Disabled Veteran with Back Impairment

Back Impairments

The hazardous and physically demanding tasks routinely performed by members of the U.S. Armed Forces put servicemembers and veterans at greater risk of developing orthopedic conditions of the back and other parts of the body. Whether a veteran’s back pain is the result of an acute injury sustained during their service, or caused by chronic stress during training and regular duty, any back conditions caused or aggravated by military service are eligible for service connection and compensation.

Orthopedic conditions affecting the back are rated and compensated differently depending on the diagnosis and the degree of disability, so it’s important to work with your doctor and/or orthopedic specialist to get the correct diagnosis and to record your symptoms as early as possible. Understanding the condition causing your chronic back pain will also help you get the most effective treatment.

Which Back Conditions Are Eligible for Service Connection?

The VA disability rating system separates orthopedic conditions affecting the spine into neck conditions (the cervical spine) and back conditions (the thoracolumbar spine). For the purposes of calculating a veteran’s total disability rating, back and neck impairments are treated as separate disabilities (except for unfavorable ankylosis of both segments, which is treated as a single condition).

The VA’s Disability Benefits Questionnaire (DBQ) for evaluating back conditions tells VA examiners to consider the following thirteen back conditions:

-Mechanical back pain syndrome

-Lumbosacral sprain/strain

-Facet joint arthropathy (degenerative joint disease of lumbosacral spine)

-Degenerative disc disease

-Degenerative scoliosis

-Foraminal/lateral recess/central stenosis

-Degenerative spondylolisthesis

-Spondylolysis/isthmic spondylolisthesis

-Intervertebral disc syndrome

-Radiculopathy

-Ankylosis of thoracolumbar spine

-Ankylosing spondylitis of the thoracolumbar spine

-Vertebral fracture (vertebrae of the back).

Other conditions and types of back pain may also be eligible for service connection and compensation. Be sure to talk to your treating physician and your VA examiner in depth about your symptoms, service history, and medical history. This gives you a better chance of receiving the correct diagnosis, treatment, and VA disability rating.

Proving Service Connection and Unemployability for Back Conditions

If your back pain began during or was made worse by your military service, you are eligible for service connection and VA disability benefits. To prove service connection to the VA, assembling your service medical records, military personnel files reflecting an in-service accident, diagnosis, or change of duty to due back issues, and any private medical records you have will help you establish the connection between your military service and the progression of your back condition. Sworn declarations from fellow servicemembers, friends, family members or others familiar with your back condition can also help verify that your condition was caused or made worse during your military service.

As you can see by reading the rating schedules below, the only back condition eligible for a 100 percent schedular rating is unfavorable ankylosis (immobility) of the entire spine. Other back impairments have maximum schedular ratings of 60 percent or lower. However, the pain and limited mobility associated with many back impairments can make it all but impossible to perform ordinary daily tasks, let alone work a regular job. This is especially true for veterans with other service-connected impairments, such as cervicogenic headaches or mental health conditions.

If you are unable to work due to your back condition, getting maximum monthly benefits will usually require a total disability rating based on individual unemployability (a TDIU rating). In addition to your service medical history, personnel files, employment history, and other medical records, other supplementary evidence may need to be submitted. This may include sworn declarations, opinions from medical and vocational experts, and other documents. Your professional veteran advocate will make it clear exactly what you need to do in order to win a TDIU rating.

Disability Rating Schedules for Back Conditions

Back Muscle Injuries

Injuries to the back muscles are compensated differently depending on the muscles affected and the severity of the impairment. Back and torso muscles are organized into muscle groups, each with their own schedule.

Diagnostic Code 5319, Group XIX

Function: Support and compression of abdominal wall and lower thorax; flexion and lateral motions of spine; synergists in strong downward movements of arm (1).

Muscles of the abdominal wall: (1) Rectus abdominis; (2) external oblique; (3) internal oblique; (4) transversalis; (5) quadratus lumborum.

Severe: 50%
Moderately Severe: 30%
Moderate: 10%
Slight: 0%

Diagnostic Code 5320, Muscle Group XX

Function: Postural support of body; extension and lateral movements of spine.

Spinal muscles: Sacrospinalis (erector spinae and its prolongations in thoracic and cervical regions).

Cervical and thoracic region:

Severe: 40%
Moderately Severe: 20%
Moderate: 10%
Slight: 0%

Lumbar region:

Severe: 60%
Moderately Severe: 40%
Moderate: 20%
Slight: 0%

Diagnostic Code, 5321 Group XXI

Function: Respiration.

Muscles of respiration: Thoracic muscle group.

Severe or Moderately Severe: 20%
Moderate: 10%
Slight: 0%

Musculoskeletal Back Conditions

Conditions affecting the thoracolumbar spine such as vertebral fracture, cervical strain, spinal stenosis, ankylosing spondylitis, and spinal fusion are usually evaluated using the General Rating Formula for Diseases and Injuries of the Spine:

General Rating Formula for Diseases and Injuries of the Spine

Unfavorable ankylosis of the entire spine: 100%

Unfavorable ankylosis of the entire thoracolumbar spine: 50%

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: 40%

Forward flexion of the cervical spine 15 degrees or
less; or, favorable ankylosis of
the entire cervical spine: 30%

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: 20%

Forward flexion of the thoracolumbar spine greater
than 60 degrees but not greater than 85 degrees; or,
forward flexion of the cervical spine greater than
30 degrees but not greater than 40 degrees; or,
combined range of motion of the thoracolumbar spine
greater than 120 degrees but not greater than 235
degrees; or, combined range of motion of the cervical
spine greater than 170 degrees but not greater than
335 degrees; or, muscle spasm, guarding, or localized
tenderness not resulting in abnormal gait or abnormal
spinal contour; or, vertebral body fracture with loss
of 50 percent or more of the height: 10%

The exception to this is intervertebral disc syndrome (IVDS). IVDS is evaluated either using the General Formula for Diseases and Injuries of the Spine (above), or the Formula for Rating Intravertebral Disc Syndrome Based on Incapacitating Episodes (see below). The VA is required to use whichever formula gives the highest combined rating when all of the veteran’s disabilities are evaluated together.

Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes

With incapacitating episodes having a total duration
of at least 6 weeks during the past 12 months: 60%

With incapacitating episodes having a total duration
of at least 4 weeks but less than 6 weeks during
the past 12 months: 40%

With incapacitating episodes having a total duration
of at least 2 weeks but less than 4 weeks during
the past 12 months: 20%

With incapacitating episodes having a total duration
of at least one week but less than 2 weeks during
the past 12 months: 10%

Win Total Disability Benefits for Your Back Condition with Friedman Disability

If you have been denied total disability benefits or service connection for your back condition, hiring a legal team with experience winning back impairment claims is the best way to ensure the success of your appeal. The award-winning veteran advocates at Friedman Disability have more than 25 years of experience helping veterans win their VA claims. Our team is ready to help you through every stage of the VA disability claims process, informed by the experience gained over the course of 5,000 total disability victories to date. Our fee is 20 percent of your past-due benefits ONLY if we win your claim. Call our offices at 800-742-5035 today or visit https://veterans-disability-lawyers.com/contact-us/ for a free evaluation of your VA disability claim.