EDUCATIONAL TOOL ONLY. Not legal or medical advice. Not affiliated with the VA.
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Costochondritis VA Disability Rating
DC 5321/5299-5321 | 38 C.F.R. § 4.73 | M21-1, Part IV.ii.2
OVERVIEW
Costochondritis is inflammation of the cartilage connecting ribs to the sternum, causing chest wall pain. Rated by analogy under DC 5321 (muscle group XXI - muscles of respiration: thoracic muscle group) or as a musculoskeletal condition. Common in veterans from body armor wear, rucking, physical training injuries, and blast concussive force. Often misdiagnosed as cardiac pain.
RATING CRITERIA (3 LEVELS)
30% -- Moderate limitation and pain with breathing/activity
Rate by analogy to thoracic spine or chest wall muscle injury. Moderate chest wall pain causing limitation in physical activity, documented on examination with palpable tenderness at costochondral junctions.
20% -- Mild to moderate limitation
Mild to moderate chest wall pain with palpable tenderness at costochondral junctions, causing some limitation in physical activity or respiratory function.
10% -- Mild pain on motion or palpation
Mild pain at costochondral junctions on movement or palpation without significant functional limitation. Imaging or bone scan evidence supports the diagnosis.
KEY EVIDENCE TO GATHER
-Rheumatology or primary care diagnosis of costochondritis
-Documentation ruling out cardiac causes (normal EKG, cardiac workup)
-Service records showing body armor wear, physical training, or blast exposure
-Treatment records for anti-inflammatory medications, steroid injections
SECONDARY CONDITIONS (2 MAPPED)
DC 9413/9412
Chronic chest pain causes health anxiety and panic attacks.
DC 5237-5243
Costochondritis and thoracic spine dysfunction share biomechanical links.
C&P EXAM TIPS (3)
1.Costochondritis is not a cardiac condition. Make sure you have documentation ruling out heart disease so the VA does not defer to cardiology.
2.Body armor wear is a strong nexus for service connection. Document the weight of gear you carried and duration of wear.
3.Describe how the pain affects breathing, lifting, sleeping on your side, and physical activity.
RELEVANT CASE LAW
38 C.F.R. 4.71a; 38 C.F.R. 4.20 (Rating by Analogy)
Costochondritis has no specific diagnostic code. Under 4.20, rate by analogy to the most closely related body part -- typically thoracic spine codes (5237) or chest wall muscle injury codes.
DOLLAR IMPACT
Costochondritis at 10-20% pays $175-$345/mo. The primary value is establishing service connection and supporting secondary claims for anxiety.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026