VA Disability Ratings for Restless Leg Syndrome (RLS)
Restless leg syndrome (RLS) can be a frustrating condition that causes discomfort in a veteran’s legs. The condition commonly interferes with sleep and can lead to exhaustion, affecting a veteran’s day-to-day life. Veterans with restless leg syndrome may qualify for disability benefits from the Department of Veterans Affairs.
What is Restless Leg Syndrome?
Restless leg syndrome, or Willis-Ekbom Disease, is a condition that can cause painful and uncomfortable leg sensations in the legs as well as the irresistible urge to move them. These sensations can occur most commonly in the late afternoon or evening and can become particularly excruciating at night. The nature of RLS can make it difficult to sleep at night, whether it be falling asleep or returning to sleep once having been awoken.
Moving one’s legs may provide relief to the discomfort, but the unpleasant sensations may return once the movement has stopped. Walking may also provide temporary relief.
What Causes Restless Leg Syndrome?
Restless leg syndrome is often classified as a sleep disorder and a movement disorder, as the symptoms are brought on by sleep and lack of movement. It may also be characterized as a neurological sensory disorder because the symptoms are produced by the brain.
Exhaustion and daytime sleepiness can lead to restless leg syndrome. Lack of sleep can affect a person’s concentration, mood, and personal relationships. Often, people who experience RLS also find that they have difficulty concentrating, impaired memory, and decreased work productivity. RLS can also lead to anxiety and depression in moderate or severe cases.
RLS affects men and women, although it affects women more commonly than men. The symptoms can also worsen and become more frequent with age.
There are several conditions which can accompany or may be linked to restless leg syndrome:
- End-stage renal disease
- Iron deficiency
- Use of certain medications (including antinausea medications, antipsychotic medications, antidepressants, and allergy medication)
- Use of alcohol, nicotine, and caffeine
- Sleep Apnea
Though restless leg syndrome may subside with time, there are some treatments which may be used to reduce the discomfort.
- Reduced Exercise—Reducing the level of exercise may ease the pain of RLS. Additionally, warm baths, leg massages, heating, and icing the legs may provide additional relief.
- Lifestyle changes—Some lifestyle changes may help reduce symptoms of RLS. Specifically, ceasing to use alcohol and tobacco, as well as maintaining a consistent sleep schedule could help reduce the recurrence of RLS and alleviate symptoms.
- Medications—Specific medications may be used to treat RLS, such as anti-seizure drugs and dopaminergic agents.
- Iron supplements—RLS may occur in individuals who have low iron levels in their blood. Iron supplements may be used to increase an individual’s iron levels, which in turn may help treat RLS.
Establishing VA Service Connection for Restless Leg Syndrome
To file a claim for VA disability benefits for restless leg syndrome, a veteran will need three things:
- A current diagnosis of restless leg syndrome;
- An in-service injury, event, or illness which caused or aggravated the RLS; AND
- A medical nexus that links the veteran’s RLS to their service.
To file a claim, veterans may use VA Form 21-526EZ, which has sections regarding the veteran’s service, condition, and identifying information. Veterans may also wish to include information regarding the severity of their condition. Restless leg syndrome can range drastically in severity and some veterans may not recognize they have it.
Compensation and Pension (C&P) Exams for Restless Leg Syndrome
VA may request a Compensation and Pension (C&P) exam once a claim has been filed for restless leg syndrome. The exam will be performed by a VA physician or a VA-contracted physician. Prior to the exam, the examiner should review the veteran’s c-file, which contains the veteran’s medical and service records.
It is important to attend the exam, as failing to attend or to follow through with scheduling the exam could result in a denial of the veteran’s claim.
During the exam, the examiner may ask the veteran questions about their restless leg syndrome or about their military service. They may also physically examine the veteran.
The veteran may also use a DBQ, or Disability Benefits Questionnaire, to bolster their claim. A Disability Benefits Questionnaire is a form created by VA so that the veteran may address important aspects of their condition, such as symptoms, severity, possible causes, and relation to other disabilities. For restless leg syndrome, veterans may use the Disability Benefits Questionnaire for knee and lower leg conditions.
How VA Rates Restless Leg Syndrome for Disability Benefits
VA issues ratings for restless leg syndrome for each individual leg affected. The ratings start at 10 percent and increase based on severity.
When issuing a rating for restless leg syndrome, VA will often consider the additional evidence. This could include the amount of times a veteran has sought treatment and how effective treatment has been.
More specifically, VA rates restless leg syndrome under Diagnostic Code 8620, which relates to neuritis. The ratings may also range from mild to severe:
- Mild – 10%
- Moderate – 20%
- Moderately Severe – 40%
- Severe – 60%
Secondary Service Connection and Restless Leg Syndrome
Secondary service connection can be granted when a condition arises or is aggravated by an already service-connected condition. Veterans may be awarded secondary service connection disability benefits for restless leg syndrome in instances where an already service-connected condition caused or worsened the veteran’s restless leg syndrome.
For example, if a veteran has been service-connected for sleep apnea and their sleep apnea causes or aggravates RLS, the veteran can file a claim for secondary service connection. Conversely, if the veteran has been service-connected for RLS and it causes or aggravates their sleep apnea, they may also file for secondary service connection.
The nature of RLS can make it difficult to determine whether the condition is caused by another condition or whether it causes another condition. Additionally, sometimes it can take years for restless leg syndrome to manifest or for a veteran to realize that they suffer from RLS.
In order to prove secondary service connection, the veteran will need an opinion from a doctor or medical professional which links the service-connected condition to the claimed secondary condition. The opinion should state how the two conditions are linked. Additionally, the veteran will need a current medical diagnosis for the claimed secondary condition.
TDIU and Restless Leg Syndrome
Another benefit which may be available to veterans who experience restless leg syndrome is total disability based on individual unemployability, or TDIU. This disability benefit is available to veterans who may not regularly meet the criteria needed to reach the 100 percent rating.
Veterans who are service-connected for RLS may be eligible for this benefit. There are generally two pathways to become eligible for TDIU:
- 38 CFR § 4.16a(“Schedular”) – For this form of TDIU, the veteran must have:
- One condition rated at a minimum of 60 percent OR
- Two conditions combined to reach 70 percent, where one condition is rated at a minimum of 40 percent.
- 38 CFR § 4.16b(“Extraschedular”) – This form of TDIU is for veterans who may not be able to achieve the ratings necessary for schedular TDIU but are still unable to obtain substantially gainful employment on account of their conditions. In this instance, the veteran must prove that their condition is uniquely hinders their ability to obtain substantially gainful employment and therefore should not be rated on the standard disability rating criteria.
The rating given for a veteran’s restless leg syndrome may be combined with a rating for another condition to help the veteran meet the criteria for schedular TDIU.
Was Your VA Disability Claim Denied?
Often, claims for restless leg syndrome can be difficult to win due to the nature of the condition. If your VA disability claim for restless leg syndrome has been denied, the VA disability lawyers at Chisholm, Chisholm & Kilpatrick may be able to help. Contact us today at 800-544-9144.
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