VA Disability Rating for Osteomalacia
Diagnostic Code 5014 · 38 CFR §4.71a
What Is It?
Osteomalacia is a softening of the bones caused by inadequate mineralization, typically due to vitamin D deficiency. Unlike osteoporosis where bones lose mass, osteomalacia involves bones that are present but not properly hardened. This causes diffuse bone pain, muscle weakness, and an increased risk of stress fractures. Veterans may develop osteomalacia from prolonged vitamin D deficiency during deployments with limited sun exposure, malabsorption conditions that developed during service, kidney conditions affecting vitamin D metabolism, or medications that interfere with bone mineralization.
Rating Criteria
| Rating | Criteria |
|---|---|
| 30% | Severe softening with multiple stress fractures, significant bone pain, and marked muscle weakness |
| 20% | Moderate disease with notable bone pain, some stress fractures, and functional limitation |
| 10% | Mild disease with diffuse bone aching and mild muscle weakness |
| 0% | Documented history with successful treatment and no current symptoms |
Evidence Needed
- Blood work showing vitamin D levels, calcium, phosphorus, and alkaline phosphatase
- Bone imaging showing characteristic changes of osteomalacia
- Bone biopsy results if performed
- Medical records connecting the condition to service or a service-connected cause
- Documentation of symptoms including bone pain and muscle weakness
C&P Exam Tips
- Describe the diffuse nature of your bone pain and where it is worst
- Demonstrate any muscle weakness, especially difficulty rising from a chair or climbing stairs
- Bring laboratory results showing your vitamin D and calcium levels
- Explain what you believe caused the vitamin D deficiency during service
- Mention any stress fractures or bone deformities that have developed
How to File
File under DC 5014 for osteomalacia. Include laboratory evidence showing abnormal vitamin D, calcium, or phosphorus levels. If the condition resulted from a service-connected kidney condition or malabsorption disorder, file it as secondary. Document the functional impact of bone pain and muscle weakness.
Common Mistakes
Confusing osteomalacia with osteoporosis, which has different causes and diagnostic criteria Not getting complete blood work to demonstrate the metabolic cause Failing to document the functional impact beyond just reporting bone pain Not establishing how the vitamin D deficiency connects to service
Frequently Asked Questions
Is osteomalacia the same as osteoporosis?
No, they are different conditions. Osteoporosis involves loss of bone mass while the remaining bone is normal. Osteomalacia involves normal amounts of bone that are not properly mineralized, making them soft. They have different causes, different treatments, and different diagnostic codes.
Can osteomalacia be cured?
In many cases, osteomalacia can be significantly improved with vitamin D supplementation and treatment of the underlying cause. However, if bone damage or deformities have already occurred, those may be permanent. VA rates based on your current condition after treatment.