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Chronic pain syndrome is one of the most misunderstood and underrated conditions in the VA disability system.
While many veterans suffer from debilitating pain that persists long after service, few realize they may qualify for monthly, tax-free VA disability compensation—especially when the chronic pain leads to severe functional limitations and mental health symptoms.
In this expert-level guide from Brian Reese the VA Claims Insider, he’ll reveal and explain what chronic pain is, how it’s rated by the VA, and how you can file a claim to get the benefits you’ve earned.
We’ll also cover how chronic pain can lead to a mental health condition called Somatic Symptom Disorder, which is rated under the General Rating Formula for Mental Disorders from 0% to 100%.
Let’s begin!
Table of Contents
Summary of Key Points
- Chronic Pain Can Qualify for VA Disability: Many veterans suffer from chronic pain due to service-related injuries or overuse. If that pain causes severe functional limitations or mental health issues, it may qualify for monthly, tax-free VA compensation—even if the original injury has “healed.”
- Chronic Pain Syndrome is Often a Mental Health Claim: Chronic Pain Syndrome is typically rated under Somatic Symptom Disorder (SSD), a mental health condition in the VA system. SSD acknowledges that chronic physical pain causes significant emotional distress and impairs daily functioning. VA rates SSD from 0% to 100% using the same criteria as PTSD, anxiety, and depression.
- SSD Can Be Filed as a Secondary Condition: Veterans can file SSD secondary to a service-connected condition like chronic back pain, joint injuries, migraines, or TBI. Under 38 CFR § 3.310, SSD can be service-connected by causation or aggravation. Medical evidence and a Nexus Letter linking the conditions are required.
- Steps to File for Chronic Pain/SSD VA Disability: Veterans should begin with an Intent to File, gather medical and service records, and submit a fully developed claim. A C&P exam may be required. If denied or underrated, veterans have appeal rights to fight for the benefits they’ve earned.
What Is Chronic Pain?
According to the U.S. National Center for Complementary and Integrative Health, chronic pain is defined as pain that lasts longer than three to six months, or beyond the normal healing time.
For veterans, this pain is often the result of combat-related injuries, overuse during training, or service-connected orthopedic conditions that deteriorate over time.
Examples of chronic pain include:
- Chronic low back pain following a spinal injury
- Ongoing knee pain after years of marching and rucking
- Persistent neck pain after a vehicle accident while deployed
- Migraines or post-concussive headaches from blast exposure
This pain isn’t just uncomfortable—it can significantly impair your ability to function in daily life, work, or maintain relationships.
Chronic Pain Syndrome = VA Mental Health Claim
One of the most important things veterans need to know is this: Chronic Pain Syndrome is often evaluated as a mental health condition under the DSM-5.
The official diagnosis in the VA system is Somatic Symptom Disorder (SSD) with predominant pain.
This diagnosis acknowledges that your physical symptoms (chronic pain) cause serious emotional distress and can interfere with your day-to-day life—even if the original injury has “healed.”
According to the DSM-5:
Somatic Symptom Disorder involves “one or more somatic symptoms that are distressing or result in significant disruption of daily life.”
It is not a question of whether the pain is real.
SSD is a recognized mental health condition where your physical symptoms are real and present, but they also lead to excessive thoughts, feelings, or behaviors related to the pain.
Example: Somatic Symptom Disorder Secondary to Chronic Back Pain
Let’s say you have service-connected chronic back pain rated at 20%.
Over the years, the pain becomes unmanageable.
You develop depression and anxiety because you can’t work or engage in social activities.
Your doctor diagnoses you with Somatic Symptom Disorder secondary to your service-connected back pain.
You can now file SSD as a secondary claim for secondary service connection, and it will be rated under the General Rating Formula for Mental Disorders (38 CFR § 4.130) from 0% to 100%, depending on the severity of your symptoms and negative impacts to your work, life, and social functioning.
How the VA Rates Chronic Pain Syndrome (Somatoform Disorders)
Somatic Symptom Disorder is rated from 0% to 100% with breaks at 10%, 30%, 50%, and 70%, the same ratings and criteria used for PTSD, depression, anxiety, and all other VA mental health claims:
| Level of Occupational and Social Impairment and Approximate Severity of Symptoms | Somatic Symptom Disorder VA Ratings | Minimum Monthly Payment |
|---|---|---|
| Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. | 100% | $3,831.30 |
| Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships. | 70% | $1,759.19 |
| Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. | 50% | $1,102.04 |
| Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). | 30% | $537.42 |
| Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication. | 10% | $175.51 |
| A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication. | 0% | Non-Compensable |
Example: Somatic Symptom Disorder Rated at 70%
A veteran experiences constant knee pain from a service-connected injury.
They develop insomnia, depression, and isolation as a result.
They struggle at work and in completing daily tasks due to the pain and associated mental health symptoms.
A C&P examiner confirms SSD with serious limitations.
The VA assigns a 70% rating based on the mental health effects of the chronic pain secondary to knee pain.
Secondary Service Connection for Chronic Pain
In many cases, chronic pain is not the primary condition.
Instead, it’s a result of another service-connected condition like:
- Degenerative Disc Disease (DDD)
- Knee, hip, or shoulder injuries
- Migraines or traumatic brain injury
- Amputation or limb loss
In these cases, SSD or Chronic Pain Syndrome should be filed as a secondary claim.
38 CFR Secondary Service Connection: Definition of Secondary Service Connection to Include Aggravation
According to 38 CFR 3.310(a) and (b), service connection can be granted for disabilities that are either directly caused by or aggravated by a service-connected condition.
This includes:
- Secondary Causation: Where the new secondary disability is proximately due to or the result of a current a service-connected condition.
- Aggravation: When a non-service-connected disability is aggravated (e.g., made worse) by a service-connected disability. It’s important to note that this does not require the aggravation to be permanent.
How to Establish Secondary Service Connection for Chronic Pain Syndrome (Somatic Symptom Disorder)
To establish a secondary service connection for SSD, veterans need to provide the VA with two primary pieces of evidence:
- Current Diagnosis: The veteran must have a current diagnosis of SSD. This diagnosis must be documented in a medical record by a qualified medical professional.
- Nexus Evidence Between the Two Conditions: The veteran must provide medical evidence that links the secondary condition to the already service-connected condition. Ideally, you submit a Nexus Letter for a secondary condition that explain how the new disability is proximately due to or aggravated by the primary service-connected condition.
How to File a VA Disability Claim for Chronic Pain or SSD
- Intent to File: Begin your VA claim online and start your intent to file to preserve your filing date for back pay. You have one year from your intent to file date to submit your VA claim.
- Gather Evidence: Collect medical records, service records, and supporting statements.
- Submit Claim: File your claim through the VA’s online portal or by mail.
- Compensation & Pension (C&P) Examination: Attend the C&P exam if requested, where a VA examiner will assess your condition.
Be thorough and detailed in your application to enhance the likelihood of a favorable decision.
If your initial claim is denied or underrated, you have the right to appeal the decision.
>> Click HERE to learn about your VA appeal options!
Conclusion & Wrap-Up
Chronic pain is real.
It impacts your physical abilities, your mental health, and your quality of life.
And too often, veterans don’t even know they can get compensated for it.
If your chronic pain has led to psychological symptoms, functional limitations, or unemployability, you may qualify for significant VA disability benefits under Somatic Symptom Disorder.
Whether as a primary condition or secondary to another service-connected disability, chronic pain syndrome should not be ignored.
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About the Author
Brian Reese
Brian Reese is a world-renowned VA disability benefits expert and the #1 bestselling author of VA Claim Secrets and You Deserve It. Motivated by his own frustration with the VA claim process, Brian founded VA Claims Insider to help disabled veterans secure their VA disability compensation faster, regardless of their past struggles with the VA. Since 2013, he has positively impacted the lives of over 10 million military, veterans, and their families.
A former active-duty Air Force officer, Brian has extensive experience leading diverse teams in challenging international environments, including a combat tour in Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy and earned his MBA from Oklahoma State University’s Spears School of Business, where he was a National Honor Scholar, ranking in the top 1% of his class.
