Autoimmune Diseases Overview and Guide 2024

An autoimmune disease is a condition where the body’s immune system mistakenly attacks its own healthy tissues and organs. Our immune system is designed to protect the body from harmful invaders like bacteria and viruses. But in the case of autoimmune diseases, the immune system can’t tell the difference between healthy cells and foreign invaders, so it ends up attacking the body’s own healthy cells. 

According to the data from the Autoimmune Association, nearly 50 million Americans suffer from autoimmune diseases. 75% of those affected are women. In fact, autoimmune diseases are among the top 10 leading causes of death among American women. 

The National Institute of Health conducted population-based research that showed that military personnel, especially Veterans with PTSD, face a higher risk of developing autoimmune diseases.

While the exact cause of autoimmune diseases is not fully understood, scientists suggest that factors like stress, restricted diet, infections, and exposure to chemicals and toxins play a significant role in the risk of developing an autoimmune disease. 

All those factors are commonly associated with military service. That’s why today we want to talk about how Veterans can claim VA disability benefits for autoimmune diseases and what you should keep in mind before filing your claim.

Autoimmune Disease Explained

Autoimmune disease is a pretty wide term that covers over 80 different conditions. Based on the tissues and organs they affect, those conditions can be divided into 4 groups:

  1. Systemic Autoimmune Diseases
    They affect multiple organs or the entire body.
    Examples: Lupus, Rheumatoid Arthritis.
  2. Localized (Organ-Specific) Autoimmune Diseases
    These conditions target specific organs or tissues.
    Examples: Type 1 Diabetes (pancreas), Multiple Sclerosis (nervous system), Hashimoto’s Thyroiditis (thyroid).
  3. Autoimmune Skin Diseases 
    Those that affect the skin.
    Examples: Psoriasis, Vitiligo.
  4. Autoimmune Gastrointestinal Diseases
    Diseases of the digestive tract.
    Examples: Crohn’s Disease, Celiac Disease

Autoimmune diseases can occur due to a combination of various factors and have a huge variety of symptoms. That is why these conditions are extremely hard to diagnose.

Scientists distinguish 5 main factors that may put you at risk of developing an autoimmune condition:

  • Genetics and Family History
    Certain genes can increase predisposition to autoimmune diseases. For example, some variations in the HLA (human leukocyte antigen) gene complex are associated with a higher risk of developing conditions like type 1 diabetes and rheumatoid arthritis. 
    Autoimmune diseases also often run in families. If a close relative has an autoimmune disease, you are at a higher risk of developing one as well.
  • Infections
    Certain viruses and bacteria can trigger abnormal responses of the immune system and lead to the development of autoimmune conditions
  • Exposure to Chemicals
    Contact with various chemicals, including solvents, fuels, and other environmental toxins, can contribute to the development of autoimmune diseases
  • Stress
    Both physical and psychological stress are often linked to the development and exacerbation of autoimmune diseases.
  • Hormones
    Hormonal changes, especially in women, can influence the development of autoimmune diseases. This might explain why women are more frequently affected by autoimmune conditions than men. Autoimmune diseases are among the top 10 leading causes of death among American women.

Living with an autoimmune disease can severely affect your ability to work and function normally in everyday life. This effect can be even more severe for Veterans who are already facing many challenges of transitioning to civilian life finding new purpose and employment and building new relationships.

The good news is, that you can get up to a 100% VA disability rating if you suffer from an autoimmune condition. However, it is important to understand how the VA classifies the conditions and which factors it considers to make sure that you receive a just VA disability rate and corresponding benefits.

VA Rating for Autoimmune diseases

VA rates autoimmune diseases under the §4 Schedule of Ratings.

Generally, these conditions are rated from 0% to 100%. The main criteria used for rating an autoimmune disease are:

  • Severity and Frequency of Symptoms
    The severity and frequency of general symptoms such as pain, fatigue, and organ dysfunction.
  • Impact on Daily Life
    How the condition and its symptoms affect your ability to perform in everyday life, find and sustain a job, etc.
  • Treatment Requirements
    The type and frequency of treatments such as medication, physical therapy, or surgery needed and their efficiency.

It can be hard to demonstrate a service connection to autoimmune diseases. It mainly happens because, as we have already mentioned, the true nature and origin of these numerous conditions are still not fully understood. 

Also, unlike a missing limb or PTSD, which can be connected to a certain event, that occurred during your service, an autoimmune disease can be a result of a combination of various factors, which may be hard to track and link to a particular event of conditions of your service.

So, how do you prove that your autoimmune disease is service-connected and claim your VA disability benefits?

There are 3 ways to do it:

  1. Track the Timing
    The best way to prove a service connection between your autoimmune diseases is to demonstrate medical evidence that shows a close or overlapping timing of your military service and the development of the autoimmune diseases.
  2. Autoimmune Disease as a Presumptive Condition
    If you served in a qualifying time period and location and then developed a particular health condition, the VA automatically “presumes” that it is a service-related disability and recognizes your right to VA benefits. For example, rheumatoid arthritis, lupus, and multiple sclerosis are just a few examples of the numerous known autoimmune diseases that develop after repeat exposure to Agent Orange.
  3. Autoimmune as a Secondary Condition
    In case you have no medical evidence or qualifying records that would connect your autoimmune disease directly to the time in the military, you can claim it as a secondary to an existing service-connected disability. There is multiple evidence that autoimmune diseases can occur as secondary to Hepatitis C, PTSD, and Gulf War Syndrome as well as physical trauma that develops into chronic pain and inflammation.

Most Common Autoimmune Diseases and VA Rates

Though there are about 80 different autoimmune conditions, some of them are considered most common among Veterans. Let’s take a look at their diagnostic codes and VA rates you may expect once diagnosed.

Systemic Lupus Erythematosus (SLE) (Diagnostic Code 6350):

  • 10% – Exacerbations once or twice a year or symptomatic during the past 2 years.
  • 60% – Exacerbations lasting a week or more, 2 or 3 times per year.
  • 100% – Acute with frequent exacerbations, producing severe impairment of health.

Rheumatoid Arthritis (Diagnostic Code 5002):

  • 20% – One or two exacerbations a year in a well-established diagnosis.
  • 40% – Symptom combinations productive of definite impairment of health, or incapacitating exacerbations occurring 3 or more times a year.
  • 60% – Less than the criteria for 100% but with weight loss and anemia productive of severe impairment of health or severely incapacitating exacerbations 4 or more times a year.
  • 100% – Constitutional manifestations associated with active joint involvement, totally incapacitating.

Multiple Sclerosis (Diagnostic Code 8018):

  • 30% – Minimum rating.
  • Higher Rates – Based on the severity of symptoms like loss of motor function, coordination issues, and cognitive impairment, rated under specific diagnostic codes for affected body systems.

Claiming VA Disability Benefits for Autoimmune Diseases

The process of claiming your VA disability benefits for an autoimmune condition is not much different from the procedure for any other service-connected disability. However, there are some things you need to keep in mind:

  • Medical Examination
    You can claim benefits for an autoimmune condition only if it is formally diagnosed by a qualified medical professional
  • Evidence
    Since it may be hard to service-connect an autoimmune condition, you need to collect as much evidence as possible. Those can be thorough medical records as well as service records, buddy letters, and statements from people who observed your experience in the military, the development of the condition, and its effect on your current lifestyle
  • Disability Benefits Questionnaire (DBQ)
    A DBQ may be used to provide additional detailed information about the severity of the condition
  • Compensation and Pension Exam (C&P)
    It is a series of examinations conducted by a VA or a VA-accredited medical professional. The results of the C&P Exam often play a key role in the evaluation of your case and the final decision about your VA disability rate or whether you are entitled to the benefits at all. 
  • Total Disability Individual Unemployability (TDIU)
    If you cannot maintain substantially gainful employment due to your autoimmune disease and the severity of its symptoms, you may qualify for TDIU. That way, you may receive compensation at the 100% disability rate, even if your combined disability rating is less than 100%

Final Thoughts

The system of VA ratings can be extremely confusing, especially when it comes to such complex conditions as autoimmune diseases. However, you don’t have to fight this battle on your own. Here at VCU, we make sure that every Veteran has a team of qualified professionals by their side. Combining our knowledge and experience, we make sure that Veterans and their families get maximum in the VA disability benefits they deserve, gain and maximize their VA disability rates, and have 100% control over their cases.

Book your FREE 30-minute call with a Veterans Specialist today and learn how to optimize your VA disability claim. Our professionals provide tailored advice for every customer to help Veterans understand their options and receive the full support and compensation they deserve.

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