VA Disability Ratings for Neck Pain
Orthopedic conditions are typically categorized as those that impact the musculoskeletal system. Common orthopedic conditions impacting veterans include neck pain and low back pain. Veterans may be eligible to receive service-connected compensation for neck pain if they are able to prove that their neck pain is a result of their time in service. Importantly, VA reserves disability benefits for those veterans with chronic neck pain. In other words, VA will not award a compensable rating for a neck condition that was present at one time or another but has since resolved.
How Does VA Rate Neck Pain?
Similar to VA disability ratings for back pain, VA uses the General Rating Formula for Diseases and Injuries of the Spine under 38 CFR § 4.71a to evaluate the majority of neck pain conditions. This rating formula is based mainly on range of motion measurements according to the following criteria:
- “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 spine 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 resulting in abnormal gait or abnormal spine contour; or, vertebral body fracture with loss of 50 percent or more of the height”
Examples of neck pain conditions that are rated using the above formula include the following:
- Cervical strain (Diagnostic Code 5237) – stretched or torn muscle or tendon in the neck
- Degenerative arthritis of the spine (Diagnostic Code 5242) – degeneration of the cervical vertebrae resulting in pain
- Cervical spine stenosis (Diagnostic Code 5238) – narrowing of the spinal canal in the neck
Secondary Service Connection for Conditions Associated with Neck Pain
Secondary service connection is when a veteran’s already service-connected condition causes a new, separate disability, or aggravates a preexisting disability, that is not service connected. Veterans can receive disability compensation for that new or aggravated condition as a result of their already service-connected disability. Secondary conditions commonly occur as the result of service-connected orthopedic conditions. Examples of secondary conditions associated with neck pain include radiculopathy, due to a compressed nerve in the cervical spine, and migraine headaches. To establish secondary service connection for these conditions, veterans must show that the onset and/or progression of each condition is the result of their neck pain.
Saunders – Disability Benefits for Pain
In April of 2018, the Court of Appeals for the Federal Circuit held that VA can award disability compensation for a veteran’s undiagnosed pain if it is linked to an in-service event, injury, or symptom. The Federal Circuit’s ruling affects the first element of direct service connection, the current medical diagnosis, insofar as it is no longer required. Instead, to be service-connected on a direct basis, veterans will only have to show VA that there was an in-service event, injury, or symptom that caused their pain, and provide a medical nexus linking their pain to that in-service incident or symptom. Additionally, if a service-connected condition aggravates pain, or is aggravated by pain, the veteran can be awarded benefits resulting from the pain. In all events, the veteran’s pain must cause functional impairment or loss, defined as the inability to perform the working movements of the body with normal strength, speed, coordination, and endurance. Importantly, subjective complaints of pain are not enough to be awarded disability compensation.
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