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The VA orders this exam to verify your diagnosis and measure how severe it is right now. It can shape your rating and your monthly compensation — but it does not decide your claim. A rating specialist weighs it against your full record, and if the exam does not reflect your condition, you can say so and ask the VA to correct it.
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A type of inflammatory arthritis that occurs in people who have psoriasis, a skin condition. It causes joint pain, stiffness, and swelling, and can affect any joint in the body. The VA rates psoriatic arthritis based on disease activity and how it limits your ability to function.
The percentages this diagnostic code can be rated at. Which one applies depends on the findings — no tool here can tell you in advance.
Rated under 38 CFR 4.71a, DC 5009. The examiner records findings on the DBQ; a rating specialist makes the decision.
| Rating | Rating criteria | What that means for you |
|---|---|---|
| 0% | § 4.31 Zero percent evaluations. In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. | Your psoriatic arthritis is service connected and documented, but at the time of examination it is neither in an active exacerbation nor leaving limitation of motion that any joint code compensates. The lowest compensable rung on this ladder is 10 percent. A zero percent rating pays nothing now, but it establishes service connection and fixes the effective date any later increase runs from. |
What supports this level
| ||
| 10% | Note (2): With the types of arthritis, diagnostic codes 5004 through 5009, rate the acute phase under diagnostic code 5002; rate any chronic residuals under diagnostic code 5003. Degenerative arthritis established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved (DC 5200 etc.). When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 pct is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. | Your psoriatic arthritis is not in an active flare, but it has left chronic residuals — limitation of motion of an affected joint that is objectively confirmed by swelling, muscle spasm, or painful motion, yet is not severe enough to be compensable under the diagnostic code for that joint. DC 5009 Note (2) sends chronic residuals to DC 5003, which pays 10 percent for each such major joint or group of minor joints. |
What supports this level
| ||
| 20% | One or two exacerbations a year in a well-established diagnosis. | You have psoriatic arthritis with one or two joints affected and occasional flare-ups, in a well-established diagnosis. You have pain and stiffness, but you can still perform most daily activities with medication. |
What supports this level
| ||
| 40% | Symptom combinations productive of definite impairment of health objectively supported by examination findings or incapacitating exacerbations occurring 3 or more times a year. | You have psoriatic arthritis with multiple joints affected and frequent flare-ups. Your symptoms significantly limit your physical activities and may require stronger medications such as biologics. |
What supports this level
| ||
| 60% | Less than criteria for 100% but with weight loss and anemia productive of severe impairment of health or severely incapacitating exacerbations occurring 4 or more times a year or a lesser number over prolonged periods. | You have psoriatic arthritis with severe joint damage, significant skin involvement, and constitutional symptoms like fatigue and weight loss. You cannot perform most physical work. |
What supports this level
| ||
| 100% | With constitutional manifestations associated with active joint involvement, totally incapacitating. | You have psoriatic arthritis with completely disabling joint disease and widespread skin involvement. You are unable to work or care for yourself independently. |
What supports this level
| ||
The middle column is our transcription of the criteria at 38 CFR 4.71a, DC 5009, condensed for reading. Read the section itself on eCFR before relying on the exact wording. The items under each level are the kinds of evidence that document it — not a VA checklist, and not a prediction of which level applies to you.
Not filing separate claims for psoriasis and psoriatic arthritis — the skin condition (rated under DC 7816) and the joint condition (rated under DC 5009) are rated separately, and you should have both on your record.
Not documenting dactylitis and enthesitis — these findings are hallmarks of psoriatic arthritis that distinguish it from other types and support the diagnosis.
Failing to get imaging of all affected joints — psoriatic arthritis can cause unique erosive changes ("pencil-in-cup" deformity) that are diagnostic and support higher ratings.
Not reporting nail changes — nail pitting and dystrophy are closely linked to psoriatic arthritis severity and help establish the diagnosis.
These apply to every C&P exam, whatever the condition.