VA Disability Rating for Hip Pain
Joining the U.S. military gives you the opportunity to serve and protect our country. However, military service isn’t easy, and many veterans experience physical and mental disabilities due to the grueling nature of the job. One common ailment is hip pain, which can arise from conditions like arthritis and osteoporosis. Veterans Guide explains how to obtain a VA rating for hip pain, which allows you to collect VA disability compensation.
When you first joined the military, your intentions were honorable. You wanted to serve the country and protect our national interests. A military career is something to be very proud of, and veterans can expect appreciation for their time in service.
However, military service can be tough on your health. Many service members experience injuries or develop physical or mental disabilities as a direct result of their work. One common condition is hip pain, which often occurs following an injury or over time due to the physicality required in most military jobs. The Department of Veterans Affairs (VA) recognizes hip pain as a consequence of military service, and eligible veterans may obtain a VA rating for hip pain conditions.
Veterans and Hip Pain
Hip pain can develop from injuries to the body or due to wear and tear of joints caused by the physical nature of many military roles. Risk factors for hip pain include the following:
- Repetitive stress on the hips from physical activity
- Hip injury caused by a fall or blunt trauma
- Diseases of the spine or bones, such as scoliosis or arthritis
- Surgery to the spinal region or areas around the hip
- Bone spurs on the tendons that attach to the trochanter
- Differences in the length of the legs
Veterans who suffer from hip pain may have minor aches they can treat with over-the-counter medication or severe pain that prevents them from walking or performing everyday activities. Hip pain isn’t something to ignore. Left untreated, it can cause further problems in other areas of the body, like the spine and knees. It may also be a symptom of serious conditions like arthritis or bursitis. In severe cases of hip pain, a hip replacement may be required.
If you notice symptoms of hip pain, like pain on the outside of your hip, upper thighs, or outer buttocks, it’s smart to seek help from a physician. A qualified physician can evaluate your condition to find the cause of your pain and recommend a treatment plan. If your hip pain is service-connected, you’ll want to ensure you have medical records documenting any specific incidents that resulted in your condition.
How does the VA rate hip pain?
The VA rates several conditions related to hip pain under its schedule of ratings for the musculoskeletal system.
Ankylosis is a condition that results in stiffening or immobility of the hip joints due to trauma, overuse, or disease. People who experience ankylosis of the hip will likely notice pain in the lower back, hips, and through the legs and knees. Hip pain caused from ankylosis is rated under Diagnostic Code 5250.
- 90% rating – extreme cases of ankylosis, where the veteran cannot touch both feet on the ground and requires crutches to move
- 70% rating – intermediate cases of ankylosis
- 60% rating – veterans who maintain some flexibility of their hips at an angle between 20-40 degrees
Osteoarthritis refers to inflammation of the hip joints and surrounding soft tissues. Typically, osteoarthritis develops due to overuse of the hip joints from activities like running or carrying heavy equipment. Overuse results in degeneration of the cartilage that protects the joints during movement. The VA will use Diagnostic Code 5003 to rate hip pain caused by osteoarthritis.
- 20% rating – if the veteran’s X-rays show osteoarthritis of two or more major joints or minor joint groups and their condition results in occasional incapacity. For instance, if the veteran requires periodic hospital care or documents times when they cannot walk due to osteoarthritis-induced hip pain, they may qualify for 20% disability.
- 10% rating – veterans with X-rays demonstrating osteoarthritis in two or more major joints or minor joint groups but with no documented incidents resulting in incapacity
Occasionally, hip pain is severe enough to warrant a hip replacement. A service member or veteran who requires a service-connected hip replacement will automatically receive a 100% disability rating for the first four months following their surgery. After the four months pass, they’ll undergo an examination to determine whether they continue to qualify for disability. The VA rates hip replacements under Diagnostic Code 5054.
- 90% rating – a veteran who continues to experience hip pain upon motion and requires crutches
- 70% rating – individuals who do not need crutches but exhibit severe residual weakness and limitation of movement
- 50% rating – veterans with moderate residual weakness that limits motion and causes pain
- 30% rating – individuals who have minimum problems following a hip replacement.
TDIU and Hip Pain
It’s possible to qualify for Total Disability Individual Unemployability (TDIU) if you’re a veteran with a service-connected disability that causes hip pain. TDIU allows veterans to receive disability compensation at the same rate as a veteran with a 100% disability rating. To qualify for TDIU, you’ll need to meet either of the below conditions in addition to proving that you can’t work:
- At least one service-connected disability with a minimum rating of 60%
- At least two service-connected disabilities, where one has a minimum rating of 40% and the combined rating of all disabilities is at least 70%
In addition to meeting the disability rating requirements, veterans must show they cannot work. For instance, if your conditions result in frequent hospitalizations or times when you cannot function normally, the VA may declare you eligible for TDIU.
Hip Pain as a Secondary Disability
In some cases, hip pain may be the result of another disability. For instance, a veteran with service-connected cancer, like leukemia or bone cancer, or who suffers from osteomyelitis may experience hip pain as a direct result of their illness. Pinched nerves in the neck or spinal region due to sacroiliitis or sciatica may also cause hip pain.
Some conditions require veterans to take medications that can result in osteoporosis. Pharmaceuticals used to manage symptoms of epilepsy and post-traumatic stress disorder can potentially cause osteoporosis. Veterans with service-connected conditions taking medications with osteoporosis as a side effect should see a physician if they experience hip pain.
If you have a disability rating for another condition and believe your hip pain is caused by it, the VA may increase your rating accordingly.
How To Obtain VA Disability Compensation for Hip Pain?
Veterans who can demonstrate a service-connected condition or a secondary condition that causes hip pain may file a claim for compensation with the VA. Once the VA receives your claim, they’ll likely schedule you for a Compensation and Pension exam (C&P). During your C&P appointment, your examiner will review your medical records and conduct a thorough physical to understand the severity of your disability.
Your examiner will complete the Disability Benefits Questionnaire for Hip and Thigh Conditions. The questionnaire requires the examiner to list any medical diagnoses you have for your condition. They’ll also observe your range of motion and whether you need additional assistance for normal movements, such as walking. They may also order diagnostic tests, such as an X-ray.
It would be best if you prepared for your C&P exam by gathering all your medical and service records relating to your hip pain and resulting condition. If you have a private physician, ask them to provide you with a nexus letter establishing a connection between your disability and your time in service. A nexus letter helps the VA evaluate whether your condition is genuinely service-related.
After your C&P exam, the provider will submit the questionnaire and any supporting documentation to the VA. It generally takes three to four months to receive your results from the VA.
If you have additional questions regarding a VA rating for hip pain, contact Veterans Guide. We’ll help you with any inquiries you have.
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