EDUCATIONAL TOOL ONLY. Not legal or medical advice. Not affiliated with the VA.
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Chronic Corticosteroid Use
DC 6299 | 38 CFR § 3.310 (secondary service connection) |
Chronic Corticosteroid Use is rated by the U.S. Department of Veterans Affairs under DC 6299 of 38 CFR § 3.310 (secondary service connection) across 3 severity tiers (40%+ -- Severe limitation or ankylosis / 20% -- Moderate limitation / 10% -- Mild limitation or painful motion). Service connection requires (1) a current diagnosis, (2) an in-service event, injury, or exposure, and (3) a medical nexus opinion linking the two under 38 C.F.R. § 3.303. This condition is frequently rated as secondary to Osteoporosis or Diabetes Type II under 38 C.F.R. § 3.310.
OVERVIEW
Long-term use of systemic corticosteroids (prednisone, methylprednisolone, dexamethasone) prescribed to treat a service-connected condition. While the medication itself is not rated, the documented side effects — Cushing's-like syndrome, secondary diabetes mellitus, osteoporosis, cataracts, glaucoma, immunosuppression, weight gain, hypertension, peptic ulcer disease, avascular necrosis — are eligible for secondary service connection under 38 CFR § 3.310 when the underlying condition driving the steroid prescription is service-connected.
RATING CRITERIA (3 LEVELS)
40%+ -- Severe limitation or ankylosis
Severe limitation of motion or ankylosis of the affected joint. Specific percentages depend on the joint and whether dominant/non-dominant.
20% -- Moderate limitation
Moderate limitation of motion with significant functional impairment. DeLuca factors may increase the effective rating.
10% -- Mild limitation or painful motion
Mild limitation of motion, or X-ray evidence of arthritis with painful motion under DC 5003.
KEY EVIDENCE TO GATHER
-Service treatment records showing injury or complaints
-Imaging (X-ray, MRI, CT)
-Range of motion measurements
-Flare-up documentation per Sharp v. Shulkin
-Buddy statements describing limitations
-Prescription history
-Physical therapy records
-Employment impact documentation
SECONDARY CONDITIONS (10 MAPPED)
DC
Steroids inhibit bone formation and calcium absorption
DC
Steroids increase blood glucose and insulin resistance
DC
Steroids cause posterior subcapsular cataracts
DC
Steroid-induced intraocular pressure elevation
DC
Steroids damage blood supply to bones
DC
Long-term use suppresses adrenal function
DC
Steroids break down collagen in skin
DC
Steroids cause fluid retention and vascular changes
DC
Increased appetite and fat redistribution
DC
Steroid myopathy from protein catabolism
C&P EXAM TIPS (6)
1.Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation.
2.Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.
3.Tell the examiner about flare-ups: frequency, duration, estimated ROM loss. Sharp v. Shulkin (2017) requires estimates.
4.Request active, passive, weight-bearing, and non-weight-bearing ROM testing per Correia v. McDonald (2016).
5.If you use assistive devices (brace, cane), bring them.
6.Describe daily activity impact: work, sleep, household tasks.
SOURCES & EDITORIAL
Rating criteria reference 38 C.F.R. Part 4 (Schedule for Rating Disabilities). This entry has not yet undergone editorial review against the live regulation text — consult the authoritative source directly before relying on the criteria shown.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026