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Is Lower Back Pain A Disability

Hire A Disability Attorney

VA Disability Rating for Lower Back Pain

While some degree of back discomfort is typical as you age, severe pain that interferes with your daily life and ability to work may give rise to a disability claim. The single best choice you can make to increase your chances of success is to hire a qualified disability attorney to represent you. LTD carriers have experienced attorneys working for them you should too.

Arthritis Of The Back Secondary To Back Pain

Degenerative arthritis of the back occurs when cartilage between joints erodes over time resulting in joint stiffness, limited mobility, and pain. This type of arthritis usually takes place in weight-bearing joints . Arthritis of the spine is a breakdown of the cartilage of the joints and discs in the neck and back.

Temporary Total Ratings Due To Hospitalization

If veterans are hospitalized for over 21 days as a result of their back pain, they can apply for a temporary total rating. Importantly, veterans must apply for this benefit directly as VA will not grant it on its own. Veterans can be granted 100 percent for the rest of the hospitalization period and possibly after, depending on how VA evaluates the back condition following discharge. After discharge, VA will complete an assessment and reassign a rating that reflects the current severity of the veterans back pain.

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What Is The Diagnostic Code For Traumatic Arthritis

The diagnostic code for traumatic arthritis is 5010. So if a veteran has traumatic arthritis in his spine, the final diagnostic code would appear as 5010-5003. Think of the first number as an identifying diagnostic code that tells you what joint is affected, while the second diagnostic code tells you the rating system the condition is being rated under.

Keep in mind that arthritis will only be rated under diagnostic code 5003 when the condition does not result in severe enough limitation of motion to be rated under the general rating formula for the spine. If there is decreased range of motion of the cervical or thoracolumbar spine, the condition would be rated according to the general rating formula for the spine that is based off of range of motion measurements. There must be x-ray evidence of arthritis in the cervical or thoracolumbar joints for the VA to rate a spinal condition under the code for degenerative arthritis.

Va Disability Rating For Cervical Spine

Low back pain is the single leading cause of disability ...

The cervical spine is towards the top, so cervical rating criteria also cover VA disability rating for neck pain or cervicalgia VA rating. Compensation will be decided on the following measurements:

  • 0 percent rating: Flexion greater than or equal to 45 degrees, OR a combined ROM greater than or equal to 340 degrees
  • 10 percent rating: Flexion between 30 and 45 degrees, OR a combined ROM between 175 and 340 degrees
  • 20 percent rating: Flexion between 15 and 35 degrees, OR a combined ROM less than or equal to 170 degrees
  • 30 percent rating: Flexion less than or equal to 15 degrees, OR the entire cervical spine is being stuck in a favorable position
  • 40 percent rating: The entire cervical spine is stuck in an unfavorable position
  • 50 percent rating: This rating does not apply to only the cervical spine
  • 100 percent rating: The entire spine will not move and is stuck in an unfavorable position

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Dont Back Down: Reach Out For Help

Chronic back pain often persists through multiple treatments and even surgical intervention. Conditions like failed fusion syndrome can leave patients with unmanageable pain. As a result, they may be unable to return to normal work and leisure activities. In addition to seeking further treatment to combat their pain, these patients often need more than just medical help.

Social Security disability benefits provide that additional assistance. But getting approved for disability benefits for back problems can be challenging, largely because of how difficult it is to measure pain.

Thus, consulting an attorney provides you with a much better chance of getting the aid you need. And doing so before you submit your application could save you from suffering through the months-long appeals process.

An experienced disability lawyer will help you navigate the complex Social Security system. Theyll show the SSA that you will not back down from proving that youre entitled to SSDI or SSI benefits.

At The Law Offices of Jeffrey A. Rabin & Associates, we offer free evaluations of patients cases. We have some of the best disability lawyers in the Chicago area on our team. And we can lead you through every step of the application process.

So call us today at 229-0008 and let us fight to get you the help you deserve.

Documenting Chronic Back Pain For Long

Your doctor may perform a variety of diagnostic tests to determine the cause of your back pain. Tests may include x-rays, MRIs, and CT scans. This objective medical evidence is the most convincing evidence of chronic back pain you can submit for a long-term disability claim.

However, most LTD claims for back pain do not have clear and convincing diagnostic tests to prove the cause of the back pain. Even in cases with a precise diagnosis of a condition that generally causes chronic back pain, a person may not receive LTD benefits. The condition must be disabling. Two people could have the same condition, but one person may not suffer from disabling pain and restricted range of motion.

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Va Ratings For Functional Impairment Of The Thoracolumbar Spine

The rating chart for thoracolumbar spinal pain is used for primary and secondary conditions to lower back pain. The measurements used for determining compensation are as follows:

  • 0 percent rating: Flexion is greater than or equal to 90 degrees, OR a combined ROM greater than or equal to 240 degrees
  • 10 percent rating: Flexion between 60 and 90 degrees, OR a combined ROM between 125 and 240 degrees
  • 20 percent rating: Flexion between 30 and 65 degrees, OR a combined ROM less than or equal to 120 degrees, the minimum scoliosis percent for a scoliosis VA rating.
  • 30 percent rating: This rating cannot be applied to the thoracolumbar spine
  • 40 percent rating: Flexion less than or equal to 30 degrees, or the entire thoracolumbar spine is stuck in a favorable position
  • 50 percent rating: The entire thoracolumbar spine is stuck in an unfavorable position, also called unfavorable ankylosis of the entire thoracolumbar spine.
  • 100 percent rating: The entire spine will not move and is stuck in an unfavorable position

Back Pain As A Disability

Winning Strategies for Back Pain Disability Cases

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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What Is ‘medically Determinable’ Back Pain

The first thing you need to know about qualifying for disability based on back pain is that the Social Security Administration does not typically grant benefits to those with mild, moderate, or intermittent back pain. Despite the fact that the SSA receives millions of applications for back pain-more applications for any other type of illness or injury, in fact-it only grants benefits to individuals with ‘medically determinable’ back impairments. This means that, in order to qualify for Social Security disability benefits, you’ll need to show that you have an impairment that can be detected and affirmed by a medical professional.

The Social Security Administration has a section on ‘Disorders of the Spine’ in its Listing of Impairments, which is typically used to determine whether back pain is compensable.

In order to be considered a ‘disability,’ your back pain must involve, among others, one of the following:

  • Herniated discs
  • Difficulty walking
  • Chronic pain associated with compression of the lumbar spine

This list is not exhaustive you may be required to meet additional criteria in order to qualify for disability for your back pain or spinal condition.

Service Connection For Back Pain

Many veterans suffer from back pain following their military service. Chronic back pain can limit your ability to work, earn a living, and even perform basic activities, such as bathing and dressing. If you can establish service connection for your back condition, you might be eligible to receive VA disability benefits. Service connection is the acknowledgment by VA that a veterans current health condition is related to their military service. Importantly, there are many types of service connection, including direct and secondary service connection.

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What If Your Claim Is Denied

You have done all the paperwork and have gathered all the evidence you can. But when you receive the decision a few weeks later, you are denied your disability benefits for back pain. This puts you in a very difficult situation.

Getting denied is a tough pill to swallow, and I know that I have seen it many times before with clients. Suppose you dont get the right type of evidence for your disability claim. In that case, the insurance companies will deny your disability claim for these technical reasons, even if they know you are disabled.

Where Can I Get More Information

The Lowdown On Low Back Pain

For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources and Information Network at:

Office of Communications and Public LiaisonNational Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesda, MD 20892

NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.

All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.

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Find The Best Law Firm To Win Your Disability Case

If you hurt your back on the job, you will first file for Workers Compensation. You must report your injury to your employer. The requirement to report your injury to your employer is the same in both Utah and Nevada. The goal if Workers Compensation is to pay you for time off work and also to reimburse you if you have a loss in function. Most people recover from back injuries and can return to work. However, if you do not recover or if you have multiple back injuries, you may need to apply for disability benefits through the SSA.

Understanding Va Back Ratings

Your VA disability rating for back injury or spine injury will depend on which code the condition falls under. Diagnostic codes 5235 through 5243 of 38 CFR § 4.71a, Schedule of Ratings, Musculoskeletal System are dedicated to back and neck pain. Some of which are listed below:

Diagnostic codes 5242 and 5243 are reserved for arthritis and spinal disc conditions.

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What Are Va Benefits For Back Pain

First of all, although it is possible to receive benefits for pain incurred during your time in service without a diagnosis, it is not guaranteed. A current diagnosis is always recommended if possible to obtain. In addition to your current diagnosis, you will need to include a NEXUS letter and DBQ to partner with your medical evidence and in turn, prove your service-connection. Without these outside documents, you are significantly decreasing your chance of winning your VA disability for back problems claim.

In determining benefits, the VA refers to the back as the thoracolumbar spine. This is the term used to reference middle or lower back pain. The VA considers upper back pain in the same category as neck pain. Therefore, anything above middle or lower back pain will be referred to as the cervical spine and falls under a different rating system.

The thoracolumbar spine is composed of two parts of the spine the thoracic and the lumbar . These are the two areas that will be examined in order to determine benefits for any back pain.

How The Social Security Administration Views Back Problems

Back pain and Social Security Disability

Claims for Social Security disability because of back pain resulting from disc problems and arthritis are extremely common. The SSA knows that many working people have back problems once they reach their forties and fifties, and it expects most of them to be able to continue working until retirement age with moderate discomfort. As a result, it can be very difficult to win a Social Security disability claim based on common back problems.

To win a disability claim based on back pain, you’ll have to show the Social Security Administration that your pain is beyond the moderate back pain that many people experience, and instead is severe and debilitating. Depending on your condition, you may have to prove that you either cannot sit or stand for several hours at a time or cannot walk without assistance. For all conditions, your back problems must have lasted or be expected to last 12 months or more.

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Insufficient Objective Evidence Of Disability

Although insurers often cite insufficient objective evidence of disability to deny claims, this reason doesnt work with back pain. This is because modern medicine has yet to find objective evidence of disability caused by pain.

If you receive this as a reason, address it in your appeal letter. Fortunately, objective evidence is not a requirement under most disability insurance policies and programs.

Your appeal letter should focus on how your doctor followed best practices for diagnosis and treatment. It should mention that you stuck to the recommended treatment. You should also emphasize all the things youve tried to stay at work.

Conditions Causing Back Pain

Numerous conditions can cause chronic back pain. Some conditions may be genetic, while other conditions might be related to a work injury or accident. Some conditions that can result in long-term back pain include, but are not limited to:

  • Spinal Stenosis is common in the lower back and the neck. The condition causes compression of the spinal cord or nerve roots. The pain from spinal stenosis can radiate in the extremities and also cause numbness through the extremities.
  • Degenerative Disc Disease is the deterioration of the cushions between the bones of the back. The disease is common in older individuals, but it can also affect younger adults. The pain is chronic and can radiate down through the hips and legs.
  • Osteoporosis can result in brittle bones in the back, which increases the risk of fractures. Intense pain is common with vertebral fractures.
  • Herniated discs, also referred to as slipped discs or ruptured discs, can cause severe and chronic back pain. The inner portion of the disc breaks through the outer section of the disc, thereby causing fluid to leak into the spinal column. The fluid causes pain when it comes into contact with the nerves in the spinal column. Pain may radiate through the lower back and legs.
  • Sacroiliitis, rheumatoid arthritis, ankylosing spondylitis, arachnoiditis, and other inflammatory conditions cause also cause severe and long-term back pain that can prevent a person from working or performing daily activities.

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Back Impairment And The Americans With Disabilities Act

The ADA does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet. A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act .

Traumatic And Degenerative Arthritis

Low back pain is the single leading cause of disability ...

Traumatic arthritis is joint damage, pain, or inflammation due to an injury. If an individuals joints begin causing problems after excessive movement or physical trauma, their arthritis will not be considered chronic.

Degenerative arthritis refers to a chronic breakdown of cartilage around joints. The joints between vertebrae are called facets. When facet joints are damaged, veterans experience facet arthropathy. The VA rating for facet arthropathy can contribute to the VA rating for degenerative arthritis of the spine.

Both of these forms of arthritis are rated under code 5003. Each specific joint will also have its own identifying arthritis code. For example, degenerative arthritis of the spine is listed under diagnostic code 5242, meaning decisions regarding degenerative arthritis of the spine will reference the condition as 5242-5003.

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Va Ratings For Spinal Arthritis & Back Pain

In order to ensure that youre getting the most out of your disability claim, you need to understand how the VA rates your condition. Errors are frequently made when rating conditions. The VA not only makes mistakes in evaluation the severity of a condition, but sometimes they evaluate a condition according to the completely wrong rating criteria.

With this in mind, its important to know which spinal conditions are not rated under the general rating formula. The VA has a separate rating system for these conditions. Some of the conditions included in this category are degenerative arthritis, traumatic arthritis, and rheumatoid arthritis.

The rating systems used for arthritis of the spine is the second most common rating system for spine conditions. There are two types of arthritis that are rated under the same rating system degenerative arthritis, and traumatic arthritis. Rheumatoid arthritis is rated under its own rating system.


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