As discussed in our previous blog post entitled “Federal Circuit Rules Veterans Can Get Disability Benefits for Pain”, the U.S. Court of Appeals for the Federal Circuit recently held that VA can award disability benefits for pain related to military service. Before this decision, the Court of Appeals for Veterans Claims had held that veterans had to have a diagnosed disability explaining the source of their pain in order to receive VA disability benefits. However, VA can now award disability compensation for a veteran’s undiagnosed pain if it is linked to an in-service event, injury, or symptom.
This decision may affect both veterans seeking service connection and those seeking increased ratings for conditions that are already service-connected.
Service Connection for Pain
Service connection is the way of showing that a veteran’s disability is linked to an in-service event, symptom, or diagnosis. There are three elements of direct service connection that a veteran should provide in order to receive VA disability compensation. Before the Saunders decision, in most situations, a veteran must have:
- A medically-diagnosed disability;
- An in-service event, injury, or disease;
- Medical evidence linking the current diagnosed disability to the in-service occurrence.
The Saunders decision affects the first of those three criteria: a medically- diagnosed disability. VA can now award service connection for pain that lacks a specific diagnosis, as long as that pain is connected to an event that occurred or symptom that appeared while the veteran was on active duty. 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: subjective complaints of pain are not enough to be awarded disability compensation.
Ratings for pain
VA assigns ratings based on the functional impact from the service-connected condition. Functional loss or impairment is the inability to perform the working movements of the body with normal strength, speed, coordination and endurance. For orthopedic conditions, VA ratings are typically awarded based on the degree to which the veteran experiences a limited range of motion in the specific joint affected. For example, VA will look at whether, and how much, a service-connected low back disability limits a person’s ability to bend forward, bend backward, bend to each side, and rotate from the waist.
With Saunders, it is now clear that a claimant does not need to show that his or her condition actually causes a loss of movement in the specific joint. Instead, a veteran may be able to get benefits for functional loss due to headaches or other limitations resulting from pain. For example, a person who gets headaches from his service-connected neck disability should be able to be compensated for those headaches. As another example, a person with a service-connected back condition should be able to be compensated for problems sleeping, standing, lifting, sitting and walking, even though those kind of limits may not be measured in the same way as problems with bending are.
If you are unsure whether you are eligible for VA disability compensation, click here to learn more about eligibility for VA disability benefits.