If you sustained an ankle injury during military service or had a pre-existing ankle condition that worsened due to active duty, you may qualify for disability benefits through the Department of Veterans Affairs (VA). Establishing service connection and gathering the right evidence are key steps in presenting a successful VA disability claim.
What Is Ankle Instability?
VA Disability Ratings for Ankle Instability
The VA uses the Schedule of Ratings for the Musculoskeletal System to determine disability ratings for ankle instability, with ratings based on the degree of limitation in the range of motion and other factors affecting the joint. Ratings are generally assigned under Diagnostic Code 5271, which specifically addresses limitations in ankle motion.
- 10% Rating: Assigned for moderate limitation of motion in the ankle.
- 20% Rating: Assigned for marked limitation of motion, which indicates more severe instability or restricted movement.
This information can be found in 38 CFR § 4.71a, which outlines the criteria for musculoskeletal system ratings.
Factors That May Affect Your Rating
While ankle instability alone may result in a rating between 0% and 20%, additional conditions often occur alongside it, potentially leading to a higher combined rating. Common secondary conditions include:
- Arthritis of the Ankle Joint: Degenerative or traumatic arthritis may develop in the affected ankle, contributing to pain and further limitation of motion.
- Knee or Leg Pain: Compensation for instability may result in secondary issues in the knees or legs.
If these conditions are service-connected or related to the ankle instability, the VA may increase your overall disability rating accordingly.
Service Connection for Ankle Instability
To obtain a VA disability rating for ankle instability, the most common method is to establish a direct service connection. This requires meeting three essential criteria:
- Current Diagnosis: You must have a recent diagnosis of ankle instability confirmed by a medical professional.
- In-Service Occurrence or Aggravation: You must identify an event, injury, or series of incidents during active duty that caused or worsened your condition. Examples include: rolling your ankle during training, marches or runs, injuries sustained in combat, slips or falls while performing duties.
- Medical Nexus: A medical professional must provide evidence linking the in-service occurrence or aggravation to your current ankle instability.
Secondary Service Connection for Ankle Instability
You may also qualify for a VA rating by proving a secondary service connection. This occurs when ankle instability develops as a result of another service-connected condition.
Example: If you sustained a service-connected right foot fracture and later developed ankle instability in your left ankle due to overcompensating for the injury, you may qualify for a secondary service connection. A medical opinion linking the two conditions would be critical to establishing this connection.
Service Connection by Aggravation for Ankle Instability
If you had pre-existing ankle instability before entering active service, you may still be eligible for VA disability benefits if your military service worsened the condition.
Example: The rigorous physical demands of military training, deployments, or combat could aggravate a pre-existing ankle injury. In such cases, you can establish a service connection by aggravation, which is recognized by the VA as a valid claim. To succeed, you’ll need medical evidence showing that your condition worsened beyond its natural progression due to your time in service.
Compensation & Pension (C&P) Exams for Ankle Instability
When you file a VA disability claim for ankle instability, the VA may schedule a Compensation & Pension (C&P) exam. Attending this exam is crucial, as it often plays a key role in determining your disability rating. If you cannot attend your scheduled exam, be sure to reschedule promptly to avoid delays in processing your claim.
What to Expect During a C&P Exam
The C&P exam is a focused medical evaluation that aims to:
- Assess the severity of your ankle instability
- Review your medical history, specifically as it relates to your ankle condition
- Determine if your condition is service-connected
Accessing Your C&P Exam Results
Veterans have the right to access the results of their C&P exam, but the VA won’t automatically provide them. Be sure to request a copy of the exam report for your records. This information can be vital if you receive an unfavorable decision and need to appeal or provide additional evidence to support your claim.
Evidence for Ankle Disability Claims and Appealing Under the AMA System
If you’ve received an unfavorable VA disability rating for ankle instability, you have several options to appeal under the Appeals Modernization Act (AMA). Successfully appealing a claim often requires gathering strong evidence to support your case.
Building Evidence for Your Appeal
To strengthen your appeal, consider including the following:
- Medical Evidence: Obtain updated medical records, diagnosis details, and a clear medical opinion connecting your ankle instability to your military service.
- Lay Statements: Collect statements from family, friends, and fellow service members who can attest to your ankle condition and its impact on your daily life.
- Employer Documentation: If your ankle instability affects your ability to work, include letters or performance reviews from your employer highlighting the challenges you face.
This combination of medical and personal evidence can significantly bolster your case.
Submitting a Notice of Disagreement (NOD)
If you decide to appeal, you’ll need to file a Notice of Disagreement (NOD) with the VA. Once your appeal is initiated, you may also have the opportunity to submit additional evidence to further support your claim.
This step is important to ensure the VA has all the relevant details to reassess your case and potentially grant the benefits you deserve.
VA Disability Ratings for Ankle Instability
The VA rating schedule for joint problems, including ankle instability, is based on the range of motion as well as other specific criteria that affect the joints and musculoskeletal system. The VA may require documentation that shows the range of motion of the ankle. This documentation may include medical records, notes from a medical practitioner, or physical evidence like x-ray images.
In many cases, ankle instability itself would receive a rating of between 0 and 20% on the rating schedule. However, the ankle instability may occur in conjunction with other issues, such as knee pain, and leg pain. The VA might note the presence of other conditions and award the veteran an even higher VA disability rating. Arthritis of the ankle joint is a common condition that can occur with ankle instability. Arthritis and ankle instability together might lead to a higher disability rating.
Denied VA Disability Benefits for Ankle Instability?
If your VA disability claim for ankle instability was denied or you believe your rating is too low, don’t give up. At Hill & Ponton, we specialize in helping veterans appeal unfavorable decisions and secure the benefits they deserve.
Our experienced team will review your case, help you gather the necessary evidence, and build a strong appeal to fight for the compensation you’re entitled to. For a free, confidential, no-obligation case evaluation, contact us today →
