Musculoskeletal System§ 4.71aUpdated
Rating criteria

VA Diagnostic Code 5003Degenerative arthritis, other than post-traumatic

Rated from 10% to 20% under § 4.71a. Here is what the VA requires at each level.

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In short

Summary

Degenerative arthritis established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved (DC 5200 etc.). When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 pct is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. In the absence of limitation of motion, rate as below:

The ladder

What each rating requires

The VA assigns the highest level your evidence actually supports. Read up the stack until your records stop matching.

  1. 20%

    With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations

  2. 10%

    With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups

From the schedule

Notes on this code

These notes are part of the regulation. They change how the levels above are applied.

  • Note (1): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be combined with ratings based on limitation of motion.
  • Note (2): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be utilized in rating conditions listed under diagnostic codes 5013 to 5024, inclusive.

Degenerative Arthritis (Other Than Post-Traumatic) — VA Diagnostic Code 5003

Musculoskeletal System · Rated under 38 CFR § 4.71a

What This Condition Is

Degenerative arthritis is a joint condition established by X-ray findings. Under VA Diagnostic Code 5003, the way this condition is rated depends primarily on how much it limits the motion of the joint or joints involved.

How the VA Rates It

Rated first on limitation of motion. Degenerative arthritis established by X-ray findings is rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved (such as DC 5200 and others).

When limitation of motion isn't compensable. When the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10% applies for each major joint or group of minor joints affected by limitation of motion. These are combined — not added — under Diagnostic Code 5003.

Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion.

Rating Levels Based on X-Ray Findings

In the absence of limitation of motion, the condition is rated as follows:

RatingWhat the VA Looks For
20%X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations
10%X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups

Important Notes

  • Note (1): The 20% and 10% ratings based on X-ray findings above will not be combined with ratings based on limitation of motion.
  • Note (2): The 20% and 10% ratings based on X-ray findings above will not be used in rating conditions listed under Diagnostic Codes 5013 to 5024, inclusive.

Key Takeaways

  • X-ray findings are central to establishing this condition.
  • The VA looks first at limitation of motion for the specific joint(s) involved.
  • Where motion loss is noncompensable, a 10% rating may apply per affected major joint or minor joint group, combined under DC 5003.
  • Objective evidence — swelling, muscle spasm, or satisfactory evidence of painful motion — is used to confirm limitation of motion.

These criteria are a rendering of § 4.71a, diagnostic code 5003. The official version is the one that governs your rating.

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What next

How to claim this

Knowing the criteria is the first half. Getting your file to show them is the second.

  1. Find your level in the stack

    Read each rung against what your medical records already say. The level your records document today is the one the VA can support today.

  2. Name the gap

    Look at the rung above yours and write down exactly what it asks for that your file does not show yet — a diagnosis, a measurement, a prescribed brace, a doctor’s opinion linking it to service.

  3. Claim it by code

    File under diagnostic code 5003 and attach the evidence for the level you are asking for. Other Musculoskeletal System codes may cover your secondary conditions.

Find out which rating your evidence supports.

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