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5000
§ 4.71a Schedule of ratings—musculoskeletal system.

Osteomyelitis

A bacterial infection of the bone that may cause pain, swelling, and fever.

What the rating means

VA rates osteomyelitis under diagnostic code 5000. Five percentage levels are possible: 100%, 60%, 30%, 20%, and 10%. The highest rating, 100%, applies when the infection involves the pelvis, vertebrae, or extends into major joints, spreads to multiple sites, or causes long-standing debility along with symptoms such as anemia, amyloid liver changes, or other ongoing constitutional symptoms. A 60% rating applies when you have frequent episodes with constitutional symptoms. A 30% rating requires a definite involucrum or sequestrum, with or without a discharging sinus. A 20% rating applies when there is a discharging sinus or other evidence of active infection within the past five years, but only if your osteomyelitis has recurred after the initial infection. A 10% rating covers inactive osteomyelitis following repeated episodes with no evidence of active infection in the past five years, and requires at least two episodes after the initial infection. Ratings of 30% or below can be combined with ratings for related joint or bone problems, subject to the amputation rule. No rating under this code is assigned if the affected bone was surgically removed or radically resected.

Evidence that helps

Medical records documenting the location of the infection matter greatly. Records showing involvement of the pelvis, vertebrae, or a major joint, or infection at multiple sites, support the 100% level, as do lab results or clinical notes confirming anemia, amyloid changes, or other persistent constitutional symptoms. For a 60% rating, records of recurring flare-ups with fever, weight loss, or other systemic symptoms are relevant. Imaging studies such as X-rays or MRIs showing an involucrum or sequestrum support the 30% level. For the 20% level, clinical notes, imaging, or lab findings confirming active infection or a discharging sinus within the past five years are needed, along with records establishing that reactivation occurred after the initial infection. For the 10% level, records must show at least two episodes after the first infection and confirm no active infection in the past five years. Statements from you describing how symptoms such as pain, drainage, fatigue, or limited mobility affect your work and daily activities can help show the overall impact of the condition.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.