Arthritis is one of the most common chronic conditions affecting veterans. Years of physical strain, training, and injuries during military service often lead to long-term joint damage. Arthritis can cause significant pain, stiffness, limited mobility, and additional physical challenges.
At Kerr Robichaux & Carroll, our disability team helps disabled persons navigate both VA disability benefits and Social Security Disability Insurance (SSDI). Understanding how each system evaluates arthritis and how to present a strong claim can make all the difference in securing the benefits you deserve.
How the VA Rates Arthritis
The VA uses specific diagnostic codes to rate arthritis severity and its impact on joint function.
Degenerative Arthritis (Osteoarthritis) — Diagnostic Code 5003
Ratings focus on the limitation of motion in the affected joint(s):
- 10% Rating: For each major joint or group of minor joints with confirmed symptoms like painful motion, swelling, or muscle spasms.
- 20% Rating: Awarded when there are occasional incapacitating exacerbations—periods when pain becomes severe enough to limit your activity significantly.
Rheumatoid Arthritis — Diagnostic Code 5002
Rheumatoid arthritis can be more disabling, so ratings increase with symptom frequency and severity:
- 20% Rating: 1–2 exacerbations per year
- 40% Rating: Multiple flare-ups causing definite health impairment
- 60% Rating: Severe health impairment with anemia, weight loss, or 4+ exacerbations per year
- 100% Rating: Totally incapacitating symptoms with active joint involvement
These ratings determine monthly compensation and eligibility for additional VA benefits such as health care, adaptive equipment, and special monthly compensation.
How to Build a Strong VA Claim
A successful claim requires evidence and clear documentation. Applicants should focus on the following:
1. Get a Clear Medical Diagnosis. Your provider must document:
- Type of arthritis (osteoarthritis, rheumatoid, post-traumatic, etc.)
- Severity
- Range-of-motion limitations
- Imaging results (X-ray, MRI), when available
2. Establish Service Connection. There are two main ways to establish a link between an arthritis diagnosis and military service: direct service connection and secondary service connection.
Direct Service Connection
You must illustrate that your arthritis:
- Began during military service, or
- Developed due to an in-service injury or repetitive stress
- Service treatment records and in-service complaints of joint pain are helpful
Secondary Service Connection
If arthritis developed because of another service-connected condition, such as an altered gait from a knee injury or back condition, you can claim it secondarily. This requires a medical nexus letter linking the two.
3. Strengthen Your Claim with Lay Evidence. Statements from family, friends, co-workers, and fellow service members can help show how arthritis affects your daily life, mobility, and ability to work.
4. Document Daily Limitations. Keep a record of:
- Flare-ups
- Difficulty lifting, standing, walking, or bending
- How pain impacts work or home activities
- Assistive devices you use
This personal documentation shows the VA the true impact of your condition.
5. Prepare for the C&P Exam. During the Compensation & Pension exam:
- Be honest and thorough
- Describe your worst days—not just how you feel at that moment
- Explain flare-up frequency
- Discuss how pain affects mobility and function
Reviewing the Arthritis Disability Benefits Questionnaire (DBQ) beforehand helps you know what the examiner will look for.
How Arthritis Can Qualify For SSDI Eligibility
Disabled veterans may also qualify for SSDI; however, VA approval does not automatically mean approval from the Social Security Administration (SSA).
The SSA criteria for qualifying for SSDI benefits due to arthritis involves the following:
1. You Must Show You Cannot Perform Substantial Work
SSA focuses on how arthritis limits your:
- Standing and walking
- Ability to grasp, lift, or use your hands
- Ability to sit for extended periods
- Dexterity or fine motor skills
2. Medical Evidence Is Required
SSA requires imaging or lab results confirming:
- Joint degeneration
- Inflammatory markers (for RA)
- Reduced range of motion
3. The Condition Must Last at Least 12 Months
4. Your Age, Work Background & Functional Limitations Matter
SSDI looks at whether you can return to:
- Past work you’ve done, or
- Any job that exists in the national economy
This is where detailed medical evidence and legal support become crucial.
VA Benefits vs. SSDI: Key Differences
| VA Disability | SSDI |
|---|---|
| Benefits must be tied to military service | Any disabling condition may qualify |
| You can work while receiving VA benefits | You must stay below the SGA income limit |
| Ratings range from 0–100% | SSDI is all-or-nothing |
| Not based on income | Not income-based—only work history matters |
| Monthly benefit amount based on VA rating | Monthly benefit based on prior work credits |
How Kerr Robichaux & Carroll Can Help
Navigating VA claims and SSDI applications is complex—but you don’t have to do it alone. Our disability attorneys can assist with:
- Preparing and filing VA disability claims
- Appealing denied VA or SSDI decisions
- Gathering medical and lay evidence
- Obtaining expert nexus letters
- Preparing for C&P exams
- Explaining how VA and SSDI benefits can work together
We know what examiners look for and how to present your case effectively.
Need Help With a VA or SSDI Claim for Arthritis?
If arthritis is limiting your ability to work or live comfortably, our dedicated team of disability and veterans’ benefits attorneys at Kerr Robichaux & Carroll is here to help.
Contact us today by submitting an online form or calling our office at (503) 255-9092 for a free case evaluation.