VA Disability Rating for Paget's Disease of Bone
Diagnostic Code 5016 · 38 CFR §4.71a
What Is It?
Paget's disease of bone is a chronic condition where the normal process of bone renewal becomes disrupted, leading to bones that are enlarged, misshapen, and weakened. The affected bones break down and rebuild faster than normal, resulting in bone that is structurally abnormal. It most commonly affects the pelvis, skull, spine, and leg bones. Many people have no symptoms, but the condition can cause bone pain, deformities, fractures, and complications like arthritis in nearby joints or hearing loss if the skull is affected. The exact cause is not fully understood, but it may relate to both genetic factors and environmental triggers.
Rating Criteria
| Rating | Criteria |
|---|---|
| 60% | Severe disease affecting multiple bones with significant deformity, fractures, and major functional limitation |
| 30% | Moderate disease with bone pain, some deformity, and limitation of function in affected areas |
| 20% | Active disease with bone pain requiring medication and mild functional impact |
| 10% | Documented disease with mild symptoms controlled with medication |
| 0% | Asymptomatic disease found incidentally on imaging |
Evidence Needed
- Blood work showing elevated alkaline phosphatase levels
- Bone imaging showing characteristic Paget's disease changes
- Bone scan identifying all affected sites
- Medical records documenting symptoms and treatment
- Evidence connecting the onset or aggravation to military service
C&P Exam Tips
- Describe which bones are affected and the symptoms in each area
- Show any visible bone deformities such as bowed legs
- Bring laboratory results showing alkaline phosphatase levels over time
- Explain how bone pain and deformity limit your activities
- Mention any complications like hearing loss or joint arthritis
How to File
File under DC 5016 for Paget's disease of bone. Include laboratory and imaging evidence documenting the diagnosis and extent of the disease. If the condition has caused secondary problems like arthritis or hearing loss, file those as separate secondary claims. Document all affected bone sites and their functional impact.
Common Mistakes
Not getting a bone scan to identify all affected sites Failing to file for secondary conditions caused by Paget's disease Not monitoring alkaline phosphatase levels to track disease activity Assuming asymptomatic Paget's disease cannot be rated
Frequently Asked Questions
Can Paget's disease cause hearing loss?
Yes, when Paget's disease affects the skull bones, particularly the temporal bone near the ear, it can cause hearing loss. This hearing loss can be rated separately under the hearing loss diagnostic codes if it is documented as a complication of your service-connected Paget's disease.
Does Paget's disease get worse over time?
Paget's disease is generally a progressive condition, though the rate of progression varies widely. Some people have stable disease for years while others experience gradual worsening. Regular monitoring and treatment can help manage the disease and document changes that may warrant a higher rating.