How To Qualify For Higher Va Ratings For Back Pain
The VA rates back pain based on how much of the spine, or range of motion, is affected.
In addition to range of motion scores and medical findings like ankylosis, the VA has to consider the severity of a veterans functional loss, said Cecilia Ton, a VA-certified disability benefits lawyer. Functional loss refers to any impairment in a veterans functioning due to a service-connected back or neck disability. Making the VA aware of the severity of your functional loss could trigger the VA to assign a higher rating.
Veterans also might not have to show an actual medical finding of ankylosis. If a veterans condition requires a neck or back brace that could be considered the functional equivalent to ankylosis. For example, braces help a veterans stability, but while wearing the brace, their back may be stuck in an upright position, which could be the functional equivalent of ankylosis.
The VA also factors in conditions related to back or neck disabilities. Neurological disabilities that can be tied to a veterans back or neck pain must receive a separate rating. As we discussed earlier, radiculopathy is a common neurological disability stemming from back or neck injuries. The VA also requires that bowel and bladder incontinence and impairment receive a separate rating.
Is Chronic Back Pain Considered A Disability
Many people experience back pain throughout their livesand it can be debilitating. Chronic back pain can affect your ability to move, work, and live freely. According to the Centers for Disease Control and Prevention , work-related musculoskeletal disorders like back pain are the number one cause of disability during a persons working years.
If you have chronic back pain, you might wonder if it qualifies as a disability. If so, you might be able to receive Social Security Disability Insurance benefits. Heres what you need to know about pain back and disability.
Back Pain As A Disability
Back pain affects thousands of Americans every year. Its often debilitating and is a leading cause of work absences and applications for Social Security disability benefits. Studies show that 20% of people who initially suffer from acute back pain eventually develop chronic and pervasive back pain.
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Is It Hard To Get Disability For Degenerative Disc Disease
Degenerative Disc Disease, or DDD, is among the most common impairments for which the Social Security Administration receives disability applications. While it is a qualifying disability under certain circumstances, proving your condition meets the SSA’s duration and severity level requirements can be difficult.
Examples Of Functional Limitations
- Unable to remain seated for 6 hours in a normal workday
- Unable to stand for 2 hours a day
- Unable to walk one block without stopping
- Need to lie down during the day
- Unable to carry 10 pounds intermittently during a workday
- Must keep one or both legs elevated during the day
- Maintain Your Credibility
When you have to appeal up to a hearing, the administrative law judge may also consider your personal statements to determine if they are believable or if you seem to be exaggerating your claims. A psychiatric consultation could also be ordered for a better picture of your mental health and to assess whether your claims are inconsistent with what is expected with your particular condition.
To gauge your credibility, a hearing officer or judge may consider the following:
- Your statements
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Applying Specific Medical Tests To Your Back Pain Disability
Common tests used to diagnose back pain include X-rays, MRIs, and CT scans. These imaging tests can help doctors rule out serious causes of back pain, such as fractures or herniated disks. However, in many cases, the cause of back pain cannot be determined with certainty from these tests alone.
In cases where the cause of back pain is unclear, your doctor may also recommend specific physical or neurological exams. These exams can help rule out other possible causes of your symptoms and better pinpoint the source of your pain.
What Are Va Ratings For Back Pain
The VA ratings for back pain reflect the seriousness of a veterans mobility loss and how much the spine is affected.
Back injuries are rated using the General Rating Formula for Diseases and Injuries of the Spine in the Schedule of Ratings. The ratings consider:
- Degree of flexion
- If the veteran is experiencing unfavorable ankylosis or favorable ankylosis
- If the problem is in the thoracolumbar spine or cervical spine
|Only rated with medical proof of nerve irritation because of a displaced disc fragment|
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What Type Of Back Problem Qualifies For Disability
If you have chronic pain or other symptoms that limit your ability to work, you may be eligible for Social Security disability benefits. Disc herniation, foraminal stenosis, and spondylolisthesis are some of the back conditions that may qualify you for disability benefits. To learn more about whether your back condition may qualify you for disability, contact a Social Security disability attorney.
Social Security Listing 115 Nerve Root Involvement
Social Security gives several examples of back conditions that involve nerve root compression:
- facet joint arthritis, and
- vertebral fracture.
If you have a compressed nerve root, Social Security will evaluate your condition under listing 1.15, To meet the requirements of the listing, your medical records must show that you experience at least one of the following conditions that starts in your back and travels to one or both legs:
- muscle fatigue, or
- a burning/prickling sensation .
An examination by your doctor or imaging like an X-ray or MRI must also show muscle weakness and signs that something is pushing on the nerve root with one of the following:
- abnormal “sensory nerve latency” on electrodiagnostic testing , or
How Much Disability Will I Get For Back Pain
When applying for disability benefits, you should have evidence to support your claim. Specifically, you should have medical records showing that your back pain is medically determinable and is limiting your life. The documentation should include tests, examination records, physician notes, and a definitive diagnosis.
Your back pain must limit your ability to do your usual daily activities. Your doctor can document this by evaluating how much time you spend resting or sitting for at least two hours. This will increase your chances of receiving a disability award. Your pain must prevent you from working for more than two hours per day and limit your daily activities.
Social Security has specific criteria for determining whether back pain is a disabling condition. It also requires that the pain be long-term and medically determinable. This requirement is difficult to meet for back pain that is a result of an injury.
What If I Don’t Meet A Disability Listing
Meeting the criteria explained in the listings can be difficult. In fact, most disability claims that are approved for benefits don’t meet the requirements of one of the listings. Most people who successfully win disability benefits do so by proving to Social Security that:
- their severe symptoms and limitations make them unable to perform their previous jobs, and
- they’re unable to transition into another type of work.
To decide if you’re unable to work, Social Security will look at your medical records to see whether there’s enough evidence that you have a serious medical condition that limits your ability to do many work-related activities. This means you must have a medical diagnosis of a severe condition that’s backed up by medical findings, like lab tests or imaging, not just your reports about back or leg pain.
If Social Security agrees that you have a severe medical condition, a claims examiner must next determine your residual functional capacity . Your RFC is the most intensive work you can still do , despite the limitations caused by your medical condition. For example, if you have several bulging discs, your doctor might limit you to standing or walking a certain number of hours per day.
An RFC for someone suffering from severe back pain might include the following limitations:
Learn more about how to qualify for a medical-vocational allowance because of the combined effect of your condition, age, education, and job skills.
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Tip #: Solicit Medical Opinion On Your Ability To Work
Treating doctor opinions about your functioning, your limitations, and your ability to work are vital to winning a disability case. We have a long and detailed post on this subject. A detailed doctor opinion tells the judge that yours is not the garden-variety case of law back that he may get from time to time.
Do I Need A Lawyer To Receive Va Disability Benefits For My Back Pain Injury
While the VA does not require you to have a lawyer to apply for VA disability benefits, it can greatly boost your chance of winning your case. The VA has a reputation for being complex, unwieldy, and difficult to work with. The decisions it hands down are often arbitrary. Many veterans receive a grant for benefits only after first receiving multiple rejections, and the appeals process is long and arduous. The entire task from beginning to end is unpleasant and trying.
The VA disability attorneys at Chisholm Chisholm & Kilpatrick LTD can take the burden off your shoulders by handling your case for you. We have helped many veterans win VA disability, and we can put our vast resources to work for you. Call our office today for a free consultation: 544-9144.
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Request A Free Consultation
If your claim has been wrongfully denied or terminated, call or provide your contact information using the form on our contact page to request a free case evaluation. You will only need to answer a few questions to help us determine if this is a claim we can assist you with, and we can schedule a time for you to discuss an attorney-client relationship with our firm. We would welcome the opportunity for you to tell us about your case.
Back Pain Va Rating Chart:
- 100% VA Disability for Back Pain: Unfavorable ankylosis of the entire spine
- 50% VA Disability Rating for Back Pain: Unfavorable ankylosis of the entire thoracolumbar spine
- 40% VA Rating for Back Pain: Unfavorable ankylosis of the entire cervical spine or, forward flexion of the thoracolumbar spine 30 degrees or less or, favorable ankylosis of the entire thoracolumbar spine
- 30% VA Rating for Back Pain: Forward flexion of the cervical spine 15 degrees or less or, favorable ankylosis of the entire cervical spine
- 20% VA Disability Rating for Back: Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees or, forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees or, the combined range of motion of the cervical spine not greater than 170 degrees or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis
*If no limitation of range of motion is observed, but the claimant has painful motion, the minimum rating or 10% should be applied.
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Not Enough Info On Medical Conditions And Employability
To be approved for CPP Disability, you must prove to Service Canada that you cannot work due to your condition. To prove this, you must provide extensive medical evidence highlighting your conditions severity and prolonged nature and how it prevents you from retaining employment. Without substantial evidence proving this, your application will most likely be denied.
Was Your Va Claim Denied
The accredited attorneys and advocates at Chisholm Chisholm & Kilpatrick LTD have decades of experience successfully representing disabled veterans and their families before the Department of Veterans Affairs, the Court of Appeals for Veterans Claims, and the Federal Circuit. We may be able to help if your claim was denied. Contact us today at 800-544-9144.
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What Do You Need To Prove There Are No Jobs You Could Do
In order to prove there are no jobs you could do, you need medical documentation from your doctors of all of your medical conditions. This means you need to make an effort to get regular treatment to document your condition over time. Further, it is helpful to get statements from your doctors on how your medical condition limits your ability to work. This can include a letter from the doctor or simply having your doctor fill out a questionnaire on your condition. Doctors often do not comment on your ability to work in their office notes because theyre focused on treating you rather than commenting on your ability work. It helps to ask your doctors opinion on your ability to work. Our firm often gives our clients questionnaires to take to treating physicians to document your symptoms and how they would limit your ability to work. We have developed questionnaires over time that ask the questions we have found are helpful in proving your case.
It can be overwhelming to try to prove that you are disabled. You have to collect medical records and submit them to social security and you have to get opinions from doctors that prove your inability to work. We can help you get all this information and improve your chances of getting social security disability benefits. Our Atlanta Social Security Disability lawyers can help you prove you are entitled to Social Security Disability due to your back pain, feel free to contact us for help.
The Ssa Evaluation And Medical Qualifications
The SSA uses their own medical guide to evaluate disability benefits applications that they receive. This guide, known as the Blue Book, helps to determine whether or not an individual meets the criteria to be considered disabled and eligible for SSDI. There is no listing for back pain, but there are listings that apply to specific conditions that cause the pain. As an example, degenerative disc disease does not have a specific listing. You have to have severe symptoms such as requiring assistance to walk, needing to adjust your position more than every two hours, and suffer from nerve-specific problems.
Regardless of the cause of your back pain, you have to provide evidence of how it impacts your ability to work and causes your daily limitations. Your documents need to include notes from your physician about limitations you have when walking or standing, and if you have to have a cane, walker or crutches in order to be mobile. These are all considered with great weight when making a disability determination decision.
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Is Osteoarthritis Classed As A Disability
Is Osteoarthritis a Disability? Osteoarthritis can be considered a disability by the SSA. You can get Social Security disability with osteoarthritis. When you apply for disability benefits, your diagnosis and medical evidence to back up your diagnosis needs to match a listing outlined in the SSAs Blue Book.
How Is Service Connection Established For Back Pain
The VA will consider your condition to be service-connected if you can show that it was either caused or worsened by your military service.
It can be tricky to prove that your condition was caused by your time in the military, but not impossible. Your doctor will need to provide objective medical evidence that your condition is connected to your military service.
Veterans must provide evidence to back up their application for VA disability for back pain. Evidence will include:
- Diagnosis of the condition where possible or an explanation of how back pain affects daily life
- The event, injury, or illness that occurred in-service to cause the injury
- Link, or medical nexus, between service-related events and the pain youre experiencing
Secondary service connections may also be made. A secondary connection, for example, would link the back pain to another service-related condition. If a knee injury caused by your service altered your normal gait and led to back pain, a claim will be approved if the link is proven.
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How Do I Pass The Va C& p Exam
If youve ever applied for VA benefits for back pain, you may have wondered how to pass the compensation and pension exam . The exam is a medical examination given by a VA-approved practitioner and consists of a physical examination and verbal opinion. The practitioner will also assess range of motion and ask you questions about your back pain.
You should prepare by writing down the symptoms and frequency that you experience, and the impact that these symptoms have on your life. If possible, get someone to help you keep track of this information, such as a spouse or friend. This will help you prepare for the exam.
The VA will rate your back condition according to the range of motion you can perform with minimal pain. This means that you must be limited in some way in certain ranges of motion. To get the highest rating, you must have a range of motion of at least thirty degrees. The VA will also take into account the functional loss caused by your back condition.