VA Disability Ratings for Back Pain
Updated: October 10, 2022
Written by John W. Mitchell
Lower back pain is the leading cause of disability in the United States, affecting about 4.3 million Americans – twice the burden of any other health condition. About 20% of such cases are chronic, lasting a year or more, according to the National Institutes of Health.
However, the incidence of low back pain is about a third for veterans, with slightly less suffering from related arthritis, according to the National Center for Biotechnology Information.
Military service can puts veterans at risk for conditions that cause back pain.
“Those in the U.S. military frequently carry and lift heavy loads, jump, or quickly pivot and run in their line of duty,” said an article on OrthoInfo, a patient education site by the American Academy for Orthopedic Surgeons. “Repeated stress and trauma on these joints contribute to the overall health and well-being of the spine”.
Can I Get VA Disability For Back Pain?
Yes. Veterans can receive VA disability compensation for back pain with a diagnosed cause, and for associated spinal arthritis related to a back injury.
These conditions must be caused by a documented service-connected injury, illness or condition. Pre-service conditions aggravated by military duty may also qualify for VA benefits.
Submit your active-duty and civilian medical records to help the VA determine if your condition qualifies for a VA disability rating, and how to rate it.
The VA uses a set scale to determine VA ratings. For back pain, your medical evaluator will consider factors like your back and neck’s range of motion.
Back Pain as a Secondary Condition
Veterans may suffer back pain as a secondary condition, according to veteran disability law firm Chisolm, Chisolm and Kirpatrick.
For example, a veteran has a service-connected hip condition that causes them to favor one side when walking, resulting in an altered gait. This uneven shift in weight then contributes to back pain. In this case, the veteran’s back pain is caused by their service-connected hip condition, and therefore warrants secondary service connection.
You must file a new VA claim for a secondary condition. You can’t use the same appeal process you’d use to file for an increased rating.
How Hard Is It to Get VA Disability for Back Problems?
There is no data available on the approval rate of VA back pain claims. Anecdotally, in online forums some veterans said they breezed through the self-directed claims process while others complained of denials and lengthy appeals.
A veteran service organization (VSO) such as AMVETS, the American Legion or Veterans of Foreign Wars (VFW) can assist you with your claim or appeal. These organizations are experienced in navigating the VA claims process and can work on your behalf.
Here is a list of VA-accredited Veteran Service Organizations that can help with your claim.
Additionally, you can reach out to an attorney that specializes in VA disability claims. But, keep in mind that this option may be costly. In addition to legal fees for a retainer, you may need to cover additional associated medical costs, like an appointment for a second opinion.
VA Disability Ratings for Back Pain
The VA has established specific ratings for back pain, depending on the cause and its effect on your life. For example, the VA may rate some vertebral disc disorders between 10% and 60% depending on how frequently it interferes with your routine each year.
Check out the VA’s rating schedule for more information on any specific service-connected injuries or illnesses that may be causing your back pain.
If you have more than one VA disability, consult the VA’s combined ratings table.
The VA cites three specific factors in evaluating a chronic back pain claim:
- The evidence you provide
- The results of your VA claim exam (also called a compensation and pension, or C&P, exam)
- Other information the VA may get from other sources, including federal agencies, employers and more
How to Apply for VA Disability for Back Pain
Before you begin any VA disability claim, consider speaking to a VSO.
You will need to provide medical evidence to support your claim. This evidence can come in the form of a diagnosis from a doctor, medical records and witness statements.
Once you have gathered the necessary documentation, you will need to file a claim with the VA.
To file for benefits, you will need to fill out VA Form 21-0966, Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DIC. You don’t need to do this if you plan to file your claim online. Beginning an online application for disability benefits notifies the VA of your intent to file.
Keep in mind, you must submit your VA claim within one year of your effective date.
You can file your claim online or deliver your completed VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits, by mail or in person at your closest VA regional office.
Address mail-in forms to:
Department of Veterans Affairs
Claims Intake Center
PO Box 4444
Janesville, WI 53547-4444
When applying, you can choose to provide the required supporting documentation for a fully-developed disability claim, which usually yields a quicker decision. Or, you can ask the VA to handle the claim review and gather the needed documents through a standard disability claim.
There is no time limit to file a VA back disability claim. However, it’s best to start the process when you separate from active duty, if at all possible.
Eligibility to File a VA Disability Claim
According to the VA, to be eligible to receive VA disability benefits:
- You must have served on active duty, active duty for training or inactive duty training.
- You must have received an honorable, general or under honorable conditions discharge.
- You must have a current injury or illness connected to your active-duty service. This means:
- You became sick or injured while on active duty
- Your military service worsened a pre-existing condition
- An injury or illness that can be linked to your service appeared after you left active duty.
Veterans who develop a chronic illness within one year of discharge, after exposure to toxic chemicals or other hazardous materials or experience illness due to time spent as a prisoner of war (POW) also qualify for VA compensation.
Proving VA Service Connection for Your Back Condition
According to the VA, to prove a service-related back injury you must:
- Provide VA, military or private medical records related to your back pain injury claim that support when your condition began and how it has worsened over time.
- Provide military separation documents, including your DD-214
- Provide supporting statements from family members, friends, clergy members, law enforcement personnel or those you served with that can tell the VA more about your claimed condition and how and when it happened or how it got worse.
VA C&P Exams for Back Pain
After you file your claim, the VA may decide to conduct a compensation and pension (C&P) compensation exam on your back or spine if they need more information or medical evidence to support your claim.
C&P exams help VA evaluators determine the severity of your condition and assign a rating for it. Your rating will determine your eligibility for monthly payments and other VA health care benefits, according to the VA.
How to Apply to Increase Your VA Disability Rating for Back Pain
It is possible to get an increased back pain VA rating if your condition has worsened since the VA rated it.
To get an increased VA rating, you must file an appeal, providing evidence that shows how your condition has changed. You may also have to go in for another evaluation.
Reach out to a VA-accredited VSO for help filing an appeal.
TDIU for Back Pain
If your back pain is severe and debilitating enough to prevent you from working, you may be able to file for total disability individual unemployability (TDUI). TDIU is different from a 100% permanent and total VA disability rating, but the benefits are the same, according to the VA.
How Long Does it Take to Receive VA Disability Benefits?
As of May 2022, it takes an average of 142 days for the VA to decide if a veteran meets criteria to receive disability compensation for back pain, according to the VA’s tracker.
