VA Disability Rating for Residuals of Osteoporosis (DC 5013)

Diagnostic Code 5013 · 38 CFR §4.71a

What Is It?

Osteoporosis is a condition where bones lose density and become fragile, making them more susceptible to fractures. The condition is more common in older veterans and those who took certain medications during service, including long-term corticosteroids. Female veterans and veterans with hormonal conditions are at higher risk. Some environmental exposures during service may also contribute to bone density loss. 38 CFR 4.71a lists DC 5013 as "Osteoporosis, residuals of" and gives it no percentage. It sits in the block of codes from 5013 to 5024, which carries one shared instruction: "Evaluate the diseases under diagnostic codes 5013 through 5024 as degenerative arthritis, based on limitation of motion of affected parts." So bone density itself — the DEXA T-score — is not what is rated. What is rated is the residual: the motion a joint or the spine has lost after a fragility fracture or other osteoporotic change, measured in degrees under the limitation-of-motion code for that part. A healed wrist fracture is evaluated on wrist motion, a hip fracture on hip motion, a vertebral compression fracture on spinal motion. Two provisions set the floor. Where limitation of motion of the specific 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, objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. And 38 CFR 4.59 entitles actually painful, unstable, or malaligned joints, due to healed injury, to at least the minimum compensable rating for the joint. One route is closed: DC 5003 Note (2) bars the X-ray-based 20 and 10 percent ratings for every code from 5013 to 5024.

Rating Criteria

Rating	Criteria
See pathways	DC 5013 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 is therefore taken from the limitation-of-motion code for each affected joint. Where limitation of motion of the specific joint is noncompensable under the appropriate code, DC 5003 provides 10 percent for each such major joint or group of minor joints affected by limitation of motion, which must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. Under 38 CFR 4.59, actually painful, unstable, or malaligned joints, due to healed injury, are entitled to at least the minimum compensable rating for the joint. DC 5003 Note (2) bars the 20 and 10 percent ratings based on X-ray findings for conditions under diagnostic codes 5013 to 5024.

Rating

Criteria

See pathways

DC 5013 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 is therefore taken from the limitation-of-motion code for each affected joint. Where limitation of motion of the specific joint is noncompensable under the appropriate code, DC 5003 provides 10 percent for each such major joint or group of minor joints affected by limitation of motion, which must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. Under 38 CFR 4.59, actually painful, unstable, or malaligned joints, due to healed injury, are entitled to at least the minimum compensable rating for the joint. DC 5003 Note (2) bars the 20 and 10 percent ratings based on X-ray findings for conditions under diagnostic codes 5013 to 5024.

Evidence Needed

DEXA scan results showing bone mineral density measurements — these establish the diagnosis, but the evaluation is not scored from them
Imaging showing fractures attributed to osteoporosis
Range of motion in degrees for each joint, and the spine, affected by a fracture or other residual
Medical records linking osteoporosis to service or service-connected conditions
Documentation of medications that may have caused bone loss
Records of falls and fractures with treatment history

C&P Exam Tips

Bring your DEXA scan results showing T-scores
Describe any fractures you have suffered from minimal trauma
Ask that range of motion be measured in every joint a fracture has affected, and in the spine if you have had a compression fracture — those measurements are what the rating is built from
Say where in the motion pain begins, so painful motion is recorded
Explain how bone fragility affects your daily activities and what you avoid doing
Mention if medications taken during service contributed to bone loss
Describe any height loss or spinal curvature changes you have noticed

How to File

File under DC 5013 for residuals of osteoporosis, and name the residuals — each fracture and the joint or spinal segment it affected. DC 5013 assigns no percentage itself; the evaluation is written under the limitation-of-motion code for each affected part, so the examination needs to measure those parts. Include DEXA scan results and records of any fragility fractures. If long-term steroid use for a service-connected condition caused the bone loss, file osteoporosis as a secondary condition and explain that relationship.

Common Mistakes

Filing for osteoporosis without documenting the residuals. The diagnosis and the T-score establish the condition; the fractures and the motion they cost are what is rated.
Not connecting medication-induced bone loss to a service-connected condition.
Relying on X-ray findings for a percentage. DC 5003 Note (2) bars the X-ray-based 20 and 10 percent ratings for conditions under DCs 5013 through 5024.
Not reporting fragility fractures from minimal trauma, or not having the joints they affected measured.

Frequently Asked Questions

What percentage does DC 5013 pay?

None by itself. 38 CFR 4.71a lists DC 5013 as "Osteoporosis, residuals of" with no percentage column. The Note to DCs 5013 through 5024 directs that these diseases be evaluated as degenerative arthritis, based on limitation of motion of affected parts, so the percentage in a decision is written under the limitation-of-motion code for each joint involved, and two or more joints combine under 38 CFR 4.25.

Can osteoporosis be service-connected?

Yes, osteoporosis can be service-connected directly if it developed during service, or secondarily if it was caused by medications for a service-connected condition, such as long-term corticosteroid use. Hormonal conditions treated during or after service can also contribute to bone loss.

What is a DEXA scan and why do I need one?

A DEXA scan measures your bone mineral density and gives a T-score that indicates how your bone density compares to a healthy young adult. It is the standard diagnostic test for osteoporosis and is essential evidence that you have the condition. The rating itself comes from the residuals — the limitation of motion of the affected parts.

Can X-ray evidence of two or more joints get me 10 or 20 percent?

No. DC 5003's 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. DC 5013 sits inside that block, so the evaluation has to come from measured limitation of motion, from DC 5003's 10 percent per joint where that limitation is noncompensable, or from 38 CFR 4.59 for a painful joint.