Disarticulation refers to amputation through a joint. Amputation refers to removing a limb, appendage, or outgrowth of the body. Loss of the extrinsic pelvic girdle muscles occurs as a result of the disarticulation.

Amputations result from severe circulatory problems resulting in gangrene; certain bone cancers; and trauma.

There will be loss of use of the amputated limb. Postoperative infection at the operative site, pain, loss of blood, and shock are possible.

Examinations to evaluate the need for an amputation would most likely include: physical examinations focused on evaluation of the patient's musculoskeletal system for swelling, deformity, tenderness, range of motion and circulation; x-rays to visualize bone loss; and laboratory tests to determine the underlying cause and possible complications. Computed tomography (CT) scan and magnetic resonance imaging (MRI) are not commonly used, but may assist in visualizing areas that cannot be seen by regular x-ray.

Disarticulation and amputation would be the treatment for some severe circulatory problems, certain bone cancers, and trauma.

• May be entitled to special monthly compensation where the veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).

• To properly rate this disability, accurate and complete descriptions of the affected extremity are necessary. Descriptions of the affected extremity should include exact place of amputation or resection, length of stump, limitations of motion, pain, weakness, carriage, gait, and posture. An occupational therapy work-up is extremely beneficial, especially when amputation of the hands or fingers is involved.

• Consider entitlement to specially adapted housing (SAH), special home adaptation (SHA), and/or automobile or other conveyances and adaptive equipment, if otherwise in order. See 38 CFR 3.808 – Automobile or other conveyances and adaptive equipment; 38 CFR 3.809 – Specially adapted housing; 38 CFR 3.809a – Special home adaptation grants.

• Consider entitlement to SMC under 38 CFR 3.350 as an issue in every case where there is a severe degree of disability involving the loss or loss of use of an extremity or sensory organ or any other functional loss providing entitlement to SMC. 
  

• Compensation is payable under 38 U.S.C. 1160 for disabilities involving certain paired organs or extremities, one SC and the other non-service-connected (NSC), provided the NSC disability is not the result of the Veteran’s own willful misconduct.

• A determination as to loss of use (LOU) of a hand or foot is not restricted to organic loss; it includes functional LOU as well.

• Where an NSC cause necessitates amputation of an extremity resulting in elimination of an SC disability distal to the site of the amputation, do not sever SC for or reduce the evaluation of the SC disability.

• With service incurred lower extremity amputation or shortening, a disabling arthritis, developing in the same extremity, or in both lower extremities, with indications of earlier, or more severe, arthritis in the injured extremity, including also arthritis of the lumbosacral joints and lumbar spine, if associated with the leg amputation or shortening, will be considered as service incurred, provided, however, that arthritis affecting joints not directly subject to strain as a result of the service incurred amputation will not be granted service connection. See 38 CFR 4.58 – Arthritis due to strain.

• Ischemic heart disease or other cardiovascular disease, including hypertension developing in a veteran who has a service-connected amputation of one lower extremity at or above the knee or service-connected amputations of both lower extremities at or above the ankles, shall be held to be the proximate result of the service-connected amputation or amputations. See 38 CFR 3.310(c) – Disabilities that are proximately due to, or aggravated by, service-connected disease or injury. 

• Consider entitlement to Dependents’ Educational Assistance (DEA) under 38 U.S.C. Chapter 35, if otherwise in order. 

• Separately evaluate residuals involving other body systems (e.g., bowel impairment, bladder impairment) under the appropriate diagnostic code.

• Also entitled to special monthly compensation. (AMPUTATIONS: LOWER EXTREMITY)