Should the use of medications used to alleviate pain and other symptoms of musculoskeletal conditions be considered when evaluating severity?

The case was published by the court on March 12, 2025.

This is a case that applies to a huge percentage of veterans.

The Foundation: The veteran was rated for back and ankle conditions. The veteran took over-the-counter and prescription medications to alleviate symptoms (that is, “to diminish symptoms”).

VA’s examiner noted the use of medications, but did not document the severity of the conditions had medications not been used.

The Analysis: The Court determined that Jones v. Shinseki, 26 Vet.App. 56 (2012), applied, as did McCarroll v. McDonald, 28 Vet.App. 267 (2016), Sharp v. Shulkin, 29 Vet.App. 26 (2017), Mitchell v. Shinseki, 25 Vet.App. 32 (2011), and DeLuca v. Brown, 8 Vet.App. 2002 (1995).

The Holding: VA cannot consider the ameliorating effects of medications when evaluating a veteran’s musculoskeletal conditions because the rating schedule does not take into account medications, just like it must consider functional loss during flare-ups.

Simple case with significant effects for veteran benefit law. If you take Motrin, Tramadol, Indomethacin, or anything else to help with muscle or joint pain, the VA cannot consider that and must determine what the impairment is if you did not take the medication, while also considering functional loss, and functional loss during a flare-up.

If the examiner does not consider these factors, it is clear legal error. Note: this constitutes a prejudicial error, not a CUE, because it creates an incomplete record, not an inaccurate record.