Rheumatoid arthritis, or more commonly known as RA, is an autoimmune disease in which the body’s immune system mistakenly attacks the joints. Different from degenerative arthritis, rheumatoid arthritis is an autoimmune condition seen quite often among active duty service members or former military service members. While not all cases of rheumatoid arthritis will have a service connection, some do and should be brought to the attention of the Department of Veterans Affairs.
What is rheumatoid arthritis?
Rheumatoid arthritis, or RA, is an autoimmune disease in which the body’s immune system mistakenly attacks the joints. A normal, healthy immune system operates by protecting the body and itself by attacking foreign substances such as bacteria and viruses. Rheumatoid arthritis is a form of arthritis that creates inflammation that causes the tissue lining the inside of the joints to swell. This swelling will result in pain in and around the affected joints.
Joins affected by rheumatoid arthritis?
Rheumatoid arthritis is most commonly seen affecting the joints of the hands, feet, wrists, elbows, knees, and ankles. Rheumatoid arthritis in the wrists and hands can sometimes be mistaken for soreness due to over-usage but will persist much longer and degrade the joint over time. In most cases RA will affect the joints bilaterally, meaning if you have RA in your right hand, then you will most likely also have it in your left hand.
Symptoms of Rheumatoid Arthritis
Initially, people with RA may not see their symptoms. At first, most veterans may come to the conclusion that a VA disability claim is not necessary but after years of continued weight-bearing use, the pain can become more intense. Some people may experience the following symptoms:
- Pain in major joints, minor joint pain, tenderness, swelling, or stiffness for 6 weeks or more
- Morning stiffness lasting 30 minutes or more
- Fatigue
- Flexion or loss of joint mobility
- Episodes of exacerbations
- Loss of appetite & Weight loss
- Low-grade fever
If the inflammation caused by RA goes unchecked, it can cause damage to cartilage and to the bones. Over time there is a loss of cartilage, which caused the joint spacing between the bones to become smaller. This can result in joints becoming loose, unstable, and painful. In addition to the pain that some veterans undergo, there is also a high risk that RA will lead to a loss in their mobility. Joint deformity also may occur which is non-reversible.
Rheumatoid arthritis can also affect other body systems such as the respiratory and cardiovascular systems. In this case, the body’s immune system allows foreign cells to thrive and accidentally targets beneficial cells that would typically fight off pleural diseases.
How the VA Rates Rheumatoid Arthritis and Degenerative Arthritis
Any rheumatoid arthritis that is less severe than the above-listed symptoms is just rated on its own, such as limited motion. RA can come in all levels of No combined rating will apply.
Rheumatoid Arthritis is rated under Diagnostic Code 5002. RA can be evaluated at up to a 100 percent disability rating which is not common amongst service-connected health ailments. A 100 percent VA disability rating can be given if the medical condition results in the veteran becoming bedridden or completely incapacitated.
Even if the veteran is not fully bedridden or incapacitated, other lower ratings can be given for individuals suffering from the limitation of motion, osteoarthritis, inflammatory pain, musculoskeletal pains, and more. Other lower than 100 percent ratings will be assigned for occasional incapacitating episodes. The rating schedule for the VA is as follows:
VA Ratings for Rheumatoid Arthritis (RA)
- 100 percent: Total incapacitating rheumatoid arthritis symptoms – total disability may require an x-ray or x-ray evidence and can often bring up the possibilities of residuals.
- 60 percent: four or more incapacitation episodes per year or experiencing weight loss, anemia, and a decline in health. A decline in health can include functional loss of use of limbs, evidence of painful motion, and more.
- 40 percent: three or more incapacitating episodes per year or a definitive impairment in overall health.
- 20 percent: Will apply to any vet with two or more incapacitating episodes per year
It is important to note that these ratings cannot be used in addition to other ratings for limited motion to accrue more VA disability benefits. Any rheumatoid arthritis that is less severe than the above-listed symptoms is just rated on its own, such as limited motion or other rheumatic diseases. This means that these symptoms can be rated under their own specific diagnostic code for each major or minor group of joints. A minimum of 10 percent is given for every joint that has pain with motion. In order to be rated under the different diagnostic codes, a limited range of motion must be confirmed with symptoms of swelling, painful motion with evidence, and muscle spasms.
