Veterans with osteomyelitis may be eligible for VA disability benefits under §4.43 Osteomyelitis. In plain English, VA is essentially saying that chronic, or recurring, suppurative osteomyelitis is a condition that will always disable you. It is a continuous process that may not always have an active sinus or other sign of infection. If the focus of the infection is not entirely removed by amputation, then you will be given a permanent rating that can be combined for residuals no greater than amputation.
This article will explore how the VA rates disabilities for osteomyelitis and what evidence is necessary to establish service connection.
What is Osteomyelitis?
Osteomyelitis is a serious infection of the bone. It can occur in any bone in the body, but is most common in the long bones of the arms and legs. Osteomyelitis can be caused by bacteria, fungi, or other organisms.
Symptoms of Osteomyelitis
The symptoms of osteomyelitis vary depending on the location and severity of the infection. Common symptoms include pain, swelling, redness, warmth, and tenderness over the infected bone. Fever and chills may also be present.
What if osteomyelitis is untreated?
If osteomyelitis is not treated, it can lead to serious complications including bone damage, sepsis (a life-threatening condition caused by infection), and amputation.
What is the treatment for Osteomyelitis?
Osteomyelitis is typically treated with antibiotics and, in some cases, surgery. The goal of treatment is to eradicate the infection and prevent complications.
Service Connection for Osteomyelitis
VA disability ratings for osteomyelitis are based on the severity of the condition. VA rating schedules provide a range of 0% to 100% for different levels of disability.
In order to establish service connection for osteomyelitis, the veteran must provide evidence of:
- A current diagnosis of osteomyelitis
- Active duty or military service exposure to an event or injury that resulted in osteomyelitis
- A link between the current diagnosis of osteomyelitis and the event or injury during military service
Osteomyelitis and Military Service
There are a few different ways that osteomyelitis can be related to military service. The most common is if the veteran has a history of trauma, such as a fracture, open wound, or surgery. Osteomyelitis can also develop secondary to another condition, such as diabetes mellitus or sickle cell anemia, which may be service connected. If the veteran does not have a history of trauma, but develops osteomyelitis within one year of discharge from service, it may be possible to establish service connection based on the “in-service event.”
Compensation and Pension Exam for Osteomyelitis
A Compensation and Pension (C&P) exam is usually required by VA to establish a diagnosis of any medical condition such as osteomyelitis. The exams typically include going over your medical history and a physical examination. The doctor will also likely order lab tests and x-rays to help make the diagnosis.
VA Disability Rating for Osteomyelitis
The VA disability rating for osteomyelitis ranges from 0% to 100%, depending on the severity of the condition under VA Diagnostic Code 5000. Let’s go over each of the va ratings for osteomyelitis now:
- 100% VA Rating for Osteomyelitis: The VA will give a 100% rating if your osteomyelitis is in your pelvis, vertebrae, or affects major joints. If it is in more than one place or it has been a problem for a long time and makes you weak and sick, you may also get a 100% rating.
- 60% VA Rating for Osteomyelitis: Frequent episodes, with constitutional symptoms
- 30% VA Rating for Osteomyelitis: If someone has osteomyelitis, and there is a sequestrum or involucrum present, regardless of sinus discharge then their rating should qualify for 30%.
- 20% VA Rating for Osteomyelitis: If there is evidence of discharging sinus or any other evidence of active infection within the past 5 years, then a 20% rating should be given for osteomyelitis.
- 10% VA Rating for Osteomyelitis: The person has not had any active infections in the past 5 years.
TDIU for Osteomyelitis
If you are unable to work because of your osteomyelitis, you may be eligible for Total Disability Individual Unemployability (TDIU) benefits. To qualify, you must have a VA disability rating of 60% or higher and be unable to engage in meaningful work duties. TDIU allows veterans to be awarded 100% rating compensation, even if their rating is technically lower than 100%. This is a good thing because there are many severe disabilities like osteomyelitis that can affect veterans in such unique ways that can’t all be accounted for in the regulations; we’re humans after all.
If you feel like your claim was denied unjustly then please give us a call regarding a free case evaluation on claims with active rating decisions.
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