Let’s start with the good news about getting VA disability for back problems!
In April 2018, it was determined by the Federal Circuit that the VA must award disability benefits for pain due to military service. Previously, pain without an underlying diagnosis was not awarded compensation, meaning that many, many veterans with a back disability were not awarded benefits. This had been the de facto determination according to the Court of Appeals for Veteran Claims. Thankfully, that is no longer the case.
Today, because of the Federal Circuits decision, veterans may receive disability benefits that began during their military service even without an actual diagnosis. This decision has helped a number of veterans get benefits or even increase their rating for a back disability.
Back pain for Veterans
Spine impairment is one of the leading causes of disability among veterans. Because most of those serving in the military frequently carry and lift heavy loads or engage in quick shifting and running in the line of duty, there is repeated stress and trauma on the joints which affect the health of the spine.
Fortunately, this fact has become more recognized by the VA and those creating policies for the VA. However, it is still important you know how to communicate your pain in order to receive the best possible benefits. Understanding the rules used to determine VA disability for back problems and their ratings will be helpful as you pursue help.
What are VA benefits for back pain?
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 (twelve vertebrae) and the lumbar (5 vertebrae). These are the two areas that will be examined in order to determine benefits for any back pain.
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:
- 100%– entire spine affected by unfavorable ankylosis (the abnormal stiffening and immobility of a joint due to fusion of the bones)
- 50%– the entire thoracolumbar (middle and lower) spine affected by unfavorable ankylosis
- 40%– forward flexion measures 30 degrees or less; or, the entire thoracolumbar spine is frozen in a favorable position.
- 20%– forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees.
- 10% – forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees.
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 (abnormal rounding of the upper back)
- scoliosis (a sideways curvature of the spine)
- or reversed lordosis (abnormal straightening of the spine).
Intervertebral Disc Syndrome
Intervertebral disc syndrome (IVDS), which is the condition wherein there is degeneration of one or more of the discs of the spine. A disc of the spine can deteriorate which could lead to loss of disc height. A disc can also herniate or protrude into the spinal column. Both disc conditions may cause symptoms of sharp pain, shooting pain, numbness, tingling, muscle spasms, or weakness. IVDS may receive the following ratings:
- 60% – a total duration of at least 6 weeks during the past 12 months with incapacitating episodes
- 40% – incapacitated at least 4 weeks but less than 6 weeks during the past 12 months
- 20% – incapacitated at least 2 weeks but less than 4 weeks during the past 12 months
- 10% – incapacitated at least one week but less than 2 weeks during the past 12 months
If a veteran has intervertebral disc syndrome of both the cervical spine and the thoracolumbar spine, then both are rated separately.
Osteoarthritis VA Claim
Finally, it is also possible to get benefits for osteoarthritis in the back. Osteoarthritis is also known as degenerative arthritis and is a very common rating for any joint in the body. Degenerative arthritis of the back is the accelerated “wear and tear” of the spine due to service-related activities or injuries. For successful ratings of arthritis, there must have x-ray evidence of arthritis.
If you have been diagnosed with any of these issues as a veteran, immediately go to the doctor! Getting these disabilities documented from your doctor is crucial for your claim!
Applying for VA Disability Benefits for Back Problems
Once you’ve been diagnosed with your back condition, you will need to establish a service-connection.
While most back disabilities can be traced to a specific event or injury that should be in your military records, you may also have back problems due to the physical stress of training and other work while in service. If that is the case you will want to obtain buddy letters from family, friends, and fellow service members, explaining the difference in your physical health before, during, and after your time in service.
Also, be sure to keep your own records, detailing what you experience day-to-day in regards to pain and obstacles to full functionality. You can do this by requesting your files from the military and always keeping another copy of your medical records.
In order to receive VA disability for back problems, like all VA Claims, the VA will be looking for as much evidence as possible.
For more information and details on how to submit a successful claim, check out this video below:
If you are ready to get started with your VA claim the fastest way to go is here! Don’t allow back pain to prevent you from doing the things that you love!
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About VA Claims Insider
VA Claims insider is an education-based coaching/consulting company. We’re here for disabled veterans exploring eligibility for increased VA disability benefits and who wish to learn more about that process. We also connect veterans with independent medical professionals in our referral network for medical examinations, disability evaluations, and credible Independent Medical Opinions & Nexus Statements (Medical Nexus Letters) for a wide range of disability conditions.