Osteomalacia (Vitamin D Deficiency-Related)

DC 5013Endocrine38 CFR 4.71a, DC 5013

A condition where bones become soft and weak due to severe, prolonged vitamin D deficiency or problems with vitamin D metabolism. The VA rates osteomalacia based on bone pain, fracture risk, and functional limitations.

How the VA rates this condition

The VA rates this condition based on how much it affects your ability to work and carry out daily activities. The examiner will focus on the functional limitations your condition causes, not just the diagnosis itself.

Diagnostic code

DC 5013

Rating range

0% – 60%

Rating levels

Rating criteria are defined in 38 CFR 4.71a, DC 5013. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

Your osteomalacia is severe with multiple pathologic fractures, severe muscle weakness causing difficulty walking or needing assistive devices, and significantly reduced quality of life despite maximum treatment.

What the VA looks for

Multiple pathologic fractures documented
Severe proximal muscle weakness
Use of cane, walker, or wheelchair
Pseudofractures (Looser zones) on imaging
Severely reduced bone density
Maximum supplementation and treatment documented

Common Pitfalls

⚠Not distinguishing osteomalacia from osteoporosis — osteomalacia involves defective bone mineralization (soft bones) while osteoporosis involves reduced bone density (thin bones). Different diagnostic codes and treatment approaches apply.
⚠Not connecting to deployments in areas with limited sun exposure (submarines, northern bases) or to medications used during service that interfere with vitamin D metabolism.
⚠Not documenting all fractures, even minor ones — insufficiency fractures and stress fractures are key evidence that the bone quality is compromised.
⚠Not filing for secondary conditions — osteomalacia-related muscle weakness can cause falls, and resulting fractures or joint problems may each warrant separate ratings.

Related DBQ Forms

DBQ Bone Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

How the VA rates this condition

Diagnostic code

DC 5013

Rating range

0% – 60%

Rating levels

Rating Levels

What the VA looks for

Multiple pathologic fractures documented
Severe proximal muscle weakness
Use of cane, walker, or wheelchair
Pseudofractures (Looser zones) on imaging
Severely reduced bone density
Maximum supplementation and treatment documented

Common Pitfalls

⚠Not distinguishing osteomalacia from osteoporosis — osteomalacia involves defective bone mineralization (soft bones) while osteoporosis involves reduced bone density (thin bones). Different diagnostic codes and treatment approaches apply.

⚠Not connecting to deployments in areas with limited sun exposure (submarines, northern bases) or to medications used during service that interfere with vitamin D metabolism.

⚠Not documenting all fractures, even minor ones — insufficiency fractures and stress fractures are key evidence that the bone quality is compromised.

⚠Not filing for secondary conditions — osteomalacia-related muscle weakness can cause falls, and resulting fractures or joint problems may each warrant separate ratings.