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November 12, 2019

What Can I Expect from the VA with Back Pain and Arthritis?

Last updated on December 22, 2022

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Is it possible to get a VA disability rating for back pain and arthritis, especially when the back pain is from arthritis? 

The answer is yes, but it’s not always easy. 

Understanding Arthritis

Without a highly detailed medical history, it can be difficult to get a proper rating from the VA for arthritis

This is due, in large part, to the various ways arthritis can manifest as a condition. For instance, rheumatoid arthritis can be both hereditary (inherited from a parent) or caused by an injury. 

When dealing with the VA, there are three types of arthritis that are rated. Two are rated under the same code, with the third-rated on its own. 

The first two are degenerative arthritis and traumatic arthritis. 

Degenerative arthritis

Degenerative arthritis is the chronic breakdown of the cartilage surrounding the joints. This is the most common arthritis to affect the spine. It usually affects the back and develops through general wear and tear. The pain experienced through this condition comes from mechanical damage that is usually more noticeable when bending or twisting the back. 

Traumatic Arthritis

Traumatic arthritis comes from an injury, physical trauma or excessive movement. The effects of this arthritis are very similar to other types, including pain, inflammation, and the build-up of fluid. 

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disorder and is the one form of arthritis that has its own rating code from the VA. When it occurs in the spine, it tends to affect the cervical spine (the neck) rather than the lower back. It usually leads to neck pain, back pain, and often causes pain in the legs and arms as well. 

VA Ratings for Arthritis

It is possible to receive a 100% compensation rating from the VA for arthritis in the back if you are completely incapacitated and stuck in bed. Otherwise, the VA ratings for arthritis are as follows:

  • 20%- if you experience less than 3 incapacitating episodes per year
  • 40%-  incapacitating episodes occur more than 3 times per year plus there is a notable decrease in health
  • 60%- severe incapacitating episodes occur more than 6 times per year

Back pain and arthritis and the VA

Because there are a number of reasons a veteran can experience back pain, it is important to have a detailed medical history to get the proper VA rating for arthritis in the back. 

According to the American Academy of Orthopedic Surgeons, degenerative arthritis is the primary reason for disability discharge among service members. As of 2015, over 395,000 veterans were receiving benefits for degenerative arthritis of the spine. Common causes of degenerative arthritis among service members are injury and joint overuse, such as multiple uses of heavy backpacks. 

While it’s always important to establish a direct service connection for a VA rating, both degenerative and rheumatoid arthritis may also be eligible for presumptive service connection. Under 38 CFR 3.309, arthritis is characterized as a chronic disease. 

If symptoms occur within one year of discharge from military discharge, then the presumption of service connection may apply. 

Conclusion

The VA now has an extensive record of providing care and compensation for back pain and arthritis in the back. It is recommended that any veteran experiencing back pain get seen by a medical professional to determine if they are suffering from a form of arthritis. 

With a diagnosis and the due diligence of establishing a service connection, you should easily receive the proper benefits to get you the care you deserve. Want more help with getting what you need? This is the FASTEST way to go!

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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 and nexus statements (medical nexus letters) for a wide range of disability conditions.

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