Tennis elbow, which doctors also refer to as elbow tendonitis or lateral epicondylitis, causes pain when you use the affected arm to complete ordinary movements. The most typical cause of tennis elbow is repetitive motions of the arm and wrist. Pain and stiffness are the primary symptoms of tennis elbow, which makes it challenging to complete these activities:
- Grip an object such as a pen or using a doorknob
- Shake hands
- Hold a cup of coffee
Despite the name tennis elbow, playing tennis is not the only way people develop this painful condition. Occupations that require repetitive use of a computer mouse, cutting, painting, or using tools also increase the risk of damaging the tendons in your elbow.
However, any repetitive activity that involves repeated contraction of the forearm muscles increases the risk. Veterans are particularly vulnerable to this condition because of the intense physical activity they engage in most days.
In this article we will discuss the VA rating for tennis elbow and how to file a claim for disability benefits.
Service Connection for Tennis Elbow
The Department of Veterans Affairs (VA) requires veterans applying for disability pay to meet each of the three criteria outlined below:
- A current diagnosis of elbow tendonitis.
- Proof of your diagnosis via X-ray reports, doctor’s notes, prescriptions, and items you purchase to accommodate your forearm and elbow injuries.
- A medical nexus that connects your current diagnosis of elbow tendonitis to a specific in-service event.
When submitting your application, you must provide precise details of how you developed tennis elbow to be awarded a VA disability rating. One example is a vehicle crash during your time in service that caused your arm to move forward at a high speed and possibly struck an object and you’ve had pain ever since.
Secondary Service Connection for Tennis Elbow
When a condition develops in response to a primary service-related disability, the VA considers it a secondary service connection.
For example, you may have developed a lower back disability first and later, over compensated with your elbow and forearm, and developed tennis elbow because you did not bend at the knees and use your back when lifting heavy objects. You now have chronic pain in two areas of the body and require compensation for it.
Service Connection by Aggravation | What if you received a diagnosis of tennis elbow before military service?
The term service connection by aggravation means that you had tennis elbow before the military and your service made it worse. You must prove that it progressed more rapidly because of military service than it would have otherwise. The VA requires medical documentation for service connection by aggravation just as it does for primary or secondary conditions.
You are only eligible for VA disability benefits in this situation if the worsening of your tennis elbow symptoms is permanent. Even if your symptoms worsen temporarily, the VA will deny your request for disability compensation on the assumption they will eventually improve. You need written medical documentation to prove that is not the case.
Compensation & Pension (C&P) Exams for Tennis Elbow
VA claims examiners require some applicants for disability payments to undergo a Compensation & Pension (C & P) exam if they feel they need more information to finish processing the claim. You will need to schedule an appointment with a VA doctor if you receive a letter informing you that you need to complete a C & P exam.
C & P exams differ considerably from regular medical exams. Although VA doctors ask several questions about symptoms at these appointments and preform a physical examination, they do not offer any treatment advice. Some of the questions and conditions your examiner might ask and look at include:
- painful motion
- physical therapy
- past forearm injury
- past elbow and forearm injuries
Keep in mind that the doctor will record everything you say, so be concise in your answers without saying anything that could work against you.
The VA will send a letter via postal mail informing you of the decision on your VA ratings and disability claim about three to four months after your C & P exam.
You can track your veterans disability ratings claim online at the VA website in the meantime. The complexity of your case, how many disabilities you claim, and the VA’s current backlog all contribute to how long it takes to get back to you after a C & P exam.
If you receive an unfavorable result from the VA after your C& P exam, you can appeal by writing to the VA explaining why you feel the exam was inadequate. You can also visit your own doctor for a second opinion and have people with significant knowledge about your condition write to the VA on your behalf.
If you are nervous about your C&P exam, schedule a call with a VA representative or an attorney. With an attorney you have the benefit of an attorney client relationship, so anything you say to your attorney is completely private, and undiscoverable by the VA.
Evidence for Tennis Elbow Claims and Appealing under the AMA system
Medical evidence is crucial when submitting a claim to the VA. You need to have a current diagnosis and prove that your military service caused your primary or secondary service connected condition or made a pre-existing condition worse.
You can also consider asking your doctor to write a letter to the VA explaining how your condition affects your daily life due to severe pain as this will strengthen your claim.
Here are some other types of evidence you can submit with your VA disability claim for tennis elbow:
- A letter from your current employer explaining that you can no longer perform the duties of your job due to your injury.
- Letters from your spouse or close friends who see the impact your injury has on you on a regular basis.
- X-rays and lab reports from your doctor.
If you need to appeal an unfavorable decision regarding disability pay, the VA will subject your appeal to the Veterans’ Appeals Improvement and Modernization Act (AMA) that went into effect in 2019. AMA replaces the Legacy Appeals Process and provides a more streamlined approach for veterans.
Under the AMA, you can choose one of the following lanes to appeal a VA denial:
- Higher-level review lane: You request that a more experienced claim reviewer process your claim.
- Supplemental claim lane: You submit new evidence to bolster your disability claim.
- Notice of disagreement lane, or appeal to the Board of Veterans’ Appeals: You appeal your denial directly to the board and await their instruction regarding whether they will hear an evidence docket, hearing docket, or direct docket.
How Does the VA Rate Tennis Elbow?
Ratings for tennis elbow typically fall under the Musculoskeletal System of Ratings. The VA will assign one of three diagnostic codes to your disability, which are 5206, 5207, or 5208. Each VA diagnostic code has unique ratings associated with it. The higher number refers to the dominant arm, while the lower number refers to the non-dominant arm.
Diagnostic Code 5206: Forearm with flexion limited
Ratings for this diagnostic code include:
- 50/40 percent: Flexion limit is 45 degrees
- 40/30 percent: Flexion limit is 55 degrees
- 30/20 percent: Flexion limit is 70 degrees
- 20/20 percent: Flexion limit is 90 degrees
- 10/10 percent: Flexion limit is 100 degrees
- 0/0 percent: Flexion limit is 110 degrees
Diagnostic Code 5207: Forearm with extension limited
Ratings for this diagnostic code include:
- 50/40 percent: Extension limit is 110 degrees
- 40/30 percent: Extension limit is 100 degrees
- 30/20 percent: Extension limit is 90 degrees
- 20/20 percent: Extension limit is 75 degrees
- 10/10 percent: Extension limit is 45 degrees
Diagnostic Code 5208
The VA assigns a 20 percent disability rating if your forearm flexion does not extend past 100 degrees and your forearm extension does not extend past 45 degrees.
Special Rating for Bilateral Tennis Elbow
If your doctor has formally diagnosed elbow tendonitis in both elbows, the VA adds the two percentages it assigned you together and places an extra 10 percent on top of that for your final, higher rating.
TDIU for Tennis Elbow
Total Disability Rating based upon Individual Unemployability (TDIU) is a VA benefit available to veterans whose disability prevents them from obtaining or maintaining gainful employment. You do not need to have a 100 percent disability rating for TDIU, and you may also qualify if you can work but earn below the current federal poverty line.
Qualifying for TDIU can be difficult because you must meet several criteria. For example, you must have a disability rating of at least 60 percent for your tennis elbow and at least 70 percent for two or more disabilities.
Contact Hill & Ponton for Help with Your Tennis Elbow VA Disability Claim
Hill & Ponton, a veterans’ disability law firm with several satellite locations around the country, is available to assist with your appeal. Please contact us at 1-888-477-2363 or complete this short, free case evaluation form and we will follow up with you.
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