depending on the rating assigned to each.
Arthritis Patients that Took Xeljanz:
Did you take Xeljanz for at least one year? Have you been diagnosed with cancer, blood clots, or a heart problem?
Xeljanz is a medicine prescribed for rheumatoid arthritis, psoriatic arthritis, and colitis.
If you had any of these conditions and took Xeljanz, contact us to see if your side-effects qualify for this case.
How Can I Increase My VA Disability Rating for Joint Pain and Arthritis?
Since arthritis worsens over time, you should consider having your condition reviewed every few years. If you’re already receiving VA disability benefits for joint pain or arthritis and your current rating no longer reflects the severity of your condition, you may be able to file for an increase to your disability benefits.
There are a few different ways you can request an increase in an existing disability rating. This can be done by filing:
- A request for an increased VA disability rating using VA Form 21-526EZ
- A Notice of Disagreement
- A claim for a secondary service-related disability
- A supplemental claim
You may also be able to file an appeal within one year of the VA’s decision on your claim. An experienced VA attorney can advise you concerning how best to request an increase in your disability rating based on your particular circumstances and condition.
Total Disability Rating for Joint Replacement Surgery
You may be eligible for a temporary increase of a 100% disability rating if you have been hospitalized for more than 21 days for joint replacement surgery. You may also be eligible for a 100% disability rating during the time period in which you are convalescing.
If you underwent a full knee replacement surgery, you would receive a disability rating of 100% for the first year following the surgery. Partial knee replacements are also eligible to receive 100% disability in the first year following the procedure.
It may be difficult to get 100% TDIU from one disability, but here one of our VA disability lawyers talks about common disabilities that add up to a 100% combined rating.
Increasing Your VA Rating by Combining Multiple Disabilities
One way your disability rating can be increased is by combining multiple disabilities. The VA uses a Combined Rating Table to determine your compensation when factoring in more than one condition. By combining multiple disabilities, you may be able to get your disability rating up to 80% or higher depending on the rating assigned to each.
It’s critical to understand that the VA doesn’t add your disability ratings, but rather, it combines them using a specific formula based on the “whole person remaining” concept. (What most of us call ‘VA Math’.) The combined ratings are then calculated by rounding up to the nearest ten.
Here is a video explaining how the VA combined ratings table works from one of our Veterans Disability Lawyers.
Get Help With Increasing Your Joint Pain and Arthritis Disability Rating
Going through the process of getting your disability rating increased for joint pain or arthritis can be confusing and overwhelming. If you have arthritis or joint pain issues, the VA disability lawyers at Woods and Woods can help ensure you get the highest disability rating that you’re qualified to get.
A family-owned business since 1985, our lawyers have helped thousands of veterans who are entitled to disability benefits get the highest disability rating they deserve for their service-connected joint pain and arthritis. We also assist the surviving spouses of deceased service members to obtain the benefits to which they’re entitled.
We never charge a fee to help you apply for disability benefits or increase your disability rating — you only pay if we are successful and win your case case.
Contact us today to schedule a free consultation to discuss how we can help increase your VA rating for joint pain and arthritis.
The VA is required to give you the best of everyting, but over 30% of VA decisions end up being wrong. You want to make sure you apply for every benefit you deserve, and don’t leave it to the VA to figure it out.
Only if you win a CUE case. You would have to show that it should have always been rated higher, not that your condition is getting worse.