How to Get VA Disability for Bursitis (Hip, Shoulder, Knee, and Elbow Ratings Explained)
CCK Law: Our Vital Role in Veterans Law
Due to the strain military service can cause to the body, many veterans end up developing an inflammation of the joints called bursitis. Painful, frustrating, and sometimes disabling, bursitis can impact a veteran’s ability to exercise, work, or even comfortably move their body.
If you suffer from service-connected bursitis, then you may qualify to earn monthly compensation from VA. This article will cover key aspects of the claims process so you can earn a correct and prompt bursitis VA rating.
Key Features
- How to establish service connection and gain VA disability for bursitis
- Explanations of the VA disability ratings for bursitis
- What to expect from a VA examiner during your C&P exam
- And more
What Does VA Consider Bursitis?
Bursitis occurs when small fluid-filled sacs that cushion the bones and muscles near joints, called bursae, become inflamed. This inflammation is usually caused by repetitive motion of the joint, but can also be brought on by injury or infection.
Bursitis is commonly experienced at the shoulder, elbow, knee, and hip joints, but can also affect other joints of the body. Typical symptoms include:
- Dull ache or sharp pain when moving the joint
- Swelling
- Joint stiffness
- Tenderness
- Redness or discoloration of joint
- Limited range of motion of the affected joint
When it comes to treating minor bursitis, doctors often recommend resting the joint to allow the bursae to heal. To help with pain and swelling, they may suggest applying heat or ice to the joint or taking over-the-counter painkillers like ibuprofen.
While resting the joint may relieve symptoms, recurrent flare-ups may occur, especially if you resume normal activity too quickly. For more serious cases of bursitis, your doctor might recommend physical or occupational therapy, antibiotics to treat a potential infection, or even corticosteroid injections to reduce inflammation.
Why Are Veterans Prone to Bursitis?
Due to the often physically intense nature of positions in the military, bursitis is a fairly common complaint from veterans after being discharged from service.
The types of bursitis that veterans usually suffer—and their causes—include:
- Shoulder bursitis – Consisting of a sharp or pinching pain in the shoulder, this form of bursitis can be brought on in veterans by misuse or overuse of the shoulder when carrying heavy loads, or the recoil produced when firing a rifle.
- Hip bursitis – Most commonly causing pain on the exterior of the hip, hip bursitis can develop in veterans due to excessive running, standing, or climbing, among other reasons like impacts or injuries to the hip.
- Elbow bursitis – Often beginning as a tender red bump on the tip of a veteran’s elbow, elbow bursitis can be caused by injury, overuse of, or repeated pressure applied to the elbow.
- Knee bursitis – Consisting of redness, swelling, pain, and dysfunction in the knee, knee bursitis can develop in veterans due to frequent crouching, bending, or running, as well as injury to the knee from falls or accidents.
Establishing Service Connection for Bursitis
If you are a veteran suffering from bursitis, the first step to gaining disability benefits from VA is to prove that your condition was somehow caused by your military service. This is called service connection, and there are two types.
Direct Service Connection for Bursitis
Direct service connection is when you can prove that your bursitis either developed during military service or was made worse by your service.
VA requires three key components to establish a direct service connection:
- A current diagnosis of bursitis – This is usually offered by a qualified medical professional.
- An in-service incident, injury, or illness – This serves as the potential source of your bursitis. Often, documentation from your time in service that supports this occurrence can strengthen your case.
- A medical nexus – This is a medical opinion linking your bursitis to the in-service event or injury. Typically written by a doctor or other professional, this statement must indicate that your bursitis is “at least as likely as not” related to your military service.
Secondary Service Connection for Bursitis
A secondary service connection may be established when a veteran can show that their bursitis developed as a result of another condition already deemed service-connected by VA.
For instance, imagine a veteran sustains a back injury from a serious fall during their time in service, and that VA acknowledges this back injury as service connected and compensates the veteran accordingly.
Now, if the resulting chronic back pain alters the veteran’s posture or gait, it could eventually lead to bursitis in the knees. In such a case, the veteran could file a claim linking the bursitis to the original back injury. If approved, the bursitis would be considered secondary service connected, making the veteran eligible for additional VA disability benefits.
How Does VA Rate Bursitis?
As with many conditions involving joints, ratings for bursitis are typically given based on limitations of a joint’s range of motion rather than for the condition itself.
Bursitis has a diagnostic code, 5019, which states that bursitis should be rated based on limitation of motion, such as with degenerative arthritis. Under this code, a veteran’s bursitis can be rated at 10 percent to 20 percent, based on symptom severity.
However, VA may also choose to rate your bursitis based on diagnostic codes covering the specific body part that is affected by your condition. The ratings for different kinds of bursitis are described in the sections below.
Shoulder Bursitis VA Ratings
Veterans with shoulder bursitis can be rated under diagnostic codes 5200-5203. Ratings range from 10 percent to 80 percent based on the seriousness of the condition, how impaired a veteran’s range of motion is, and whether it is the dominant or non-dominant arm that is affected.
Each of these codes corresponds to a different portion of the shoulder. These body parts, their codes, and the percentage ranges for shoulder bursitis VA ratings are listed below:
- Scapulohumeral articulation (5200): 30 percent, 40 percent, or 50 percent for dominant arm; 20 percent, 30 percent, or 40 percent for non-dominant arm
- Arm (5201): 20 percent, 30 percent, or 40 percent for dominant arm; 20 percent, 20 percent, or 30 percent for non-dominant arm
- Humerus (5202): 20 percent – 80 percent for dominant arm; 20 percent – 70 percent for non-dominant arm
- Clavicle or scapula (5203): 10 percent – 20 percent for both dominant and non-dominant arms
For example, using code 5201 above, veterans who are unable to lift their dominant arm more than 25 degrees can receive the highest schedular disability rating of 40 percent for limitation of motion of the arm. Non-dominant shoulder bursitis with the same limitation would warrant a rating of 30 percent.
Watch CCK Law attorneys discuss VA disability ratings for shoulder and arm conditions:
Hip Bursitis VA Ratings
For hip bursitis, VA rates veterans using diagnostic codes 5250-5255. These codes cover a range of motion in the hip, level of pain, and even discrepancy in limb length caused by poor hip positioning.
The codes and percentage ratings for hip bursitis VA ratings include:
- Hip, ankylosis of (5250): 60 percent – 90 percent
- Thigh, limitation of extension, or straightening (5251): 10 percent
- Thigh, limitation of flexion, or bending (5252): 10 percent – 40 percent
- Thigh, impairment of (5253): 10 percent – 20 percent
- Hip, flail joint (5254): 80 percent
- Femur, impairment of (5255): 60 percent – 80 percent
As an example of using the above codes, under code 5250, if a veteran’s hip is ankylosed in flexion between 20° and 40°, a 60 percent rating applies.
On the other hand, if their bursitis is so severe that one of their feet cannot touch the ground, they may instead be rated at 90 percent. Notably, if a veteran receives this 90 percent rating for hip bursitis, then they become eligible for Special Monthly Compensation (SMC) to increase their monthly benefits.
Elbow Bursitis VA Ratings
VA rates limited motion for elbow bursitis under diagnostic codes 5205-5212. Depending upon which body parts and motions are affected and whether it is the dominant arm that is impaired, rates can range from 0 percent to 60 percent.
Below are listed the body parts, motions, codes, and percentage ranges for specific elbow bursitis VA ratings:
- Elbow, ankylosis of (5205): 40 percent – 60 percent for dominant arm; 30 percent – 50 percent for non-dominant arm
- Forearm, limitation of flexion, or bending (5206): 0 percent – 50 percent for dominant arm; 0 percent – 40 percent for non-dominant arm
- Forearm, limitation of extension, or straightening (5207): 10 percent – 50 percent for dominant arm; 10 percent – 40 percent for non-dominant arm
- Forearm, flexion limited to 100 degrees and extension to 45 degrees (5208): 20 percent for both dominant and non-dominant arms
- Elbow, other impairment (5209): 20 percent – 60 percent for dominant arm; 20 percent – 50 percent for non-dominant arm
- Radius and ulna, nonunion of (5210): 50 percent for dominant arm; 40 percent for non-dominant arm
- Ulna (5211): 10 percent – 40 percent for dominant arm; 10 percent – 30 percent for non-dominant arm
- Radius (5212): 10 percent – 40 percent for dominant arm; 10 percent – 30 percent for non-dominant arm
For example, code 5206 refers to the limitation of flexion (bending) of the elbow. Under code 5206, if a veteran only has the capacity to bend their dominant elbow to 45 degrees, then they would receive a 50 percent rating from VA, or a 40 percent for their non-dominant elbow.
Watch CCK Law attorneys discuss orthopedic VA ratings:
Knee Bursitis VA Ratings
VA rates knee bursitis under diagnostic codes 5256-5262. These codes can indicate several different disorders of the knee, including limitations on straightening or bending the knee joint, as well as dislocation, instability, and more.
Depending on your specific symptoms, the codes and percentage ranges for knee bursitis VA ratings can be:
- Knee, ankylosis of (5256): 30 percent – 60 percent
- Knee, other impairment of (5257): 10 percent – 30 percent
- Semilunar cartilage, dislocation of (5258): 20 percent
- Semilunar cartilage, removal of (5259): 10 percent
- Leg, limitation of flexion, or bending (5260): 0 percent – 30 percent
- Leg, limitation of extension, or straightening (5261): 0 percent – 50 percent
- Tibia and fibula, impairment of (5262): 0 percent – 40 percent
For example, using the codes above, code 5260 covers limitations on a veteran’s ability to bend their knee. If the veteran can bend their knee to 30 degrees, then they might receive a rating of 20 percent. If they can only bend it to 15 degrees, however, then they would likely receive a 30 percent rating.
VA Compensation & Pension (C&P) Exams for Bursitis
A Compensation and Pension (C&P) exam is a medical assessment conducted by a VA-approved healthcare provider or contracted VA examiner. These evaluations are essential in helping VA determine whether a veteran’s medical condition is linked to their military service—either directly or secondarily. If a connection is found, the C&P exam also provides the information needed to assign an appropriate disability rating.
During an exam for bursitis, the VA examiner will likely conduct a physical assessment with a goniometer to determine a veteran’s range of motion of the affected joint. They might also inquire about a veteran’s level of pain or discomfort, any injuries they have suffered to the joint, and their military service history. They may also ask about how a veteran’s bursitis affects their activity level, daily routines, and overall quality of life.
It’s critical to be truthful and detailed when discussing your symptoms. Clearly explain how seriously your bursitis affects your life and describe how its symptoms disrupt your ability to work, move, or exercise.
Watch CCK Law attorney Alyse Phillips discuss “Range of Motion Measurements at VA C&P Exams”:
Total Disability Based on Individual Unemployability (TDIU) for Bursitis
Veterans who are unable to obtain or maintain substantially gainful employment due to their service-connected bursitis may be eligible for Total Disability based on Individual Unemployability (TDIU). This benefit allows veterans who do not meet the 100 percent disability rating to receive compensation at the 100 percent rate.
There are two main avenues through which a veteran can qualify for TDIU:
- Schedular TDIU – Veterans may be eligible under this route if they meet one of the following conditions:
- A single service-connected disability is rated at 60 percent or more, or;
- They have a combined rating of at least 70 percent, with one of those conditions rated at a minimum of 40 percent.
- Extraschedular TDIU – Even if the above rating thresholds aren’t met, a veteran may still qualify. Under the “extraschedular” pathway, VA’s Director of Compensation Service may approve TDIU for a veteran if their service-connected bursitis makes it unrealistic for them to maintain meaningful employment.
When evaluating a disability claim involving bursitis, VA should consider whether the veteran is unable to work and, therefore, may be entitled to TDIU. Alternatively, veterans may proactively file a separate claim for TDIU consideration.
Was Your VA Disability Claim for Bursitis Denied or Underrated?
The experienced, VA-accredited attorneys and advocates at Chisholm Chisholm & Kilpatrick LTD have spent decades successfully representing veterans and their families before VA and the Court of Appeals for Veterans Claims. Let us put our experience to work for you. Contact us at (800) 544-9144 to tell us about your case.
