Are you a veteran with a diagnosis of rhabdomyolysis? Do you still suffer from physical problems? Have you applied for rhabdomyolysis VA disability benefits?
Filing claims with the VA can feel like an overwhelming process. Keep reading to learn more about this condition. You’ll also learn about the disability rating, application, and appeals process.
What We Cover in this Article on Rhabdomyolysis:
- What Is Rhabdomyolysis?
- Prevalence of Rhabdo in America
- Causes of Rhabdomyolysis
- Signs and Symptoms
- Secondary Conditions Related to Rhabdomyolysis
- Rhabdomyolysis VA Disability Rating
- Rhabdomyolysis Disability Rating
- How to Apply for VA Benefits?
- Appealing Your Claim Decision in the VA Courts
- Special Monthly Compensation (SMC) benefits for Rhabdomyolysis
- Are You Looking for Help to File a VA Disability Claim?
What Is Rhabdomyolysis?
Rhabdomyolysis is a syndrome that includes a group of symptoms. It often occurs after an injury to the skeletal muscles. Damaged muscle tissue breaks down causing the release of myoglobin into the blood.
Myoglobin is a protein that binds to haptoglobin in the blood vessels. When this reaches high levels, it creates blockages that interfere with blood flow. This can lead to:
- Obstruction of the renal (kidney) tubules
- Lack of oxygen (ischemia) to the kidney(s)
- Nephrotoxicity involving renal tubular injury and ischemia
- Constriction of the blood vessels inside the kidney(s)
In many instances, this can lead to temporary or permanent kidney injury or failure. This same process can create obstructions to oxygen delivery in other parts of the body.
When body tissues or organs don’t receive adequate oxygen, they suffer injury or death. Severe rhabdomyolysis can have fatal consequences for the veteran.
Prevalence of Rhabdo in America
Each year, 26,000 Americans get rhabdo (the more common name for rhabdomyolosis). Traumatic injury is the cause of rhabdomyolysis in 85 percent of victims.
This leads to acute renal failure (liver failure) in 10 to 50 percent of these patients. If they develop acute renal failure at a later time, their mortality rate is 20 percent.
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.
Causes of Rhabdomyolysis
Rhabdomyolysis can occur due to a variety of factors. You’ll see that veterans are at risk for many of these.
Compression of muscles deprives the tissue of blood and oxygen. Suffering a severe injury may involve a crush injury leading to muscle damage. Prolonged immobilization of the arms or legs under the head or torso can also crush muscles.
Individuals who are morbidly obese have a higher risk of rhabdomyolysis from injuries. Long surgery with immobilization of an obese patient can also lead to this condition.
Exertional rhabdomyolysis has occurred among active military service members. In 2019 (the most recent records we have), there were 512 cases documented. The highest incidence occurred in non-Hispanic black males under the age of 20.
Members of the Marine Corps had the highest rates. The Army rated second with the Air Force and Navy rating the lowest.
Facilities supporting basic combat and recruit training experienced the highest rates of rhabdomyolysis. Major Army and Marine Corps ground combat units had the most cases.
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Drugs and Medication
Medications, toxins, or drugs that cause decreased mobility can lead to rhabdomyolysis. Examples include the following:
- Heroin, cocaine, alcohol, and amphetamines
- Statin drugs represent the most common prescription medication cause
- Toxins from snakes, bees, spiders, and carbon monoxide
These factors may result in muscle compression and/or specific muscle toxicity.
Viruses including HIV and influenza represent the most common infection-related rhabdomyolysis. As of September 2020, four cases of COVID-19 related rhabdomyolysis were documented.
Legionella is the most common bacterial infection-related cause. Experts have also seen an increase in cases resulting from Escherichia coli.
Rhabdomyolysis can result from heatstroke, hypothermia, or electrical burns. Some muscle diseases and uncontrolled seizures can act as triggers. Major surgery requiring large muscle incisions may also cause this syndrome.
Signs and Symptoms
Service members experiencing the following symptoms need an immediate evaluation for exertional rhabdomyolysis:
- Pain or swelling in muscles
- Decreased range of motion
- Dark-colored urine
This describes the classic diagnostic triad. These symptoms are especially worrisome, after strenuous physical activity in humid, hot weather. Other less specific symptoms can include nausea, vomiting, and fever.
Here, one of our VA disability lawyers talks about what we do when we appeal your case to the Veteran’s Administration.
Secondary Conditions Related to Rhabdomyolysis
Rhabdomyolysis can lead to several acute, chronic, and life-threatening conditions. As described, the victim may develop temporary or permanent renal injury or failure. The person may need dialysis or a kidney transplant to survive.
When the kidneys fail, the fluid and chemical balance changes. This affects many organs including the brain, heart, and lungs. The person can have chronically abnormal electrolytes, low albumin, and high uric acid.
The fluid compresses the muscle which can lead to tissue death. A surgeon must quickly make incisions in the skin (fasciotomy) to release the pressure.
Disseminated intravascular coagulation (DIC) may present as a late complication. In DIC, blood clotting proteins become over-active and cause increased clotting.
This blocks the flow of blood and oxygen. In later stages, all the clotting factors get used up and the body isn’t able to stop bleeding.
Rhabdomyolysis VA Disability Rating
The VA Schedule for Rating Disabilities (VASRD) underwent revision in late 2020. The new rating schedule includes changes to musculoskeletal system disabilities. The changes become effective on February 7, 2021.
The new schedule ensures the VASRD uses current medical terminology and evaluation criteria. These revisions include changes to the rhabdomyolysis rating schedule.
The CFR § 4.25, 5330, rating guidelines look at each muscle group affected by rhabdomyolysis. The separate muscle group ratings are then combined in accordance with § 4.25. Chronic kidney problems receive separate ratings under the appropriate body system.
The same procedures are now standard for § 4.25, 5331 addressing compartment syndrome. Thus, each affected muscle group receives its own rating and is then combined.
Rhabdomyolysis Disability Rating
Rhabdomyolysis muscle impairment usually receives a disability rating of 20 percent. This may combine with other disabilities as appropriate.
The VA uses the following general formula for rating if you have kidney problems:
- 100 percent rating:
- Veteran requires regular dialysis
- During the first year following a kidney transplant
- 80 percent: swelling, low weight, weakness, anorexia, and abnormal renal function tests
- 60 percent rating:
- Decreased to severe renal dysfunction
- Constant albumin in the urine with some swelling
- Hypertension with diastolic pressure over 120
- 30 percent rating:
- Hypertension with systolic pressures above 160 and diastolic above 100
- Or albumin with red blood cells or granular and hyaline casts in the urine
- Or the removal of one kidney
- Zero percent rating:
- A history of kidney inflammation with albumin and casts in the urine
- Or hypertension with systolic pressure below 160 and a diastolic pressure below 100.
Veterans who have a kidney transplant will have a re-evaluation after the first year. At that time, their rating may change with the lowest rating being 30 percent.
Navigating the VA disability rating system is often confusing. According to “VA math” 80 percent plus 20 percent doesn’t add up to 100 percent. To help determine your disability rating, use this VA disability calculator.
Here is a video explaining how the VA combined ratings table works from one of our Veterans Disability Lawyers.
How to Apply for VA Benefits?
Begin by speaking to a lawyer that specializes in VA disability compensation. We will help prepare your application and make sure you include all key evidence. This improves your chance of getting the most accurate benefits in the shortest time.
You need to gather documents showing evidence that your disability is service-related. The following gives a list of information commonly needed:
- DD214 or other military separation papers
- Medical reports from VA or private providers documenting your condition and it’s service connection
- A Buddy Statement from someone over the age of 21 that witnessed your service-connected injury
- Letters from friends, family, or community members showing how your disability affects daily living
- Letters and/or medical records documenting a worsening of your disability
There are different ways to get the records you need to provide evidence of your disability. You may submit a request for records from your VA Regional office. They may ask you to complete VA Form 180 in order to get the relevant documents.
In some cases, you will need to file a Freedom of Information Act (FOIA) request. Other offices ask for a Privacy Act request to get your records. If you’re trying to get Navy Deck Logs to prove your claim, this is the best approach.
Once you file your application, you only have 365 days to complete it. Having this documentation collected and ready to submit with your application saves time. The VA may also ask you to schedule a claim exam to document your current condition.
Most individuals complete their applications and file their claims online. If you aren’t able to do this, your lawyer or local VA representative can assist you.
You don’t have to use a Veteran’s compensation lawyer that is nearby. We can work with you over the phone and apply or appeal electronically.
Appealing Your Claim Decision in the VA Courts
If you disagree with the VA ruling on your disability rating, you have the right to appeal the decision. Be aware that it takes the VA between three and four months to accept or deny your claim. The COVID-19 pandemic has increased the backlog of claims at the VA so times may increase. Your claim may receive a denial based on several factors including:
- The VA medical exam doctor’s report
- Information in your medical, military, or military personnel records
- Diagnostic medical test results
- Statements provided by you or others involved in your claim
- Statements from you or other involved individuals about your medical or service history
Veterans always have the option to ask for a medical opinion from the provider who is treating them. This type of medical opinion may be beneficial if your VA medical exam was unfavorable. It may also help you provide an argument against the examiner’s findings.
Here are some tips on your C&P exam from one of our VA disability lawyers.
If the VA denies your claim, you can take your appeal to the Board of Veterans’ Appeals (BVA). Make sure you have a VA disability lawyer to advise you. The BVA process may take between 260 to over 1,000 days to reach a decision.
If the BVA upholds the VA’s decision, your next level of appeal is to the highest VA disability court. Your case will go to the Court of Appeals for Veterans Claims (CAVC). This process begins with the filing of a Notice of Disagreement (NOD).
After filing the NOD, the VA no longer has jurisdiction over your case. The CAVC’s review doesn’t include any of the legal conclusions or assumptions from the lower courts.
The fresh look by the CAVC determines if the VA broke any laws or regulations when denying your claim. All decisions are final at this point.
Special Monthly Compensation (SMC) benefits for Rhabdomyolysis
SMC is often granted for reasons that don’t have a direct service connection. This includes secondary-connected disabilities.
If you experienced rhabdomyolysis, you may qualify for SMC. Ongoing problems with renal failure, muscle pain, and weakness are considered secondary conditions.
VA disability ratings look at the loss of your ability to work. SMCE ratings focus on your difficulties in living a normal life.
For example, you may have a 70 percent rating for a leg injury that prevents you from working. If you lose your right hand and can’t perform dressing and hygiene, you can receive an SMC rating.
A 100 percent disability rating isn’t a prerequisite for SMC. Any injury or illness that causes you to need daily help or be homebound may qualify.
Healthcare providers may order regular home supervision due to a secondary service-connected problem. Applying for SMC gives you financial help to pay for in-home care.
If you receive medical in-home care, these services fall under your medical coverage. SMC pays for non-medical in-home care. The purpose of this type of help is to improve your quality of life.
Your VA disability lawyer can help you apply for SMC. At times the VA may not always consider that you may benefit from SMC.
The attorney will often submit the SMC application along with your disability application. This ensures that the VA considers the option of granting SMC.
Are You Looking for Help to File a VA Disability Claim?
Did you suffer an injury or illness that caused rhabdomyolysis while serving in the military? You may be eligible for rhabdomyolysis VA disability.
The family-owned law firm, Woods and Woods, proudly serves disabled and injured veterans and their families nationwide. We have over 95 highly trained staff members to assist with disability claims. Our firm knows that injuries and chronic illnesses can change your life.
You’ll receive expert legal advice and customer service. Our reliable and complex case management systems ensure nothing falls through the cracks. Contact us today to receive a free legal consultation.
If you have a medical record of Rhabdomyolysis – even in basic training – and currently have liver or muscle problems that can be linked, you have the service-connection required to apply for VA disability compensation. Let’s look over your medical records. Your call is free.
There is a VA rating for that condition, but you’ll have to prove that your liver was weakened while you were in the service or some other service connection. A history of muscle pain or infections on your service record might be enough.