VA Disability Rating for Other Specified Forms of Arthropathy (DC 5009)
Diagnostic Code 5009 · 38 CFR §4.71a
What Is It?
38 CFR 4.71a lists DC 5009 as "Other specified forms of arthropathy (excluding gout)." Arthropathy means disease of a joint. Note (1) to the code says these forms include, but are not limited to, Charcot neuropathic, hypertrophic, crystalline, and other autoimmune arthropathies. Gout is excluded; it has its own code, DC 5017. These conditions can follow nerve damage that leaves a joint without normal sensation, as with a Charcot joint, deposits of crystals other than the uric acid of gout, or an autoimmune disease. DC 5009 carries no percentages of its own. Like the arthritis codes just above it, DCs 5004 through 5008, it is rated through Note (2): the acute phase under DC 5002, and any chronic residuals under DC 5003.
Rating Criteria
| Rating | Criteria |
|---|---|
| See pathways | DC 5009 carries no percentage column. The schedule lists it as "Other specified forms of arthropathy (excluding gout)," with Note (1) explaining that these include, but are not limited to, Charcot neuropathic, hypertrophic, crystalline, and other autoimmune arthropathies. Note (2) supplies the pathway: with the types of arthritis at diagnostic codes 5004 through 5009, rate the acute phase under diagnostic code 5002 and rate any chronic residuals under diagnostic code 5003. DC 5002 (multi-joint arthritis, 2 or more joints, as an active process) runs 20, 40, 60 and 100 percent on constitutional manifestations, weight loss and anemia, and the frequency of incapacitating exacerbations; its Note (3) provides that ratings for the active process are not combined with the residual ratings for limitation of motion, ankylosis, or DC 5003. DC 5003 evaluates chronic residuals on limitation of motion of the specific joints involved, with 10 percent for each major joint or group of minor joints where that limitation is noncompensable. |
Evidence Needed
- Medical records with a clear diagnosis naming the specific arthropathy, such as a Charcot joint or a crystal or autoimmune arthropathy
- Imaging of each affected joint
- Specialist evaluation from a rheumatologist or orthopedist
- Dated records of flare-ups of the active disease, including any weight loss or anemia
- Range of motion measurements in degrees for each affected joint
- Documentation of how the condition connects to military service
C&P Exam Tips
- Bring documentation naming your specific joint condition
- Say whether the disease is still active, and describe how often flare-ups occur and how long they last
- Ask that range of motion be measured in each affected joint, and say where in the motion pain begins
- Describe how the condition affects your mobility and daily functioning
- Explain any connection to service
How to File
File under DC 5009 for other specified forms of arthropathy, and name the specific condition. DC 5009 assigns no percentage itself. While the disease is active, the evaluation is written under DC 5002, which turns on constitutional manifestations, weight loss and anemia, and how often incapacitating exacerbations occur, so a dated record of each flare-up matters. Chronic residuals are evaluated under DC 5003, on limitation of motion of the joints involved, so the examination needs to measure each affected joint. A specialist opinion describing the condition and its course is helpful.
Common Mistakes
- Not naming the specific arthropathy. The diagnosis is what places a condition under DC 5009.
- Not keeping a dated record of flare-ups while the disease is active. DC 5002, which rates the acute phase, turns on how often incapacitating exacerbations occur.
- Not having range of motion measured in each affected joint. Chronic residuals are rated under DC 5003, on limitation of motion.
- Filing gout under DC 5009. Gout is excluded from this code and has its own, DC 5017.
Frequently Asked Questions
What does "other specified forms of arthropathy" mean?
Arthropathy is disease of a joint. DC 5009 is the schedule's code for specifically diagnosed joint diseases that are not listed under a code of their own. Note (1) gives Charcot neuropathic, hypertrophic, crystalline, and other autoimmune arthropathies as examples, and says the list is not limited to those. Gout is excluded; it is rated under DC 5017.
What percentage does DC 5009 pay?
None by itself. Under Note (2), the acute phase is rated under DC 5002, at 20, 40, 60 or 100 percent, and chronic residuals are rated under DC 5003, on limitation of motion of the joints involved. DC 5002's Note (3) provides that the rating for the active process is not combined with residual ratings for limitation of motion, ankylosis, or DC 5003; the higher evaluation is assigned instead.
Should I try to get a more specific diagnostic code?
If your joint condition has its own listed code, that code applies. Gout is rated under DC 5017, and DC 5002 names rheumatoid arthritis, psoriatic arthritis, and spondyloarthropathies among the conditions it rates. DC 5009 is for the specified forms that have no code of their own. Work with your provider to identify the most accurate diagnosis.