VA Disability Ratings for Lumbosacral Strain
Lumbosacral Strain Explained
A lumbosacral strain is a medical term for an injury that causes low back pain. Specifically, the lumbosacral area refers to the low back and exists between the bottom of the ribcage and the top of the buttocks. Generally speaking, a strain is defined as a tearing of muscles and tendons. Importantly, these tears can be small but still cause a significant amount of pain. Muscles and tendons connected to the spine can be strained in a number of ways, including the following:
- Prolonged sitting or standing, particularly in the same position without alteration
- Poor posture can make low back pain and strains more likely
- Extending the muscles and tendons past their typical range of motion
- Twisting, bending, or lifting can cause strains
- Accidents or falls
The most common signs and symptoms of lumbosacral strains generally include pain in the back (often on one side), pain that becomes worse with movement and improves with rest, inability to move as freely as usual, swelling, redness, and tenderness in the affected area. Lumbosacral strains are most commonly diagnosed following physical examinations, and sometimes imaging tests (e.g., MRI).
Some individuals do not need treatment for lumbosacral strains as it is possible the pain will resolve itself within several weeks; however, in many cases, the pain often comes back. Treatment for lumbosacral strains focuses on reducing pain and preventing a recurrence and/or exacerbation of symptoms. Treatment options include:
- Avoiding the cause of the strain (e.g., heavy lifting, bending repeatedly)
- Prescription or over-the-counter medications (e.g., pills, gels, creams) to reduce inflammation and pain
- Cold and heating packs
- Stretching, exercises, and physical therapy to improve flexibility and strength
- Injections (e.g., corticosteroid)
If an individual’s lumbosacral strain is severe enough, surgery may be warranted. In this case, doctors would review all courses of action and choose the most appropriate given the individual’s circumstances.
Veterans and Lumbosacral Strain
Veterans frequently experience back conditions, including lumbosacral strains, after their time in service. Back injuries among veterans may be due to injury or general wear and tear caused by the physical demands of service. Lumbosacral strains, depending on severity, can greatly impact a veteran’s ability to perform activities of daily living and carry out work-related responsibilities. For this reason, veterans should consider applying for VA disability benefits.
VA Service Connection for Lumbosacral Strain
Veterans are eligible to receive disability benefits for qualifying conditions if they can establish service connection (i.e., show that their condition is due to their time in service). To establish direct service connection for a lumbosacral strain, veterans must demonstrate the following:
- A current diagnosis of a lumbosacral strain;
- An in-service event, injury, or illness; and
- A medical nexus linking the current, diagnosed lumbosacral strain to the in-service occurrence.
In most cases, veterans will undergo a Compensation & Pension (C&P) examination in order to obtain a nexus opinion. A positive nexus opinion means that the VA examiner believes “it is at least as likely as not” that the veteran’s lumbosacral strain was caused or aggravated by their time in service.
How VA Rates Lumbosacral Strain
VA rates lumbosacral strains under 38 CFR § 4.71, Schedule of Ratings – Musculoskeletal System, Diagnostic Code 5237. Importantly, this diagnostic code follows the General Rating Formula for Diseases and Injuries of the Spine. The rating criteria is as follows:
- 100% – unfavorable ankylosis of the entire spine
- 50% – unfavorable ankylosis of the entire thoracolumbar spine
- 40% – unfavorable ankylosis of the entire cervical spine; or, forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine
- 30% – forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine
- 20% – forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, the combined range of motion of the cervical spine not greater than 170 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis
- 10% – forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, forward flexion of the cervical spine greater than 30 degrees but not greater than 40 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, combined range of motion of the cervical spine greater than 170 degrees but not greater than 335 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height
TDIU for Lumbosacral Strains
Veterans who are unable to work due to their service-connected lumbosacral strain can apply for total disability based on individual unemployability (TDIU). TDIU allows for veterans to be paid at the 100 percent disability rate if their service-connected condition(s) prevents them from obtaining and maintaining substantially gainful employment.
Veterans with severe service-connected lumbosacral strains may also be entitled to a VA benefit called Special Monthly Compensation (SMC) based on the need for aid and attendance (A&A). A&A benefits are for veterans who need regular aid and attendance due to their service-connected condition(s). Regular aid and attendance generally means that a veteran needs help with activities of daily living such as dressing, bathing, cooking, eating, etc. The aid and attendance need not be constant, only regular.
VA Disability Benefits Claim Denied? Contact CCK
The attorneys and advocates at Chisholm Chisholm & Kilpatrick LTD have decades of cumulative experience helping Veterans appeal for the VA disability benefits to which they are entitled. Contact our office for a free consultation today at 800-544-9144.
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