Help understanding rating code 5003

[saxman]

I need help understanding rating code 5003.  I was rated 10 percent for a both my hands under this code for arthritis.  My question is I know it said for group of minor joints, but is that for each group minor joints meaning each group of each hand or all meaning both hands together?  If it is for each hand then it should be 10 percent for each hand because each hand is a minor group of joint. 

[gs106]

Saxman, the way I understand it is if there is xray evidence of arthritis and there is no limited or painful motion or no incapacitating episodes then the rating for two or more major joints or two or more groups of minor joints is 10%. This is from M21-1 and the award is 10% for both knees and not 10% for each knee.  If your arthritis were in only one hand then it would be rated at 0%..

III.iv.4.A.8.b.  Example of DegenerativeArthritisEvaluated Based on X-Ray Evidence Only

Situation:  The Veteran has x-ray evidence of degenerative arthritis of both knees without limited or painful motion of any of the affected joints, or incapacitating episodes. Coded Conclusion:   1. SC (PTE INC)   5003 Degenerative arthritis of the knees, x-ray evidence 10% from 12-30-01   Rationale: There is no limited or painful motion in either joint, but there is x-ray evidence of arthritis in more than one joint to warrant a 10-percent evaluation under 38 CFR 4.71a, DC 5003.

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III.iv.4.A.8.c.  Example of Noncompensable DegenerativeArthritis of a Single Joint

Situation:  The Veteran has x-ray evidence of degenerative arthritis of the right knee without limited or painful motion. Coded Conclusion:   1. SC (PTE INC)   5003 Degenerative arthritis, right knee, x-ray evidence only 0% from 12-30-01     Rationale: There is no limited or painful motion in the right knee or x-ray evidence of arthritis in more than one joint to warrant a compensable evaluation under 38 CFR 4.71a, DC 5003.

 

 

[Tbird]

http://www.ecfr.gov/cgi-bin/text-idx?SID=7d0af00bd6c9cb96254a5a94bf46bbc4&mc=true&node=se38.1.4_171a&rgn=div8

5003   Arthritis, degenerative (hypertrophic or osteoarthritis):
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:
With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations	20
With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups	10
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.

[saxman]

Thanks gs 106 and Tbird

[MarineSSgt]

I recently found out that I have "Mild Tri-compartmental Osteoarthritis with a small joint effusion" in my right knee and I have "Quadriceps insertional enthesopathy is present". Having been 3 years retired from the Marine Corps I KNOW that this had to be attributed from running and running long distance (minimum 3 miles) consistently for 20 years and "humping" 20-30 miles with 60-70 packs on those days that called for it every time we went to the "field"???

I don't think that I have anything in my medical records that could relate to having any problems in my right knee. My question is that because osteoarthritis does not happen overnight... Can I file a claim and service connect this condition to military service???

Any information will help me in trying to claim this from the VA.

[broncovet]

Saxman:  

These are great answers! Especially Tbird and GS106!

Marine:  

I would prefer you ask your quesion in another topic since it borders on "hijacking".  However, since your question was so close to that of the OP, I will answer. (But others may not, so you still should repost your qestions in a new topic)  

Its not enough YOU KNOW that your problems are from running long distances in the Marine Corps, even tho I would agree with you!  Unfortunately, our opinion to VA is useless.  You have to have a medical opinion which states "your (current diagnosis) is at least as likely as not due to running long distances in the USMC."

In other words, you need a doctors opinion, called a nexus.  You need to order your cfile, and see if a doc already made same opinion, and, if not, you can get an IMO/IME to render such opinion.  Absent this medical opinion, you have almost zero chance of getting this service connected.   

 

[MarineSSgt]

Thank you. I am still getting used trying to post to the right topic for my VA issues. I will repost this question in a new topic.