As we get older, our chances of developing osteoporosis, a condition that weakens the bones, increases. The risk is even higher for veterans who sustained injuries throughout their years in military service. If you’re a veteran with service-connected osteoporosis, you may be eligible for an osteoporosis VA rating.
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Veterans with osteoporosis may live with constant back pain and sometimes have to take extreme precautions to avoid fracturing their weakening bones. If you’ve been diagnosed with this condition, it’s important to understand how to get VA compensation for osteoporosis.
In this article about the osteoporosis VA rating:
What is osteoporosis?
Osteoporosis is a condition that causes dangerous thinning and weakening of the bones. As we age, old cells die and new cells are created to take their place. But sometimes the regeneration of those new cells can’t keep up with the decay of the old ones. When cell decay is faster than cell growth in your bones, it causes osteoporosis.
Patients with osteoporosis can break bones doing something as simple as coughing or suffering a minor fall. Most of these fractures occur in the hips, wrists, or spine.
Osteoporosis is called a “silent” disease because oftentimes, there are no symptoms of the condition until a bone is broken. One of the first signs you may notice of the condition is pain in your back. This is caused by a fractured or collapsed vertebra, which can also cause you to develop a stooped posture and lose height over time.
The prevalence of osteoporosis is much higher in women, with about one in five American women diagnosed with the condition. However, it also significantly affects men. Around two million men in the U.S. have osteoporosis and 12 million are at risk.
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Osteoporosis in veterans
Unfortunately, veterans in general are at a higher risk for developing the disease than their civilian counterparts. Veterans are especially prone to developing osteoporosis due to a higher probability of prior bone injuries. One study found that among veterans who served in Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn, the most common diagnoses were musculoskeletal conditions, including osteoporosis.
Osteoporosis VA rating
Veterans with osteoporosis can receive an osteoporosis VA rating if the condition developed because of their military service. Depending on the severity of symptoms, there are two ways the VA might rate your condition.
Osteoporosis rated as degenerative arthritis
Osteoporosis, similar to many other conditions, does not have its own diagnostic code. In these cases, the VA rates the condition “analogously,” meaning it uses the most similar diagnostic criteria available. For this reason, osteoporosis is often rated under the diagnostic code for degenerative arthritis.
For osteoporosis diagnoses that do not significantly affect the veteran’s range of motion, the VA rates the condition using diagnostic code 5003 for degenerative arthritis. Osteoporosis is rated at either 10% or 20%, depending on the number of major or minor joints affected and whether there are any incapacitating episodes. The VA defines major joints as the shoulders, elbows, wrists, hips, knees, and ankles. Minor joint groups are those on the hands and feet, as well as joints in the lower back (lumbar spine), upper back (thoracic spine), and neck (cervical spine).
A 10% rating is given when X-ray evidence shows osteoporosis in two or more major joints or two or more minor joint groups.
A 20% rating is given when X-ray evidence shows osteoporosis in two or more major joints or two or more minor joint groups when osteoporosis causes occasional incapacitating flare-ups.
In other words, if your osteoporosis periodically flares to the point that you cannot perform basic tasks, you may be eligible for a higher rating.
It is also worth noting that a 10% to 20% rating will only be given if the veteran is not already receiving a rating of at least 10% for another condition affecting the same joint(s).
Osteoporosis rated on the basis of limitation of motion
If your osteoporosis causes significant limitation of motion, your condition may instead be rated using the diagnostic code for range of motion of the specific body part affected.
For example, in severe cases of osteoporosis of the hip, veterans may be eligible to receive up to a 90% VA rating if their condition causes extreme ankylosis (stiffening or immobility) of the hip joint that results in the need for crutches.
Below is the VA schedule of ratings for osteoporosis in the hip based on limitation of motion.
Diagnostic code 5250 Hip, ankylosis of:
Description | VA Rating | Monthly payment (vet only) |
---|---|---|
Unfavorable, extremely unfavorable ankylosis, the foot not reaching ground, crutches necessitated | 90% | $2,241.91 |
Intermediate | 70% | $1,716.28 |
Favorable, in flexion at an angle between 20° and 40°, and slight adduction or abduction | 60% | $1,3161.88 |
However, osteoporosis can affect many areas of the body, and to different degrees. In these cases, you may be assigned more than one diagnostic code and more than one rating for your condition. If this becomes complicated, you can always seek help with your claim to make sure you get the full VA disability compensation you deserve.
Osteoporosis and related conditions
While osteoporosis may develop from injuries sustained during military service, it can also be caused by other service-connected conditions. Some examples of conditions that increase your risk of developing osteoporosis include:
- Thyroid problems
- Eating disorders such as anorexia nervosa
- Kidney and liver disease
- Cancer
- Rheumatoid arthritis
- Multiple myeloma
Additionally, male veterans who were exposed to chemicals such as Agent Orange are more prone to developing prostate cancer. A common treatment option for prostate cancer, androgen deprivation therapy (ADT), increases the risk of developing osteoporosis.
If you experience any of these conditions in addition to osteoporosis, it may be worth discussing with your doctor whether there is a connection, and if so, seeking additional disability compensation from the VA.
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Osteoporosis as a presumptive condition
To receive VA disability benefits, you must typically prove your osteoporosis was caused or exacerbated by service or the condition is secondary to another service-connected disability. However, you do not need to prove this link if there is a presumptive service connection.
A presumptive service connection means the VA assumes the condition is related to the unique circumstances of certain veterans’ military service. Therefore, if you’re diagnosed with a presumptive condition and your service meets the criteria, you qualify for a service connection.
Osteoporosis is considered a presumptive condition for veterans who were held as a prisoner of war (POW) for at least 30 days. Osteoporosis is also presumptive for veterans with PTSD who were POWs for any length of time.
TDIU for osteoporosis
A veteran can be awarded total disability based on individual unemployability (TDIU) if they can’t maintain “substantially gainful employment” because of service-connected conditions.
Osteoporosis can make it difficult for a veteran to work due to chronic pain and the risk of injury to the hips, back, and wrists. Manual labor may be especially risky for veterans who need to take extra precautions to avoid further injuring their weakened bones.
TDIU pays at the same level as a 100% disability rating, even when the veteran’s combined rating is below 100%.
Veterans will typically be eligible for TDIU if they have:
- At least one service-connected disability rated at 60% or more disabling OR
- Two or more service-connected disabilities with at least one rated at 40% or more disabling and a combined rating of 70% or more
In some cases, veterans may not meet these requirements but still be eligible for what is known as extraschedular TDIU.
How Woods and Woods can help
If you have service-connected conditions that affect your ability to live and work, you deserve your full VA disability compensation. Contact Woods and Woods today for a free consultation to see how we can help. You only pay us if we win.
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FREQUENTLY ASKED QUESTIONS
There are two ways the VA will typically rate osteoporosis. First, the VA can use diagnostic code 5003 for veterans with an osteoporosis diagnosis that doesn’t significantly affect their range of motion. In this case, the veteran will be given a 10% or 20% VA rating depending on the presence of incapacitating flare-ups and the number of affected joints. The VA may assign a rating from 0% to 100% depending on the severity of the limitation of motion of the affected joint.
Osteoporosis is considered a presumptive condition for veterans who were held as a prisoner of war (POW) for at least 30 days. Osteoporosis is also presumptive for veterans with PTSD who were POWs for any length of time.
Neil Woods
VA disability attorney
Woods & Woods
Neil Woods is the firm’s owner and president. He received his law degree from Western Michigan University.