Claim Raven explanation
What this means
Chronic or recurring osteomyelitis is a bone infection that can remain disabling even when obvious signs are not present at every examination. The rule addresses the ongoing process after it has been clinically identified.
It discusses a permanent rating and combination with other residual ratings, subject to the amputation limit at the relevant site. The diagnostic schedule supplies the particular severity criteria.
How this helps your claim
This helps explain why an interval without visible drainage is not the same as a complete review of the disease history. Look for the diagnosis, recurrence, treatment, and lasting effects in the record.
What to check in your records
Use your decision, examination reports, and relevant records to check the following points.
- Locate the clinical diagnosis and evidence of chronicity or recurrence.
- Find treatment records from active episodes and quieter periods.
- Check the site, associated residuals, and code used in the decision.
Document the recurring course of bone infection
A chronic infection can have active and quieter periods. Records of drainage, recurrence, operations and clinical identification may therefore matter even when a single examination shows fewer outward signs. Keep those events in chronological order.
The condition's history and its current residuals serve different roles in evaluation. Read the applicable osteomyelitis criteria along with this principle and any combination limit. Do not assume that the absence of visible drainage on one day proves that the entire documented disease process has ended.
Can every residual be added without a limit?
No. The regulation discusses combination with other residual evaluations subject to the applicable amputation limit. The particular manifestations and diagnostic criteria still matter. Identify what each evaluation covers so that the same effect is not counted twice and the relevant extremity limit is respected.
Official regulatory text
38 CFR § 4.43
eCFR snapshot: September 3, 2026. Layout and spacing are adapted for reading. The full section and its tables are included below.
§ 4.43 Osteomyelitis.
Chronic, or recurring, suppurative osteomyelitis, once clinically identified, including chronic inflammation of bone marrow, cortex, or periosteum, should be considered as a continuously disabling process, whether or not an actively discharging sinus or other obvious evidence of infection is manifest from time to time, and unless the focus is entirely removed by amputation will entitle to a permanent rating to be combined with other ratings for residual conditions, however, not exceeding amputation ratings at the site of election.
Related references
- 38 CFR § 4.1: What a VA disability rating measures
- 38 CFR § 3.159: VA duty to assist: records and examinations
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