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Disabling service-connected back pain is common among veterans. In fact, back and spine conditions consistently rank in the top five most frequently claimed service-related disabilities each year.
However, getting a proper VA disability rating for back pain can be extremely frustrating and challenging. Even if you experience chronic pain that makes gainful employment challenging or even impossible, you may still be given a low rating after your initial compensation and pension (C&P) exam.
But an unfavorable initial rating doesn’t necessarily mean you’re out of options. In this post, our veterans disability lawyers take a closer look at how the VA determines disability ratings for back pain, and ways you might be able to increase your rating.
Once you file a disability benefits claim, the VA will often schedule a C&P exam. During your appointment, you will meet with a doctor and other healthcare professionals who will gather information about your back pain. This often involves both an interview and a physical examination.
After the exam, the doctor will write a report that summarizes their findings and send it to the VA. Based on this report and other information in your file, the VA will assign your disability rating.
When it comes to evaluating disability benefits for back pain, the VA uses a rating formula that is heavily based on range of motion, which is a measurement of how much you can move a joint or muscle. Doctors are required to use a tool called a goniometer at your C&P exam to assess your back’s mobility, and might not focus as much on other significant back symptoms.
This has some obvious disadvantages for veterans. First, range of motion is only one aspect of back pain and functional loss. Veterans who experience significant pain, but still have good or even complete range of motion, often feel that the VA disability system undervalues their level of disability.
Second, VA ratings can be very strict, with a 100% rating only available in very severe cases that involve not just the back, but the neck as well.
Many veterans with significant functional loss, pain, and difficulty working might initially only obtain a 10 or 20 percent rating. In fact, the average VA disability rating for back pain is only 10 percent.
To obtain a 100% VA disability rating for a spinal problem, you’ll need to show that your “entire spine is frozen in an unfavorable position.” Let’s break this down a bit more:
This is a tough standard to hit, and it requires a severe level of functional loss.
That’s why most veterans with service-related back pain who do qualify for 100% VA disability ratings often do so by combining their VA disability rating for back pain with other related conditions, or through total disability based on individual unemployability (TDIU). We’ll discuss both options later.
Assuming you still have some range of motion in your thoracolumbar spine or cervical spine, you will be assessed a lower rating based on the VA’s rating table. Both sections of your spine will be rated independently.
For the thoracolumbar spine (main part of the back):
For the cervical spine (neck):
The VA also considers the “painful motion” principle when it comes to back pain. In short, this means that if you experience pain during movement, you should still qualify for the minimum rating (10%) even if your range of motion is normal.
As you can see, though, the rating table can be particularly harsh. For example, most veterans who have severe (but not total) stiffness and pain in their lower back are probably incapable of working. But they’d only qualify for VA benefits at a 40% disability rating under the general formula if they have no other issues with their neck or elsewhere.
To get VA benefits, it’s not enough to simply be a disabled veteran. You need to show that your disability was the result of an injury, illness, or other event that occurred during your service.
That may be easier said than done. Back pain is one of the most common chronic pain conditions experienced by American adults. Surveys show that between 10 percent and 33 percent of adults report back pain to their doctors. And back pain can have many causes, including trauma, wear and tear from daily life, and the aging process.
So, proving that your back pain is connected to your military service can be challenging, particularly if the condition is degenerative and your severe symptoms developed long after your retirement from the service. To prove the connection, you must have:
This may require you to collect extensive medical records (both from during and after your time in the military), service records, or even recorded statements from those you served with who witnessed the event.
RELATED POST: Was Your VA Disability Claim Denied? Here’s What You Should Do Next – Truman Law
If you believe that your rating is too low, either because it was determined incorrectly, or because you believe your VA disability benefits don’t accurately reflect the severity of your disability, you may have several options available.
If you believe the VA made an error in assessing your rating—for example, denying that your disability is service-connected, or applying a lower rating than you deserve according to the formula—you can appeal it (if you file within one year of the date on your denial letter).
Hiring an experienced VA Disability attorney can make a huge difference to ensure your case is as well prepared as possible.
Whether you are Army Strong, one of The Few and the Proud, Not for Self but Country, you Aim High, or are Always Ready, you have represented the colors of this great nation. No matter old or young, this country owes you a debt—especially if you have physical lasting effects of your time in service. Your benefits may only be a few forms away.
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Do you want to learn more about the appeal process? Order a free copy of my book “Fight the VA and Win”
Many veterans with back pain also deal with other, related conditions that may also qualify for a VA disability rating.
For example, back and spine problems often lead to secondary conditions like nerve damage, pain, and weakness in other areas of the body—such as the neck, arms, hips, or shoulders. Common examples include radiculopathy (pinched spinal nerves that cause weakness and tingling elsewhere in the body) and even bowel or bladder syndromes.
Conditions with a secondary service connection may be rated separately by the VA and added to the rating for your primary condition. Even if the secondary condition did not develop until after you left the service, the VA will still award disability benefits if there is a service-connected primary condition that caused it.
This is the route that many veterans with service-connected back pain go when the VA rates for their back pain simply don’t align with their real-life experience.
TDIU provides VA disability compensation at 100% rating if the veteran can prove that a service-connected condition renders them unable to obtain or maintain gainful employment, even if the combined rating for all their VA disability claims doesn’t add up to 100 percent.
Filing a VA disability claim, or appealing an unfair ruling, can be a time-consuming and frustrating processes. Veterans can wait months or even years to get a favorable result, depending on whether several appeals must be made.
An experienced attorney will know what kinds of medical records and other documents will be required to prove your case, and can navigate the confusing VA disability process on your behalf. They’ll also be knowledgeable about whether you might be eligible for additional benefits from additional or related conditions.
You do not have to fight alone.
Attorney Karl Truman and his team are fierce advocates for disabled veterans. Karl served for 28 years in the Army Reserves, retiring as Lieutenant Colonel.
These cases are personal for us. We understand the struggles that veterans and their loved ones face and the frustration of dealing with the VA. You served your country honorably, and you shouldn’t have to fight so hard to get the benefits you deserve.
Whether you need help filing your back pain claim with the VA, or you’ve just received a ruling you disagree with and are considering your options, contact our team today or call us at (502) 222-2222. Our VA disability attorneys are happy to provide a free case evaluation, discuss your legal options, and advise you on your next steps.
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.
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