Back pain affects many military veterans and can leave a lasting impact on day-to-day life. For veterans applying for VA benefits for back pain, having a good understanding of the claim and appeals process is key. Below you’ll find a brief breakdown of how the VA determines disability ratings and other eligibility requirements for monthly benefits.
VA Benefits for Back Pain: Who’s Eligible to Apply?
According to the U.S. Department of Veteran Affairs, veterans looking to file a disability benefits claim must suffer from a medical issue sustained during active military duty. In addition, eligible veterans must have an honorable discharge from service.
When filing your VA benefits for back pain claim, your doctor’s medical support can be vital. Showing proof to the VA that your condition exists and limits your ability to work can increase your chances of getting a higher VA disability rating.
How VA Disability Ratings Determine Your Benefits
The VA gives every veteran who applies for benefits a disability rating for each service-connected condition. This rating ranges from 0%-100%, which also determines your benefit payments. These ratings indicate the occupational limitations a soldier may have due to active military duty. The higher your VA disability rating, the more you may potentially receive in monthly compensation. The VA lists all spinal conditions under section 4.71 Schedule of ratings–musculoskeletal system. Here you can find information on which criteria the VA looks for when determining a disability rating for various back issues.
For spinal conditions that cause back pain, the VA uses certain guidelines to determine a disability rating. First, the VA conducts a variety of back tests to determine your overall range of motion. Those results help determine your overall VA disability rating and final benefit amount.
VA Disability Rating Criteria for Spinal Conditions
Here are some standard VA disability ratings for back issues and what they mean:
- 100% VA disability rating for unfavorable ankylosis of the entire spine. This means your back’s unusually stiff and you can’t stand up straight, touch your toes, or turn from side to side.
- 50% VA disability rating for unfavorable ankylosis of your middle and lower back. This is about the same as bullet #1, but your shoulders and upper back are mostly unaffected.
- 40% VA disability rating for unfavorable ankylosis of your upper back. This means you have the same issues as bullet #1, but only in your upper back and shoulders.
- 40% VA disability rating for favorable ankylosis of your middle and lower back. This means you have the same issues as bullet #1, but only in your upper back and shoulders
- 60% VA disability rating for Intervertebral Disc Syndrome (IVDS) episodes lasting 6+ weeks. IVDS means you have loose disc fragments lodged in different back areas, causing chronic pain. If these issues last 4-6 weeks every year, you’ll get a 40% VA disability rating. For IVDS episodes of 2-4 weeks per year, it’s 20%; for 1-2 weeks per year, your VA disability rating’s 10%.
- 100% VA disability rating for total paralysis in your legs, arms or both due to spinal injury or degenerative arthritis.
- 20% VA disability rating for scoliosis, reversed lordosis, or abnormal kyphosis.
- 40% VA disability rating if you have constant fibromyalgia pain, or 3+ annual arthritis flare-ups.
- 100% VA disability rating for spinal cancer.
Most issues that cause temporary (not chronic) back pain receive a VA disability rating between 10%-40%. However, you may get a 100% VA disability rating for up to one year after serious back surgery, such as a spinal fusion.
How to Appeal a Denied Veterans Disability Claim
Appealing a veterans disability denial can be tough, especially if you face a complicated claim. For this reason, many applicants will turn to a VA-accredited attorney for assistance. Legal representatives know the process and can help you collect proper documentation, connect with the VA, and represent your appeal.
Ready to see if you may qualify? Click the button below to start your free online benefits evaluation now!
Megan Kelly is a former blogger and copywriter for LeadingResponse.