Va Disability Rating For Lower Back Pain

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Can Hip Pain Be Related To Back Pain

VA Disability Rating for Lower Back Pain

Its not uncommon for people to experience pain in both their hips and back. Hip pain and back pain are often related. A large network of muscles, ligaments, and bones connect the hip and spine. When one area is damaged or injured, it can also affect the other area. For example, if you have a herniated disc in your lower back, it can also cause pain in your hips. Likewise, if you have arthritis in your hips, it can lead to back pain.

A VA disability claim for hip and back pain can sometimes be difficult to obtain due to the lack of clear evidence linking the two conditions. However, if your doctor can document how the two conditions are related, you may be able to obtain benefits.

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Filing A Claim For Va Benefits

If you have back pain as a result of your military service, you can file a claim for VA disability benefits. You will need to provide evidence linking the cause to your time in service.

If you would like help with your claim, contact the team at Woods and Woods for guidance. We never charge veterans for help filing the initial application. Our team works diligently to submit your application correctly, allowing you to avoid the lengthy VA disability appeals process.

Traumatic And Degenerative Arthritis

Traumatic arthritis is joint damage, pain, or inflammation due to an injury. If an individuals joints begin causing problems after excessive movement or physical trauma, their arthritis will not be considered chronic.

Degenerative arthritis refers to a chronic breakdown of cartilage around joints. The joints between vertebrae are called facets. When facet joints are damaged, veterans experience facet arthropathy. The VA rating for facet arthropathy can contribute to the VA rating for degenerative arthritis of the spine.

Both of these forms of arthritis are rated under code 5003. Each specific joint will also have its own identifying arthritis code. For example, degenerative arthritis of the spine is listed under diagnostic code 5242, meaning decisions regarding degenerative arthritis of the spine will reference the condition as 5242-5003.

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Contact Tuley Law Office

Building and presenting a VA disability claim to the VA can be an arduous and difficult process. The legal team at Tuley Law Office have the knowledge and skills to guide you through the VAs dense language and often vague expectations.

If you or someone you know is experiencing back pain as a result of their time in the military, contact us today to schedule a consultation.

Proving Va Service Connection For Your Back Condition

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According to the VA, to prove a service-related back injury you must:

  • Provide VA, military or private medical records related to your back pain injury claim that support when your condition began and how it has worsened over time.
  • Provide military separation documents, including your DD-214
  • Provide supporting statements from family members, friends, clergy members, law enforcement personnel or those you served with that can tell the VA more about your claimed condition and how and when it happened or how it got worse.

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Functional Loss Full Definition

Disability of the musculoskeletal system is primarily the inability, due to damage or infection in parts of the system, to perform the normal working movements of the body with normal excursion, strength, speed, coordination and endurance.

It is essential that the examination on which ratings are based adequately portray the anatomical damage, and the functional loss, with respect to all these elements.

The functional loss may be due to absence of part, or all, of the necessary bones, joints and muscles, or associated structures, or to deformity, adhesions, defective innervation, or other pathology, or it may be due to pain, supported by adequate pathology and evidenced by the visible behavior of the claimant undertaking the motion.

Weakness is as important as limitation of motion, and a part which becomes painful on use must be regarded as seriously disabled.

A little used part of the musculoskeletal system may be expected to show evidence of disuse, either through atrophy, the condition of the skin, absence of normal callosity or the like.

Was Your Va Claim Denied

The accredited attorneys and advocates at Chisholm Chisholm & Kilpatrick LTD have decades of experience successfully representing disabled veterans and their families before the Department of Veterans Affairs, the Court of Appeals for Veterans Claims, and the Federal Circuit. We may be able to help if your claim was denied. Contact us today at 800-544-9144.

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General Rating Formula For Lower Back Pain

In most cases, VA uses the General Rating Formula for Diseases and Injuries of the Spine under 38 CFR § 4.71a to evaluate back conditions, including low back pain. This general rating formula is based primarily on range of motion, or the measurement of the amount of movement around a specific joint or body part. The range of motion measurement typically encompasses the range of flexion and extension as well. VA generally rates low back pain as follows:

Importantly, if veterans do not meet the range of motion criteria outlined above, it is still possible to obtain a high rating for their low back pain if they have intervertebral disc syndrome as well. VA rates IVDS under Diagnostic Code 5243, which focuses on the number of incapacitating episodes veterans experience as a result of their low back pain. Here, VA defines an incapacitating episode as a period of acute signs and symptoms that requires bedrest as prescribed by a physician. IVDS is rated as follows:

  • 60% with incapacitating episodes having a total duration of at least 6 weeks during the past 12 months
  • 40% with incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months
  • 20% with incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months
  • 10% with incapacitating episodes having a total duration of at least one week but less than 2 weeks during the past 12 months

Va Rating Table For Back Pain

WINNING a VA Disability Rating for Back Pain
Rating
Entire spine is frozen in an unfavorable position Entire spine is frozen in an unfavorable position

As you can see, Range of Motion measurements plays a significant role in rating spinal conditions. Because the rating formula is almost entirely based on the VAs range of motion chart and measurements, its important to make sure that a doctor performs a range of motion testing according to the VAs chart as accurately as possible.

Also, the VA requires that all range of motion measurements be taken with a goniometer. If a doctor doesnt use a goniometer to measure your range of motion, the VA will not consider the results.

In addition to the range of motion measurements, the general rating criteria for spinal involve whether the cervical and/or thoracolumbar spine is frozen in a favorable vs. unfavorable position.

A favorable position means the range of motion measurement for flexion or extension is 0 degrees. Unfavorable means any position that is not 0 degrees in flexion or extension.

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Can I Get A Higher Va Rating For A Back Disability

Many veterans find VAs rules for rating back disabilities confusing. Despite having severe impairment and a lot of pain, veterans often find that VA rates their back injuries at 10 or 20 percent.

A lot of veterans feel that this 10 or 20 percent rating is low for how much their back disability affects them. Is that rating correct or should it be higher?

In this article, I will discuss how VA rates back disabilities and the ratings your can receive. I will focus on the thoracolumbar spine.

Radiculopathy Secondary To Back Pain

Radiculopathy is a condition that can result from damage to the nerve roots. The nerve roots are the part of the nerve that extends from the spinal cord to the rest of the body. When these roots are damaged, it can cause pain, numbness, and weakness in the arms or legs.

Radiculopathy is often caused by compression or injury to the spine, a common complication of back pain.

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Va Ratings And Secondary Conditions

If you have a direct service connection for a back problem and have developed a secondary condition as a result, you may be able to file a claim to increase your overall disability rating. You may not only be entitled to benefits for your back condition, but for your secondary condition as well. Adding a secondary condition to your disability claim can give you an increase in your monthly disability compensation. Some secondary conditions make you eligible for Total Disability Individual Unemployability , depending on if the condition affects your ability to work. In order to qualify for benefits for a secondary service connection, you will be required to provide the following:

  • Diagnosis by a medical professional of the secondary condition
  • Evidence showing that your back disability resulted in the secondary condition and that there is a direct link between the two conditions

A secondary service condition will follow the same claim process as required for the primary back condition. In order to qualify for TDIU, a Veteran must have the following:

  • A 60% rating for one of the service conditions
  • Two or more conditions that are rated at 40% or more and have a minimum combined rating of 70% or more

Ratings for a back condition and a secondary condition will be used to determine what the overall disability will be for the Veteran, and benefits will be based on the overall rating.

What Are Va Benefits For Back Pain

Quebec Back Pain Disability Scale

First of all, although it is possible to receive benefits for pain incurred during your time in service without a diagnosis, it is not guaranteed. A current diagnosis is always recommended if possible to obtain. In addition to your current diagnosis, you will need to include a NEXUS letter and DBQ to partner with your medical evidence and in turn, prove your service-connection. Without these outside documents, you are significantly decreasing your chance of winning your VA disability for back problems claim.

In determining benefits, the VA refers to the back as the thoracolumbar spine. This is the term used to reference middle or lower back pain. The VA considers upper back pain in the same category as neck pain. Therefore, anything above middle or lower back pain will be referred to as the cervical spine and falls under a different rating system.

The thoracolumbar spine is composed of two parts of the spine the thoracic and the lumbar . These are the two areas that will be examined in order to determine benefits for any back pain.

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Back Pain Va Rating Chart:

  • 100% VA Disability for Back Pain: Unfavorable ankylosis of the entire spine
  • 50% VA Disability Rating for Back Pain: Unfavorable ankylosis of the entire thoracolumbar spine
  • 40% VA Rating for Back Pain: Unfavorable ankylosis of the entire cervical spine or, forward flexion of the thoracolumbar spine 30 degrees or less or, favorable ankylosis of the entire thoracolumbar spine
  • 30% VA Rating for Back Pain: Forward flexion of the cervical spine 15 degrees or less or, favorable ankylosis of the entire cervical spine
  • 20% VA Disability Rating for Back: Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees or, forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees or, the combined range of motion of the cervical spine not greater than 170 degrees or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis

*If no limitation of range of motion is observed, but the claimant has painful motion, the minimum rating or 10% should be applied.

How To Qualify For Higher Va Ratings For Back Pain

The VA rates back pain based on how much of the spine, or range of motion, is affected.

In addition to range of motion scores and medical findings like ankylosis, the VA has to consider the severity of a veterans functional loss, said Cecilia Ton, a VA-certified disability benefits lawyer. Functional loss refers to any impairment in a veterans functioning due to a service-connected back or neck disability. Making the VA aware of the severity of your functional loss could trigger the VA to assign a higher rating.

Veterans also might not have to show an actual medical finding of ankylosis. If a veterans condition requires a neck or back brace that could be considered the functional equivalent to ankylosis. For example, braces help a veterans stability, but while wearing the brace, their back may be stuck in an upright position, which could be the functional equivalent of ankylosis.

The VA also factors in conditions related to back or neck disabilities. Neurological disabilities that can be tied to a veterans back or neck pain must receive a separate rating. As we discussed earlier, radiculopathy is a common neurological disability stemming from back or neck injuries. The VA also requires that bowel and bladder incontinence and impairment receive a separate rating.

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Veterans Back Pain Claims

Back pain is a common condition among veterans who have completed active duty service. Chronic back pain can inhibit your ability to maintain employment or meet your own day-to-day needs. Fortunately, you may qualify for disability benefits from the Department of Veterans Affairs if you suffer from service-related back pain.

From acute injuries to repetitive stress syndrome, some forms of back pain will never heal entirely. This is especially true in chronic condition cases that involve nerve damage in the spine. Let an experienced VA benefits attorney advise you on pursuing veterans back pain claims.

Va Disability Rating For Cervical Spine

Common Secondary Conditions to Back Pain: VA Claims

The cervical spine is towards the top, so cervical rating criteria also cover VA disability rating for neck pain or cervicalgia VA rating. Compensation will be decided on the following measurements:

  • 0 percent rating: Flexion greater than or equal to 45 degrees, OR a combined ROM greater than or equal to 340 degrees
  • 10 percent rating: Flexion between 30 and 45 degrees, OR a combined ROM between 175 and 340 degrees
  • 20 percent rating: Flexion between 15 and 35 degrees, OR a combined ROM less than or equal to 170 degrees
  • 30 percent rating: Flexion less than or equal to 15 degrees, OR the entire cervical spine is being stuck in a favorable position
  • 40 percent rating: The entire cervical spine is stuck in an unfavorable position
  • 50 percent rating: This rating does not apply to only the cervical spine
  • 100 percent rating: The entire spine will not move and is stuck in an unfavorable position

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Back Pain As A Secondary Condition

Veterans may suffer back pain as a secondary condition, according to veteran disability law firm Chisolm, Chisolm and Kirpatrick.

For example, a veteran has a service-connected hip condition that causes them to favor one side when walking, resulting in an altered gait. This uneven shift in weight then contributes to back pain. In this case, the veterans back pain is caused by their service-connected hip condition, and therefore warrants secondary service connection.

You must file a new VA claim for a secondary condition. You cant use the same appeal process youd use to file for an increased rating.

How To Get A Range Of Motion Test For Back Pain

To assess VA disability for back problems, the VA most often uses the General Rating Formula for Diseases and Injuries of the Spine to evaluate them. Their rating is determined most commonly by assessing your range of motion. Their formula looks at the flexion at the waist and determines if it is limited by injury.

According to the VA, flexibility must be fairly limited to even get a 20 percent disability rating. This will be determined on whether there is forward flexion greater than 30 degrees but less than 60 degrees. Meaning that if you are significantly limited in your ability to bend at the waist, you might qualify for the 20 percent rating. Usually, previous diagnoses from doctors or therapists will be used to determine this.

The range of motion method of determining your VA benefits rating generally will end up as one of the following:

Of course, a limited range of motion is not the only way to get VA disability for back problems. It is also possible to obtain at least a 20 percent rating if you are regularly experiencing muscle spasms severe enough to develop an abnormal walking gait. They will also evaluate you for the following abnormal spinal contours:

  • abnormal kyphosis
  • or reversed lordosis .

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