Each group of muscles controls a single function. Phone: (888) 883-2483. For example, let’s say you have full range of motion for your back, but you have pain during movement, you should be awarded the minimum level of disability for the condition, which for most muscuoloskeltal conditions … However, the loss of use or amputation of the entire hand is only rated 70%. VA disability rating for arthritis ranges depending on your condition. For example, say the Veteran’s back condition is being reexamined. Muscle conditions can be rated on the Slight to Severe Scale. Many veterans file claims for disabilities that, while chronic, are worse on some days than on others. All of these steps are fairly common knowledge for those who must navigate the system. Range of motion forced in C&P exam Ask Jim a Question. So, if the hand has not been amputated, but has numerous conditions that can be rated separately and combined, then the combined rating for all of those hand conditions cannot be higher than the rating for the amputation of the hand. Let’s say that there is carpal tunnel in the right wrist that is rated 40%. A January 2006 compensation and pension examination recorded appellant’s complaints of intense pain when standing and walking. All the principles discussed on the VASRD Principles page also apply. The following bullet points lay down rules on combining ratings for muscles with other ratings (for nerves, limited motion, etc.). The Veteran’s back may not be painful at the moment the exam is being conducted, but he experiences painful motion and flare-ups in his back while at work. While loss of range of motion based on pain may amount to increased compensation for VA disability benefits in some instances (see Deluca v. Brown ), recently, in Mitchell v. Shinseki , 25 Vet. 60%: With chronic residuals consisting of severe painful motion or weakness in the affected extremity. The Department of Veterans Affairs has a rating process for service-connected medical issues, disabilities, and diseases. § 4.59 Painful motion. 20 Symptoms associated with musculoskeletal system conditions include limitation of range of motion (flexion), painful motion, arthritis, weakness, easily fatigued, loss of power, lack of coordination and decreased movement control. The Painful Motion rule applies to mainly joint-specific conditions, like arthritis, but also comes into play for any condition that is rated primarily on limited motion. If no limitation is present, however, the condition will then be rated based on factors including pain with motion, too much motion, weakness, deformity, arthritis, and any other problems that interfere with daily life. Therefore, regardless of diagnosis, hip and upper thigh conditions are generally eligible for service connection and compensation if they cause limited or painful motion (painful motion always merits at least the minimum rating for a joint). The Joints (§4.45): Any joint condition will be rated on limitation of motion. Additionally, there are two fingers that can’t move at all, again rated 40%. VA Gen. Coun. § 4.40, which defines functional loss and includes functional loss may be “due to pain.” The Court indicated, however, that “although pain may cause a functional loss, pain itself does not constitute functional loss.”Mitchell, 25 Vet. The Department of Veterans Affairs says of this condition that, when established via X-rays, the VA disability rating will be made “on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved.. Established in 1965 by Vietnam War veteran and attorney John Stevens Berry Sr., Berry Law Firm is a team of veterans dedicated to defending, safeguarding, and fighting to protect the rights of veterans. Prec. You might be able to pay for some heating pads or some visits to the chiropractor/spa with that. Not all of these extra rating factors apply to each joint, but this will be discussed on the individual joint pages. The regular presence of one or more of the. Condition. App. Pain with motion must be clearly documented by the physician in order for this principle to apply. An easily treated wound with good healing and function. App. All measurable deformities should also be carefully noted. Arthritis Due to Strain (§4.58): For the VA only–If arthritis is the result of a service-connected condition, then it is considered service-connected and ratable, even if it does not develop until years after the service member left the military. Loss of muscle substance and tone would be present, and there would be a definite decrease in function and use. Basically, regardless of how much the service member can move their knee (or any joint), if it hurts when they move it, then they will get at least the lowest Compensable rating for the knee–for example, 10% (money) instead of 0% (no money). Painful Motion (§4.59): This is the most commonly used principle. When each qualifying joint motion is painful but motion is not actually limited to a compensable degree under its applicable 52XX-series DC, only one compensable evaluation can be assigned. For instance, the Painful Motion principle states that if you have any pain when you move the joint, you are entitled to the minimum disability rating for that body part. Scars would be very large and jagged and would stretch across a large area. For example, all the muscles in Group X control the pointing and flexing of the toes. With any form of arthritis, painful motion is an important factor of disability, the facial expression, wincing, etc., on pressure or manipulation, should be carefully noted and definitely related to affected joints. 202 (1995); however, the Board did not grant any additional compensation for pain as a “functional loss” of use due to pain. For example, the highest rating for an ankylosed wrist is 50%, so the combined rating of all the injured muscles around the wrist must be lower than 50%. If a joint is ankylosed then any injuries to muscles connected to that joint won’t be rated. In performing C&P examinations and writing reports, many VA examiners frequently overlook or incorrectly measure functional impairment caused by pain and especially the pain and loss of motion during flare-ups (times in which the pain or disability is particularly bad). at 38. The severity of a muscle disability is decided by the presence of the “cardinal signs and symptoms.” These include loss of power, weakness, easily fatigued, pain with fatigue, lack of coordination, and decreased movement control. That will bring in about $140 a month based on the 2019 VA rating schedule. App. The information you obtain on this website is not, nor is it intended to be, legal advice. Small scars with some loss of muscle tone or substance. Contacting us does not create an attorney-client relationship. If pain is not clearly noted in an exam, it is assumed that there is none (the service member saying it hurt yesterday is not enough). There is also a muscle injury from shrapnel in the right hand that is also rated 40%. Moreover, if there is pain (without limited motion), then the VA’s painful motion principle kicks in. The Mitchell Court further stated that painful motion alone is not limited motion. § 4.59. Note the appellant did not argue that she sustained functional loss from her knee pain based upon anything other than the effect of pain on her knee’s range of motion, i.e., excursion. Let’s break that table down and explain it simply. I have a question about painful motion of the knee. Therefore, because pain alone is not functional loss and painful motion alone is not limited motion, the Court denied appellant’s argument for an increased evaluation. It is also important to fully describe to the examiner the effects of your disability upon your ordinary activity. Generally speaking, VA rates this condition based on the range of motion that exists as the veteran moves their knee in that direction. Veterans who submit claims to the VA for these issues must be evaluated by the VA and assigned a disability percentage rating. © 2020 MilitaryDisabilityMadeEasy.com - All rights reserved, The Integrated Disability Evaluation System (IDES), Combat Related Special Compensation (CRSC), Concurrent Retirement & Disability Pay (CRDP). With any form of arthritis, painful motion is an important factor of disability, the facial expression, wincing, etc., on pressure or manipulation, should be carefully noted and definitely related to affected joints. For orthopedic conditions, VA ratings are typically awarded based on the degree to which the veteran experiences a limited range of motion in the specific joint affected. 6940 O St, Suite 400 Now if the nerve condition was not carpal tunnel, but a pinched nerve from the shoulder that caused pain all the way down the arm and into the hand, then all the conditions could be combined, but could not equal more than the rating for the amputation of the entire arm up to the shoulder – 90%. My knee condition wasn't diagnosed until after I was discharged. Dominant Hand (§4.69): If a veteran has a condition that affects their arms and hands, then it is necessary to know which of their hands is the dominant one. all in the arm but not all attached to the elbow), then the rating for the worst injured muscle in the arm will be increased to the next higher level and then used as the only rating for all muscle injuries in the arm. App. The VA examiner would then be required to review the statement and address whether there is additional limitation of motion and at what point functional loss affects motion. at 37. App. My RA is rated under 5002, zero percent. This wound would need hospitalization for treatment, have the constant presence of the. You can browse all of these Q&As here, and search the Jim's Mailbag archives for helpful answers. Are they right-handed or left-handed? 32 (2011), the Court of Appeals for Veterans Claims reaffirmed its position painful motion alone does not merit an increase in disability benefits ratings. So if, All other muscle group injuries that are not related to each other as above will simply be rated individually. However, I just got a 10% rating for painful motion of the knee. If a joint can move (not ankylosed), then the combined rating for all the injured muscles that connect to it must be lower than the highest rating for that joint if it were ankylosed. If you have been honorably discharged and have joint or back pain, you can probably get the minimum 10% rating for a disability. Those conditions all combined would equal 80% disability. Does 38 CFR 4.59 pain/painful motion apply to Rheumatoid Arthritis, or am I spinning my wheels? Definitions of the different severities are listed below, but each bullet point does not have to be met in order for the condition to qualify under that severity. Our team is committed to getting you the VA benefits you earned through your faithful service to our country. Under the painful motion rule, the minimum compensable rating of 10% must be assigned. Keep in mind that there are tests that are used by the examining physician to see if the service member is faking the pain. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. The Mitchell Court cited 38 C.F.R. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. For example, a left foot injury could cause arthritis in the right hip because it had to compensate for the left foot (maybe taking more weight because of limping). 30%(Min): With intermediate degrees of residual weakness, pain or limitation of motion rate by analogy to diagnostic codes 5256, 5261, or 5262. The VA does not rate a disability under limited range of motion and degenerative arthritis. Prior to the ruling in Saunders v. Wilkie, VA required veterans to show that they had a diagnosed disability in order to receive disability benefits. In order to be adequate for VA rating purposes, joint examinations must include: A full description of the effects of the disability upon the person’s ordinary activity; Notation of when incoordination, weakened movement, and fatigability sets in; Whether there is pain on motion, and if so, when pain sets in and whether it causes functional loss; Only one hand can be considered dominant. This could include the length of a stump, the placement of a scar, and any muscle atrophy. First and foremost, welcome to our VA practice! Some loss of power and a bit more easily fatigued. Other evidence of severe disability could include X-ray evidence of foreign bodies in the muscles, skin attaching directly to the bone instead of the bone being covered by muscle, decreased response in the muscles to electric shocks, significant. These principles are just for the Musculoskeletal System. For arthritis to be the result of another condition, it has to be in a joint that was clearly under strain from compensating for that condition. We invite you to contact us and welcome your calls, letters and electronic mail. You should consult an attorney for advice regarding your individual situation. For example, if scar tissue on your elbow makes it impossible for you to fully flex your arm, that would be considered a limitation of function, as well as a limitation of motion. For example, VA will look at whether, and how much, a service-connected low back disability limits a person’s ability to bend forward, bend backward, bend to each side, and rotate from the waist. Musculoskeletal system conditions include issues with joints and muscles and must involve (1) limitation of range of motion (flexion) and/or (2) painful motion. For instance, the Painful Motion principle states that if you have any pain when you move the joint, you are entitled to the minimum disability rating for that body part. All rights reserved. For example, many muscle conditions are not caused by injuries, so the requirements for the type of wound or scar would not apply. I have taken a DMARD for almost 10 years, which has prevented incapacitating episodes. © 2020 PTSD Lawyers | Berry Law Firm. If you are a veteran with a service connected disability that limits your range of motion, you are entitled to disability compensation. Our team is committed to getting you the VA benefits you earned through your faithful service to our country. It only provides that VA policy is to recognize actually painful motion as entitled to at least the minimum compensable rating for the joint When each qualifying joint motion is painful but motion is not actually limited to a compensable degree under its applicable 52XX-series DC, 32 (2011), the Court of Appeals for Veterans Claims reaffirmed its position painful motion alone does not merit an increase in disability benefits ratings. A medical examination indicated she had a torn ACL and torn anterior aspect of the lateral meniscus. Search Jim's Mailbag. This wound would need lengthy hospitalization for treatment, have the constant and very serious presence of the. Minor joints include the joints in fingers and toes, and the vertebrae in the spine.
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