VA Disability Rating for Back Pain
Chronic back pain and related conditions, such as intervertebral disc syndrome, or IVDS, can impact a veteran’s quality of life. The VA offers benefits that can provide those suffering from this condition with some support for daily living. A VA disability rating for back pain can range anywhere from 10% to 100% and lets you receive monthly compensation determined by the extent of your disability. Contact Veterans Guide for information about maximizing your back pain VA disability benefits.
- The VA disability ratings for back pain range from 10% to 100%, determined by the severity and impact on daily functions.
- Specific conditions like intervertebral disc syndrome (IVDS) have detailed rating criteria based on incapacitating episodes.
- Veterans severely impaired by back pain may be eligible for Total Disability Individual Unemployability (TDIU) benefits.
- Effective claims for back pain-related disabilities require comprehensive medical documentation.
- Secondary conditions linked to back pain, such as ankylosing spondylitis, also influence the overall disability rating.
Back pain is one of the most common physical symptoms experienced by U.S. veterans. For many, the pain makes it impossible to work and engage in some daily activities without significant difficulty. The Department of Veterans Affairs has a rating system that helps determine the disability amount owed to former service members whose time in training and active duty has led to a chronic, ongoing physical impairment. Veterans Guide can help you learn more about back pain VA disability benefits you may be eligible to receive.
Veterans and Back Pain
According to the American Academy of Orthopedic Surgeons, one in four U.S. adults has chronic low back pain. Veterans are even more likely to suffer from back pain and spine impairment is a leading cause of disability among those who have served in the military.
Regular military training and service activities, such as jarring and impact-heavy movements, cause repeated stress to the back and spine. Load carriage training can cause back injuries, stress fractures, and foot and knee pain.
Veterans regularly lift and carry heavy objects, sprint and run long distances, pivot quickly, and jump during their service. Over time this can cause a long-term musculoskeletal disability that affects veterans long after discharge.
The VA notes that chronic back pain is hard to treat. It is one of the top five conditions for which the VA offers complementary care.
Chronic low back pain is one of the examples the VA gives of conditions that can qualify for disability benefits.
How Does the VA Rate Back Pain?
Back pain VA disability ratings depend on the extent of your pain. Disability ratings consider how your back pain affects your physical health and ability to perform daily tasks. In assessing the benefits you may receive, the VA may measure your physical health and medical history against disability ratings for musculoskeletal conditions.
The VA uses a percentage system to denote the extent of back pain disability. The assigned percentage determines the amount of your monthly benefits. If you have more than one disability, the VA uses a combined rating system to decide your monthly compensation.
Back pain ratings are part of the musculoskeletal system ratings schedule. The schedule uses the terms “unfavorable” and “favorable” ankylosis. Ankylosis is when you have limited or no mobility in the spine. If ankylosis is favorable, your spine is straight. If it is unfavorable, it is stuck in a bent position.
The ratings are as follows:
- 100 percent: Complete ankylosis of the spine.
- 50 percent: Complete ankylosis of the lower spine.
- 40 percent: Favorable ankylosis of the entire lower spine or the ability to flex the lower spine forward 30 degrees or less.
- 20 percent: Ability to flex the lower spine forward 30 to 60 degrees, a range of motion of no more than 120 degrees, or abnormal gait or spinal shape.
- 10 percent: Ability to flex the lower spine forward 60 to 85 degrees, range of motion between 120 and 235 degrees, localized tenderness, or fracture with loss of 50 percent or more of height.
Rating for Intervertebral Disc Syndrome
Intervertebral disc syndrome, or IVDS, occurs when one or more of the discs separating the spinal vertebrae degenerate or break down. The discs can herniate, or bulge out, and compress the spinal cord, causing sciatica, pain, weakness, or numbness in the back or legs. Even when discs do not herniate, IVDS can lead to chronic back pain that worsens with sitting, bending, or lifting.
The VA gives a disability rating for IVDS that ranges from 10 percent to 60 percent, depending on the frequency of incapacitating episodes. An incapacitating episode is when you have a symptom flare-up, and your doctor prescribes bed rest or treatment.
The VA ratings for IVDS are as follows:
- 60 percent: Incapacitating episodes of a total of six weeks or more over the past 12 months
- 40 percent: Incapacitating episodes of at least four weeks but less than six weeks over the past 12 months
- 20 percent: Incapacitating episodes of at least two weeks but less than four weeks over the past 12 months
- 10 percent: Incapacitating episodes of at least one week but less than two weeks over the past 12 months
Total Disability Individual Unemployability and Back Pain
A veteran who does not have a 100 percent disability rating but whose disability prevents them from working can apply for Total Disability Individual Unemployability, or TDIU, benefits. Veterans who receive TDIU benefits will receive the same benefits that veterans with 100 percent disability ratings receive. To qualify for TDIU benefits, you must meet the following requirements:
- Have at least one service-connected disability rated at least 60 percent disabling or multiple service-connected disabilities rated at least 70 percent disabling, with one rated at 40 percent or higher
- Cannot maintain steady employment that can support you because of your disability
You must submit evidence, such as doctor reports or test results, to show you cannot hold a steady job.
The VA also examines the evidence to decide the extent of your back pain. This evidence may include the following:
- A Compensation and Pension, or C&P, exam if the VA requests it
- Information from federal agencies if the VA determines that it is necessary
- Information from your doctor about the extent of your back pain
Your physician must conduct a thorough examination and complete an extensive form as part of your VA claim. The form requests the following information:
- Specific diagnoses, such as degenerative disc disease
- Medical history
- Functional limitations
- Range of motion
- Muscle strength
- Nerve health
Your doctor must provide extensive details to the VA about these factors.
Back Pain as a Secondary Disability
You can combine your disability ratings if you also have another service-connected back pain disorder. This can increase your monthly VA compensation entitlement.
Combined disability ratings take into account that a veteran may have more than one condition that impacts their life. However, it’s not as simple as combining the percentage ratings of each disorder. The VA uses a table to determine combined ratings.
For example, if you have a back pain disorder that is 50 percent disabling and another disorder that is 30 percent disabling, the VA uses a calculation table to determine a net disability rating of 65 percent. A combined rating may be given for back pain and an entirely different condition or back pain and a condition secondary to back pain.
Some conditions that may be secondary to back pain include:
- Ankylosing spondylitis
- Degenerative arthritis
- Degenerative disc disease
- Lumbosacral strain
- Spinal fusion
- Spinal stenosis
- Traumatic paralysis
- Vertebral dislocation
- Vertebral fracture
How To Obtain VA Disability Compensation for Back Pain
There are several steps in the application process for disability benefits for back pain. First, determine which documents you must submit when you file your claim. Some documents you must submit include the following:
- VA medical records
- Private medical records
- Supporting statements from friends, family, and fellow service members
After you file a claim, the VA may require you to undergo a C&P exam. The VA generally asks for evidence of a diagnosis and any event in military service that may have led to the condition. The job of the C&P examiner is to give a “nexus opinion,” or an opinion that your time in service caused your back pain.
The C&P examiner can only evaluate your claim based on the information you’ve already sent to the VA. If you have treatment or medical records that are not already part of your VA file, it’s important to submit them to the VA before your appointment.
Veterans Guide is committed to helping all those with service-related disabilities get the benefits they are owed. If you need help or information at any stage of your claim or want to know how to get started, contact us today.
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