Veterans frequently express confusion and frustration about both service-connection for and the evaluation of back conditions. Since back conditions can affect all aspects of a veteran’s life, this article will provide clarity to understand how to maximize VA benefits for a back condition.
Applying for and receiving the correct disability compensation from the VA for back conditions connected to your time in service can be difficult.
Whether you have problems finding a nexus or proving to the VA just how debilitating your back injury is, you may find yourself needing assistance when applying for VA disability compensation for injuries to your back.
At Berry Law, our team of dedicated VA appeals lawyers can help you appeal an unfavorable decision by the VA. Contact our team today at 888-838-7754 to schedule a free, confidential case evaluation.
One challenging aspect of back conditions is the potential length of time between the original injury and the realization that the injury has become chronic. One of the most frequent stories we hear about back injuries is,
“I hurt my back in service, but I was young and pushed through it.”
Over the years, of course, that back injury can reoccur and worsen. Then, years after military service, a veteran may realize that the original in-service injury has resulted in a long-term disability.
When applying for service connection for a back condition, veterans can do a few things to help their claim. The first place to look is within the records from service. If a veteran injured his back while on active duty, sometimes there are reflections of that injury in the records. Keep in mind, that “smoking gun” document might not be a medical record. It could be a notation from a supervisor excusing the veteran from their duties, a profile to keep them from doing certain exercises, or something else related to the injury. It is important to thoroughly search the service records for something related to an in-service injury.
Sometimes veterans did not have a specific injury in service. That does not mean they have to give up on service connection. It just makes their job a little harder. Many veterans attribute their back problems to service because they worked on their feet doing guard duty every day or because they participated in rucks, jumps, or other high impact exercises. For veterans who did not go to sick call for their back while in the military, they may want to start with the second step: talking to family, friends, or fellow service members who remember their complaints of back pain in service. Buddy statements from those who remember complaints of a stiff or achy back can help trace the source of the injury back to active duty.
Once the veteran has gathered all of the evidence they intend to use to show an in-service injury or circumstance which caused back problems, the next step is to get a medical professional to connect it to the current disability. This is often the hardest part. Many veterans go to their compensation and pension (C&P) exams thinking their claim will be granted because they have proof of an injury to their back in service. However, examiners will often point out that the in-service back problem resolved before the end of service. They will often use the exit exam from the military to show that the veteran exited service without any back problems.
The best practice would be to go to the examination prepared to inform the examiner about the history of the injury. Examiners are required to listen to veteran’s lay statements, where applicable. A veteran should be ready to give clear statements about the chronicity of their injury, including making it very clear that the current injury is a reoccurrence of the one in service. If that fails and the VA examiner still does not provide a connecting statement, known as a nexus, between the in-service injury and the current one, the veteran will probably want to look into getting a private medical opinion to hopefully provide that nexus.
Once the up-hill battle of service-connection for a back injury is over, veterans are often shocked by their rating decision. After years of fighting with examiners who can’t possible see a connection between a back injury in service and a current back disability, they might be awarded 10 percent for their pain.
In general, back injuries are rated low for the anguish and disability they cause. However, knowing how the VA rates back conditions and secondary conditions can help increase that rating and make it closer to actual compensation for the disability.
There are two ways the VA compensates for back disabilities. The first relates to range of motion. The second is specific to “intervertebral disc disease” and rates based on the necessity of incapacitating episodes.
When we say back disability ratings are related to range of motion, what do we mean?
Most people with back problems don’t spend a lot of time thinking about how far they can bend; they’re too busy being in excruciating pain. That focus is where many veterans inadvertently get themselves in trouble. Pain, even life-altering, agonizing pain, is ratable at 10 percent. There are limited exceptions, but, for the most part, appealing to the VA for a higher disability rating based on pain will not result in an increased evaluation.
To determine the range of motion for rating purposes, the VA will send the veteran to an examination. The examiner should use a measuring tool to determine the range of motion in degrees. If the combined range of motion of the back is 120 or less, the VA can provide a 20 percent rating.
The ratings above 20 percent require ankylosis of the entire spine, which essentially means a fusion of the vertebrae.
Needless to say, many veterans are displeased that 20 percent is practically the maximum rating for a back condition which might keep them from working, driving, exercising, or living the way they want to. One thing to do about it would be to look and see if the veteran might fall under the alternative diagnostic code relating to intervertebral disc disease and to see if that would result in a higher rating. If the veteran does not have incapacitating episodes (which basically means doctor-ordered bed rest) more than four weeks a year, pursuing an alternative diagnostic code will not help with an increased evaluation.
Another thing to do would be to investigate secondary claims. Back conditions can cause a lot of other issues. One of the most common secondary conditions related to a back problem is radiculopathy, including sciatica.
If a veteran with a service-connected back condition also feels numbness, tingling, or pain down one or both of his legs, buttocks, or hip, they might be able to claim radiculopathy secondary to the back condition. Erectile dysfunction, incontinence, and even depression might be related to a back problem.
Finally, if a back problem is keeping the veteran from working, they may wish to apply for Individual Unemployability.
Even if they do not qualify, they can apply for extraschedular Individual Unemployability. It can be difficult to obtain unemployability benefits on an extraschedular basis, so it would be helpful to provide a doctor’s opinion stating that the back condition prevents the veteran from working.
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