Back pain is in the top 10 most common veteran disabilities. Many factors contribute to back pain and disabilities, such as physical training and strain, equipment weight, falls or injuries, lack of proper shoes, etc. The Musculoskeletal system is very complex, and one area of injury or pain can often cause multiple issues. In reality, knowing what ratings you qualify for regarding Musculoskeletal injuries, pain, and disabilities can be quite confusing.
*Back pain and disability ratings are generally based on limitation of motion, as it’s the most common of symptoms. Full range of motion for forward flexion of the back is 90°, which is bending over to touch the toes. 0° is standing up straight.
Percent Forward Flexion During a Flare / Diagnostic Codes 5235-5243
40% 30 degrees or less
20% 31-60 degrees
10% 61-85 degrees
Secondary conditions from back disabilities:
Radiculopathy– a pinched nerve root in the cervical, thoracic or lumbar spinal region. Radiculopathy can be present in other places, but we are focusing on sciatic radiculopathy here, as it relates to back pain and disabilities.
Radiculopathy is rated on severity of symptoms, which can include pain, tingling and numbness / Diagnostic code 8520 (Sciatic)
40% Severe / must already be service connected for radiculopathy to be rated severe
20% Moderate- veteran has daily symptoms
10% Mild- veteran has occasional symptoms.
~You can bone up on other secondary conditions from back pain here.
Direct Service Connection for Back Pain
A veteran must show evidence of a current back condition or pain, an in-service injury, pain or event/illness, and the link (nexus) between the event and current condition.
In 2018, Saunders vs Wilkie determined that a veteran can still receive disability ratings for pain related to time in service, even if there isn’t an underlying medical diagnosis that directly explains the cause for the pain.
A C&P exam will help determine the forward, backward, and side limitations of motion. What can be problematic is ensuring the disability rating is consistent with both the range of motion and the functional limitations caused by pain. For example, a veteran may be able to bend to 75°, but pain starts at 50°. Flare-ups should also be taken into consideration. Veterans should ALWAYS request a copy of their C&P exams. If they disagree with the findings, a second opinion may be obtained, and the veteran may argue that functional loss, pain, and flare-ups were not considered fully.
**If your back pain has worsened or conditions have increased since you were rated, it is important to take action.
- Are you receiving your maximum benefit rating? Most likely not. A 2018 audit showed that 38% of VA claims had mistakes in their final decisions! We have found from our expertise and experience helping veterans that this number is much higher than 38%. Contact us for a free consult and we’ll see how we can help you.
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