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Intervertebral Disc Syndrome (IVDS) and VA Disability

Intervertebral Disc Syndrome (IVDS) and VA Disability

Intervertebral Disc Syndrome (IVDS) is a back condition in which the discs between vertebrae break down, causing pain in the back or neck. Back conditions are common among veterans, and the way VA rates IVDS is important for how much compensation veterans can receive for their disability.

 

What is Intervertebral Disc Syndrome (IVDS)?

Intervertebral Disc Syndrome (IVDS) is a back condition in which an intervertebral disc or disc fragments are displaced at any level of the spine: lumbar, cervical, or thoracic. IVDS can cause chronic pain in the back, usually made worse by prolonged sitting or bending. IVDS can also cause nerve pain in the legs and arms, depending on where the displaced disc is located in the spine. One common type of nerve pain that IVDS can cause is sciatica which is pain along the sciatic nerve. Frequently, those who suffer from IVDS have limited range of motion, and some can experience trouble controlling their bladder or bowels, and/or experience erectile dysfunction.

 

How Does VA Rate IVDS?

IVDS is rated under diagnostic code 5243, and the rating criteria relies on the number of incapacitating episodes and how much bed rest the veteran’s physician prescribed within the last year. The ratings range from 10% to 60%.

  • 10% – “With incapacitating episodes having a total duration of at least one week but less than 2 weeks during the past 12 months”
  • 20% – “With incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months”
  • 40% – “With incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months”
  • 60% – “With incapacitating episodes having a total duration of at least 6 weeks during the past 12 months”

According to the rating criteria, “an incapacitating episode is a period of acute signs and symptoms due to intervertebral disc syndrome that requires bed rest prescribed by a physician and treatment by a physician.”

Additionally, the rating criteria notes that VA is supposed rate IVDS under this diagnostic code, or under the General Rating Formula for Diseases and Injuries of the Spine, whichever results in the highest rating for the veteran.

 

IVDS Rating Criteria is Not Fair to Veterans

The rating criteria can often leave veterans with IVDS short-changed because it is based on the amount of bedrest prescribed by a doctor. It can be difficult for veterans to satisfy this rating criteria because modern medical practices no longer call for bed rest to treat IVDS. In fact, physicians have often held that such long durations of bedrest can actually do more harm for disabilities of the spine than they can help. VA’s own clinical guidelines advise VA physicians to encourage patients with low back pain to remain active, and that remaining active is more effective than resting in bed for patients with low back pain. The guidelines also state that if a patient requires bed rest, the physician should encourage them to return to their normal activities as soon as possible.

Additionally, the rating criteria does not take other symptoms or daily limitations into account, such as difficulty sitting, standing, lifting, or bending. These examples of functional impairment can limit a veteran’s daily activities, quality of life, and ability to work.

Category: Veterans Law

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