Question bout a rating

WindyinKuwait

PEB Forum Regular Member
PEB Forum Veteran
Hi All,

Im the newbie here...litterally. This is all new to me. I am not sure if this is proper place to ask this question, but I was looking for a code for Osteopenia on the VARSD links. I found it for Osteoporosis, but not for osteopenia, which is the early stages of osteoporosis. Im only in my 30's and fractured my femur at the neck {where it goes into your hip} while in Kuwait. Medevac'd to Germany for emergency surgery, then medevac'd home. Eight months later and my fracture still hasnt completely healed. I have three long screws in my femur. Its been a long rode to recovery {had to learn how to walk again}. Anyway, my question is, is there a code/rating for Osteopenia.

Thanks so much for your help,
Windy
 
I have a friend with osteopenia--we searched in vain for the code in the VASRD. When you receive your rating you will receive a "like" rating. Meaning there is not a specific code but your disease is LIKE whatever they rate you as having.

Best of luck to you in your recovery.
 
The literature on the web indicates this diagnosis is contraversial at best. It has to do with bone density. Did they give you a bone density rating of between -1.0 and -2.5? A large section of the population falls into this classification. The closest group in the VASRD is 5013-5024:

"The diseases under diagnostic codes 5013 through 5024 will be rated on limitation of motion of affected parts, as arthritis, degenerative, except gout which will be rated under diagnostic code 5002."

5002 Arthritis rheumatoid (atrophic) As an active
process:
With constitutional manifestations associated
with active joint involvement, totally incapaci-
tating ................................................................. 100

AF Cop
 
The above rating is for rheumatoid arthritis under 5002. Degenerative Arthritis is actually code 5003.
 
The literature on the web indicates this diagnosis is contraversial at best. It has to do with bone density. Did they give you a bone density rating of between -1.0 and -2.5? A large section of the population falls into this classification. The closest group in the VASRD is 5013-5024:

"The diseases under diagnostic codes 5013 through 5024 will be rated on limitation of motion of affected parts, as arthritis, degenerative, except gout which will be rated under diagnostic code 5002."

5002 Arthritis rheumatoid (atrophic) As an active
process:
With constitutional manifestations associated
with active joint involvement, totally incapaci-
tating ................................................................. 100

AF Cop

I looked at the results from my Dexascan and its too complicated to translate what my bone density rating is, but my doctors notes confirm I have Osteopenia. I am on 1500 mg of calicium a day, and I take Caltrate. I have to get a Dexa once I year to keep an eye on it.
I appreciate your help. I will just wait and see what the VA rates this at.
 
The above rating is for rheumatoid arthritis under 5002. Degenerative Arthritis is actually code 5003.

If my code is say 5003 then how do I know what the percentage is for that rating?

Thanks,
Windy
 
Here is the text:

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 code 5013 to 5024, inclusive.
 
Here is the text:

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 code 5013 to 5024, inclusive.

Thanks Jason. On my claim is also, post surgery repair/closed fracture/neck of femur/

Am I looking at the correct rating for the above injury?

5255 Femur, impairment of:


Fracture of shaft or anatomical neck of:


With nonunion, with loose motion (spiral or oblique fracture) ............ 80
With nonunion, without loose motion, weightbearing preserved
with aid of brace............................................. ................................ 60
Fracture of surgical neck of, with false joint...................................... 60
Malunion of:
 
If that is the cause of your unfitness, then yes. If you have that condition and it is not unfitting, you may end up with the arthritis code or the limitation of motion under the affected joint. But, I would argue what ever makes the most sense and is advantageous to your case. Depending on the medical evidence, you may try for both, but it may be "pyramiding" to do so (basically, you can't get rated for overlapping limitation to same anatomy from different disease/injuries).
 
If that is the cause of your unfitness, then yes. If you have that condition and it is not unfitting, you may end up with the arthritis code or the limitation of motion under the affected joint. But, I would argue what ever makes the most sense and is advantageous to your case. Depending on the medical evidence, you may try for both, but it may be "pyramiding" to do so (basically, you can't get rated for overlapping limitation to same anatomy from different disease/injuries).

Yes this is the case of my unfitness. I fractured my femur in Kuwait and was medevac'd to Germany for emergency surgery. I have three long screws in my femur that are never coming out. This was a LOD injury. This happened in Jan 08 and eight months later the fracture still hasnt completely healed. My doctor may initiate a medboard on me. Thank you for your help.
 
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