VA Disability Rating for Intermittent Hydrarthrosis (DC 5018 Retired)
Diagnostic Code 5018 · 38 CFR §4.71a
What Is It?
DC 5018 no longer exists, and there is no code that replaced it. VA rewrote the musculoskeletal schedule effective February 7, 2021 (85 FR 76453) and removed DC 5018 (intermittent hydrarthrosis), DC 5020 (synovitis) and DC 5022 (periostitis). A commenter asked VA to add notes saying where these conditions should go instead. VA declined, and its answer is the answer this page has to give: "hydrarthrosis and synovitis are signs of underlying conditions that are already captured within the evaluation criteria of other DCs," "periostitis is a non-specific inflammatory process caused by underlying conditions that can be rated in accordance with the primary diagnosis," and "VA sees no need to limit these signs to specific DCs; they will be evaluated with an underlying diagnosis." The mechanic itself did not change, which is the part worth holding onto. The surviving codes in this family — DC 5013 through DC 5024 — carry a shared Note: "Evaluate the diseases under diagnostic codes 5013 through 5024 as degenerative arthritis, based on limitation of motion of affected parts." DC 5003 then directs that the evaluation be made on limitation of motion under the code for the specific joint, and where that limitation of motion is noncompensable, 10 percent applies for each major joint or group of minor joints affected by limitation of motion, combined and not added. Two provisions cut against a low result: § 4.59 entitles an actually painful, unstable or malaligned joint to at least the minimum compensable rating for that joint, and DC 5003’s own limitation-of-motion route requires only that the limitation be objectively confirmed by findings such as swelling, muscle spasm or satisfactory evidence of painful motion. One provision cuts the other way, and it applied before 2021 too: DC 5003 Note (2) states that the 20 and 10 percent ratings based on X-ray findings "will not be utilized in rating conditions listed under diagnostic codes 5013 to 5024, inclusive." An X-ray alone was never a route to a percentage here. 38 CFR § 3.951(a) is the provision that answers it: a readjustment to the rating schedule "shall not be grounds for reduction of a disability rating in effect on the date of the readjustment unless medical evidence establishes that the disability to be evaluated has actually improved." Under § 3.951(b), an evaluation continuously held at or above its level for 20 years or more cannot be reduced at all except on a showing of fraud, with the 20 years counted from the effective date of the evaluation. Under § 3.957, service connection in effect for 10 years or more cannot be severed except for fraud or a showing from military records that the person did not have the requisite service or character of discharge. And any reduction at all has to run through § 3.105(e): a written proposal setting out all material facts and reasons, 60 days to submit evidence, and — under § 3.105(i) — 30 days from the notice to request a predetermination hearing. Intermittent hydrarthrosis is recurrent effusion — fluid accumulating inside a joint in episodes that swell it, stiffen it and then subside. The knee is the usual site. Like synovitis it is a sign rather than a diagnosis: the episodes are driven by something underneath, whether a meniscal tear, degenerative change, an inflammatory arthritis or crystal disease.
Rating Criteria
| Rating | Criteria |
|---|---|
| See pathways | DC 5018 was removed effective February 7, 2021 and there is no successor code for intermittent hydrarthrosis. The code assigns no percentage of its own, and it never did: DCs 5013 through 5024 are evaluated as degenerative arthritis based on limitation of motion of the affected part, under the diagnostic code for the specific joint (DC 5200 and following). Where limitation of motion of that joint is noncompensable under its own code, DC 5003 provides 10 percent for each major joint or group of minor joints affected by limitation of motion, combined and not added; the limitation must be objectively confirmed by findings such as swelling, muscle spasm or satisfactory evidence of painful motion. 38 CFR § 4.59 entitles an actually painful, unstable or malaligned joint to at least the minimum compensable rating for that joint. DC 5003 Note (2) bars the X-ray-based 20 and 10 percent ratings for every condition in the 5013–5024 range. |
Evidence Needed
- Medical records documenting recurring joint effusions
- Joint aspiration results if fluid was removed
- Imaging showing joint effusion during episodes
- A log of episodes with dates, duration, and joints affected
- Evidence connecting the onset to military service or a service-connected condition
C&P Exam Tips
- Schedule your exam during or near an episode if possible
- Keep a detailed calendar of episodes showing their frequency and duration
- Describe how each episode limits your mobility
- Mention any joint aspiration procedures you have undergone
- Explain the pattern of recurrence if one exists
How to File
File for the joint and the underlying diagnosis rather than for hydrarthrosis under a retired code. The effusion episodes are still valuable evidence — they are what objectively confirms limitation of motion under DC 5003 — so document them: dates, duration, whether the joint was aspirated, measured circumference during an episode, and range of motion measured during a flare rather than only on a good day. § 4.59 entitles an actually painful joint to at least the minimum compensable rating for that joint, and DC 5003 supplies 10 percent per major joint where limitation of motion is noncompensable but objectively confirmed.
Common Mistakes
Not seeking medical attention during episodes to create a documented record Failing to track the pattern and frequency of episodes Not getting joint fluid analysis to rule out other conditions Only having one documented episode when the condition is recurring
Frequently Asked Questions
The code on my rating decision was removed. Can VA reduce me?
Not on that basis. 38 CFR § 3.951(a) provides that a readjustment to the rating schedule "shall not be grounds for reduction of a disability rating in effect on the date of the readjustment unless medical evidence establishes that the disability to be evaluated has actually improved." An evaluation held continuously at or above its level for 20 years is protected under § 3.951(b) except on a showing of fraud, and service connection in effect 10 years cannot be severed under § 3.957 except for fraud or a defect in the record of service. Any reduction also has to run through § 3.105(e) — written proposal, 60 days to submit evidence, and 30 days under § 3.105(i) to request a predetermination hearing.
My knee swells in episodes and is normal in between. How is that rated?
Range of motion measured on a good day will understate it, which is the central problem in these claims. Get the joint examined during a flare where you can, keep a log of episode dates and duration, and make sure any aspiration is in the record. 38 CFR § 4.59 entitles an actually painful joint to at least the minimum compensable rating for that joint, and DC 5003 allows 10 percent for a joint whose limitation of motion is noncompensable but objectively confirmed by swelling, muscle spasm or satisfactory evidence of painful motion.