VA Disability Rating for Lower Back Pain
Alyse Phillips: Welcome to CCK Live Under 5:00. I’m Alyse Phillips and we are reviewing VA ratings for lower back pain.
Just generally, veterans frequently experience lower back pain following their time in service. These conditions depending on their severity can impact greatly a veteran’s ability to perform activities of daily living and their ability to carry out work-related responsibilities.
Thanks to Saunders v. Wilkie, a federal court decision from April 2018, veterans can actually receive VA disability for back pain even if they don’t have an actual diagnosis, such as arthritis, for example.
VA uses the general rating formula for diseases and injuries of the spine under 38 CFR § 4.71a to evaluate back conditions, including lower back pain. It is largely based on your range of motion. Range of motion is going to encompass flexion, which is bending, or extension, which is straightening.
Ratings are going to range from 0, 10, 20, 30, 40, 50, and then 100 percent based on how severe your limitation of motion is. The 10, 20, 30, and 40 ratings are partly based on flexion and range of motion. Where the 50 and 100 percent ratings are actually going to be based on unfavorable ankylosis or stiffness present – basically based on your inability to move.
If veterans do not meet the range of motion criteria, they may also get a rating for a low back pain, if they have intervertebral disc syndrome or IVDS. This going to be rated under a slightly different diagnostic code, that’s going to be 5243. It’s based on a number of incapacitating episodes that a veteran might experience due to their low back pain. Ratings there going to range between 10 to 60 percent; again, based on how many incapacitating episodes a person might experience during a certain period of time.
VA also must consider flare-ups when rating low back pain to account for additional loss of function, motion, and pain. While we did largely speak about range of motion here, I also should note that that is not the only way you can be rated for your pain. You can also be rated if you have some type of functional equivalent to range of motion, limitation in range of motion, due to things such as weakness or instability, inability to stand, those type of things.
You may also be eligible for TDIU. If your low back pain prevents working or if your low back pain combined with other service-connected conditions prevents working. A TDIU benefit would allow you to be compensated at a 100 percent level, even if your combined rating – the scheduler rating – does not equal the 100 percent level.
So, thank you for joining me. That covers lower back pain for today. Please be sure to follow social media and check out our longer videos on YouTube.
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