VA Disability Rating for Myositis Ossificans
Diagnostic Code 5023 · 38 CFR §4.71a
What Is It?
Myositis ossificans is bone tissue forming inside muscle, usually weeks after a significant contusion or crush injury to the muscle. The abnormal bone creates a hard mass in the soft tissue that can be painful, block movement in the nearby joint, and press on nerves. The thigh and upper arm are the classic locations, and veterans typically acquire it from direct blows during training, blast injury, or severe contusions from falls and impacts. Two things about the rating are worth knowing before filing. First, VA's rating schedule now lists diagnostic code 5023 as "heterotopic ossification" — the broader modern term for abnormal bone formation in soft tissue, of which myositis ossificans is the classic form. If a decision or examination uses that phrase, it is describing this condition. Second, DC 5023 carries no percentage column. It sits inside the block of diagnostic codes 5013 through 5024, all governed by a single instruction: "Evaluate the diseases under diagnostic codes 5013 through 5024 as degenerative arthritis, based on limitation of motion of affected parts." So the evaluation comes from what the nearby joint can no longer do, measured in degrees under that joint's own limitation-of-motion code — not from the size of the bone mass. Where the limitation of motion is noncompensable under the applicable code, DC 5003 supplies 10 percent for each major joint or group of minor joints affected, and under 38 CFR 4.59 an actually painful joint is entitled to at least the minimum compensable rating for that joint. Note that DC 5003's Note (2) bars the 20 and 10 percent ratings based on X-ray findings from being used for conditions in the 5013 to 5024 block, so imaging of the bone mass supports the diagnosis rather than the percentage.
Rating Criteria
| Rating | Criteria |
|---|---|
| See pathways | DC 5023 assigns no percentage of its own. The Note governing diagnostic codes 5013 through 5024 directs: "Evaluate the diseases under diagnostic codes 5013 through 5024 as degenerative arthritis, based on limitation of motion of affected parts." The evaluation therefore comes from the limitation-of-motion code for the joint the heterotopic bone restricts. Where that limitation of motion is noncompensable, DC 5003 provides 10 percent for each major joint or group of minor joints affected, and 38 CFR 4.59 entitles an actually painful joint to at least the minimum compensable rating for the joint. DC 5003 Note (2) expressly bars the 20 and 10 percent ratings based on X-ray findings from being used for conditions under diagnostic codes 5013 to 5024. |
Evidence Needed
- Imaging showing heterotopic bone formation within muscle tissue
- Medical records documenting the original muscle injury during service
- Range of motion measurements of nearby joints
- Documentation of pain and functional limitations
- Surgical records if excision was performed
C&P Exam Tips
- Show the examiner imaging that reveals the bone formation location and size
- Demonstrate any limitation of motion in the joint near the affected muscle
- Describe how the hard mass restricts your movement
- Mention if the bone mass presses on nerves causing numbness or pain
- Explain the original injury that caused the condition
How to File
File for the condition and name the joint it restricts, because DC 5023 has no percentages of its own and the evaluation is taken from limitation of motion of the affected part. Include the service record of the original muscle injury and imaging showing the heterotopic bone, then make sure range of motion of the adjacent joint is measured in degrees and that painful motion is recorded. Where motion is noncompensable under that joint's code, DC 5003 provides 10 percent per major joint or group of minor joints, and 38 CFR 4.59 entitles an actually painful joint to the minimum compensable rating. If the mass presses on a nerve, claim the nerve involvement separately under the neurological codes.
Common Mistakes
Not connecting the bone formation to the original muscle injury during service Not getting imaging to document the size and exact location of the bone mass Failing to measure how the mass limits joint motion Not reporting nerve symptoms if the mass presses on nearby nerves
Frequently Asked Questions
Can myositis ossificans be surgically removed?
Yes, surgical excision is sometimes performed when the bone mass causes significant functional problems. However, surgery carries a risk of the bone forming again. Even after surgery, residual limitations may persist and should be documented for rating purposes.
How long after an injury does myositis ossificans develop?
Bone formation typically begins within two to four weeks of the initial muscle injury and may continue to mature for several months. If you sustained a significant muscle injury during service and later developed a hard lump in that area, get imaging to check for heterotopic bone.