VA Disability Rating for Osteomyelitis
Diagnostic Code 5000 · 38 CFR §4.71a
What Is It?
Osteomyelitis is an infection of the bone that can develop after open fractures, surgical procedures, or through bloodborne spread from infections elsewhere in the body. The infection causes inflammation, pain, and can destroy bone tissue if not treated effectively. It can be acute, meaning it developed recently, or chronic, meaning it has persisted or keeps coming back over time. Veterans commonly develop osteomyelitis from combat wounds, open fractures sustained during training, surgical complications from service-connected injuries, or infections that spread from soft tissue wounds.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Active osteomyelitis with discharge or constant drainage, requiring continuous treatment |
| 60% | Frequent episodes of flare-ups with drainage, pain, and constitutional symptoms requiring antibiotic courses |
| 30% | Chronic osteomyelitis with periodic drainage and episodes requiring treatment several times a year |
| 20% | Chronic osteomyelitis with occasional flare-ups and evidence of a draining sinus or track |
| 10% | Inactive osteomyelitis with a history of active disease and evidence of past infection on imaging |
| 0% | Resolved osteomyelitis with no current symptoms but documented history |
Evidence Needed
- Medical records documenting the bone infection and its connection to military service
- Bone imaging such as X-rays, MRI, or bone scans showing infection
- Laboratory results including blood cultures and inflammatory markers
- Surgical records if debridement or bone removal was performed
- Records of antibiotic treatment courses and their duration
C&P Exam Tips
- Describe the frequency and duration of flare-ups including drainage episodes
- Bring records of all antibiotic courses you have received
- Show any visible draining sinuses or scars from surgical debridement
- Explain how flare-ups affect your ability to work and perform daily tasks
- Mention any constitutional symptoms like fevers, chills, or fatigue during episodes
How to File
File under DC 5000 for osteomyelitis. Include all imaging studies and culture results that document the bone infection. If the osteomyelitis developed from a combat wound or training injury, establish that connection clearly. Document the frequency and severity of flare-ups for the most accurate rating.
Common Mistakes
Not documenting the chronic nature of recurrent infections Failing to track and report each flare-up episode and treatment course Not getting follow-up imaging to show persistent bone changes Missing the connection between an old wound infection and current bone infection
Frequently Asked Questions
Can osteomyelitis come back after treatment?
Yes, chronic osteomyelitis is known for recurring even after prolonged antibiotic treatment. Bacteria can survive in dead bone tissue and reactivate months or years later. Each recurrence should be documented as it supports a higher rating for the chronic form of the disease.
Can I get rated for both osteomyelitis and the joint it affects?
In many cases, yes. If the bone infection has damaged a nearby joint and caused arthritis or limited motion, those functional impairments may be rated separately under different diagnostic codes, as long as the ratings address different aspects of disability.