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.
Many veterans with significant functional loss, pain, and difficulty working might initially only obtain a 10 or 20 percent rating. In fact, the average VA disability rating for back pain is only 10 percent.How does the VA determine disability rating 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 veteran's functional loss,” said Cecilia Ton, a VA-certified disability benefits lawyer.What are the VA disability codes for lower back pain? ›
The veteran's service-connected back disability is currently evaluated under 38 C.F.R. § 4.71a, Diagnostic Codes 5295- 5293. Lumbosacral strain is assigned a disability rating in the Schedule under Diagnostic Code 5295. Severe lumbosacral strain is given a 40 percent rating.Can you increase your VA disability rating for back pain? ›
You can file for a rating increase if your pain has worsened, or you can also apply for total disability based on individual unemployability (TDIU). TDIU requires that you have one condition with at least a 60% rating or two disabilities that add up to 70%.How do you prove back pain is service-connected? ›
Tracing back pain to an injury or event that occurred during a person's active duty service is the simplest way to establish a nexus. This can be done by referencing military service records. For many former servicemembers, injuries during strenuous training exercising are the cause of their chronic back pain.What is the max VA rating for lower back pain? ›
A 40 percent rating is the maximum schedular rating for limitation of motion of the lumbosacral spine under Diagnostic Code 5292. The Board has considered rating the veteran's low back disability under all potentially applicable diagnostic codes to determine whether a more favorable rating is warranted.How do you qualify for back pain disability? ›
To qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits, chronic back pain sufferers must prove they have a medically determinable impairment. Additionally, the impairment must last or be expected to last for a minimum of one year.Can back pain be secondary to knee pain for VA disability? ›
If the veteran can demonstrate that the original disability caused lower back problems, the VA might award secondary benefits due to disability from the knee arthritis. Veterans can file a secondary claim whenever an additional disability appears.What is the range of motion for the VA lower back? ›
On most days, the veteran is unable to bend forward more than 60 degrees. However, when experiencing a flare-up, the veteran is unable to bend more than 30 degrees. Therefore, during the flare-up, the veteran's back condition becomes much more disabling than 10 percent.Can you get VA disability for lower back pain and arthritis? ›
Arthritis of the back will be rated at 10 or 20 percent based upon the number of joints/joint groups affected and the level of incapacitation. VA requires that limitations of motion be confirmed by observations such as swelling, muscle spasms, or evidence of painful motion.
The VA generally rates degenerative disc disease between 10 and 20%, depending on the number of joints affected.What is the maximum VA rating for degenerative disc disease? ›
What Is the Maximum Disability Rating for Degenerative Disc Disease? Despite how much pain the condition causes, the maximum VA disability rating for degenerative disc disease, as mentioned above, is typically 20 percent. However, there are a few ways veterans can increase their DDD VA rating.How much is VA disability for erectile dysfunction? ›
Unlike other disabilities, erectile dysfunction is not given a rating schedule but instead, uses the following to determine compensation: Code 7520 Partial removal of the penis. This gives a rating of 30%.What not to say at C&P exam? ›
What not to say at a C&P exam. The most vital thing not to do at your claim exam is to pretend your symptoms aren't as bad as they are. It's not the time to play tough. You don't want to exaggerate your symptoms, but you should be honest about how bad they are and exactly how they impact your life.Can doctors prove back pain? ›
Imaging and Blood Tests
Most people do not need additional testing; however, sometimes doctors order tests to rule out a specific cause for your pain or to confirm a cause for your back pain.
Tinnitus. Tinnitus, otherwise known as “Ringing-in-the-Ear-Syndrome” is by far the #1 easiest VA disability to claim. Tinnitus is when you experience ringing, hissing, buzzing, or other noises in one or both of your ears.What is the VA rating for muscle and joint pain? ›
Veterans receive either a 10% or 20% rating depending on the severity of their symptoms and the number of joints affected. A 20% rating requires that two or more major joints or two or more groups of minor joints have occasional incapacitating episodes.What is the VA over 50 rule? ›
Once you turn 55, you are typically "protected" and will no longer have to attend an exam to prove that your condition has not changed unless there is reason to suspect fraud. This is sometimes called the 55-year rule.Does the VA give a rating for pain? ›
The VA doesn't have a specific diagnostic code for chronic pain, but it does pay benefits for veterans who experience it. Therefore, VA disability benefits for chronic pain are based on the symptoms or impairments that result from your pain.What is the most approved disability? ›
What Is the Most Approved Disability? Arthritis and other musculoskeletal system disabilities make up the most commonly approved conditions for social security disability benefits. This is because arthritis is so common. In the United States, over 58 million people suffer from arthritis.
How VA Rates Back Pain Disability. VA disability ratings for back pain go from 10% to 100% depending on how severe your symptoms are, including your range of motion and pain frequency and level. Claims involving both the cervical spine and the thoracolumbar spine are rated under the same general rating formula.Is back pain a permanent disability? ›
If your chronic back pain is preventing you from performing the essential duties of your job, you may qualify for long-term disability (LTD). Chronic back pain is a common symptom. Spine injuries and other medical conditions can cause severe back pain.What is secondary to back pain? ›
Some secondary conditions resulting from back pain include: Radiculopathy. Radiculopathy occurs when the nerves in the lower back are compressed. This can cause a range of symptoms such as sharp pain that shoots and radiates in the lower back down into the legs, weakness, and numbness.Can sleep apnea be secondary to lower back pain? ›
Sleep apnea and back pain are commonly experienced together. Although medical experts don't believe that one condition causes the other, the two health issues are found as co-symptoms often enough that the relationship between back pain and sleep apnea deserves to be explored.What are secondary conditions veterans can claim for back pain? ›
Here are some common physical secondary conditions to back pain: Paralysis. Erectile dysfunction. Sciatic nerve damage.How much is VA disability for high blood pressure? ›
A 20 percent rating is assigned for diastolic pressure that is predominantly 110 or more, or systolic pressure predominantly 200 or more. A 40 percent rating is assigned where diastolic pressure is predominantly 120 or more. A 60 percent rating is assigned where diastolic pressure is predominantly 130 or more.How does the VA check range of motion? ›
At the C&P exam, the VA practitioner will check the ROM for your affected joint using a goniometer. This is an instrument used to measure precise angles. In this case, it would be used to measure the precise degrees of motion that you experience around a joint.What is the average VA disability rating for knee pain? ›
Limitation of Flexion of the Knee (Diagnostic Code 5260)
This is the most common knee problem eligible for VA disability benefits, with ratings that typically range from 10% to 30%.
§ 4.115a, urinary frequency is to be rated as follows: Daytime voiding interval between 2 and 3 hours, or, awakening to void 2 times per night, warrants a 10 percent disability rating. Daytime voiding interval between 1 and 2 hours, or, awakening to void 3 to 4 times per night, warrants a 20 percent disability rating.What are the VA secondary conditions to knee pain? ›
Common Secondary Conditions to Knee Pain
Limitation of flexion or extension of the knee, which have diagnostic codes 5260 and 5261, respectively. Instability of the knee, diagnostic code 5257. Ankylosis of the knee, diagnostic code 5256. Total knee replacements, diagnostic code 5055.
To establish a service connection for arthritis, a veteran must prove that the condition was a result of an event that occurred during service, such as an in-service injury or overuse of a joint during a service-related task that caused the condition to develop.How hard is it to get disability for degenerative disc disease? ›
Degenerative disc disease can be a challenging condition to prove as disabling to insurance companies. While the debilitating pain of degenerative disc disease is very real, pain is considered a “subjective” symptom. Your insurance company will want objective medical evidence to back up your disability claim.What is the average VA rating for degenerative arthritis? ›
The osteoarthritis disability ratings are either 10% or 20% depending on the following symptoms: 10%: a veteran has degenerative arthritis in two or more major joints or two or more groups of minor joints seen with X-ray evidence. through X-ray evidence) along with occasional incapacitating exacerbations.What is the VA rating for L4 L5 and L5 S1? ›
The veteran's degenerative disc disease of the lumbar spine at L4-5 and L5-S1 is rated as 40 percent disabling pursuant to 38 C.F.R.What are secondary conditions to degenerative disc disease? ›
A few examples of these secondary conditions or complications are radiculopathy, myelopathy, urinary incontinence and/or frequency along with mental health conditions as well.What is the VA rating for hip pain secondary to back? ›
The secondary condition has a disability rating of 30%.How many Viagra will the VA give you? ›
Veterans who use PDE-5 inhibitors for ED are limited to four doses per month through VA pharmacy benefits.What is the VA rating for hair loss? ›
Under Diagnostic Code 7831, for alopecia areata, a noncompensable rating is assigned with loss of hair limited to the scalp and face. A 10 percent rating is warranted with loss of all body hair.What is the VA rating for insomnia? ›
Your VA rating for insomnia can be between 0% and 100% depending on the severity of your symptoms and if you can prove the insomnia is service-connected.What triggers a C&P exam? ›
#1 Q: What is a VA claim exam, also known as a Compensation and Pension (C&P) exam? If you've filed a claim with the U.S. Department of Veterans Affairs (VA) for disability compensation or pension benefits, VA may ask you to go to an examination as part of the claim process.
- Prepare for Your C&P exam ahead of time.
- Be upfront with your concerns and day-to-day issues.
- Explain about “bad days” and how often they occur. ...
- Get a copy of the C&P results.
- Bring someone close to you to the appointment.
- Remember that you might have multiple visits.
You could get a favorable decision under these conditions: The C&P exam went well, meaning you completed all questions, and the exam report was declared veteran-friendly. The attending physician reviewed all medical records and stated as such in their exam report.What is the best painkiller for back pain? ›
- Best for fast back pain relief: Ibuprofen (Advil, Motrin) ...
- Best for all day/night back pain relief: Naproxen (Aleve) ...
- Best for back pain relief if you can't use NSAIDs: Acetaminophen (Tylenol) ...
- Best topical back pain option: Diclofenac gel (Voltaren gel, Aspercreme gel)
A Computerized Axial Tomography scan (a CT or CAT scan) or a Magnetic Resonance Imaging test (an MRI) may be required. These tests are more effective than X-rays at showing the soft tissues in your spine, and can help to identify problems such as a bulging disc or a herniated disc.How do I describe my back pain to my doctor? ›
Using Adjectives – Adjectives provide the most accurate description because they give doctors a better idea of what your pain feels like, even from an outside perspective. Some adjectives you can use are burning, stinging, stiff, sore, radiating, and aching to paint the picture for your spine surgeon accurately.How do you prove back pain is service connected? ›
Tracing back pain to an injury or event that occurred during a person's active duty service is the simplest way to establish a nexus. This can be done by referencing military service records. For many former servicemembers, injuries during strenuous training exercising are the cause of their chronic back pain.How do I maximize my VA disability? ›
Seek treatment and obtain medical evidence to support the claim. One of the most important factors in obtaining an increased VA disability rating is providing medical evidence that supports the veteran's claim. This medical evidence can include records from military service, private doctors, and VA medical centers.What is the fastest VA claim? ›
Veterans can file a Priority Processing Request using VA Form 20-10207 to ask VA to address their claim in a more expedient manner. In order to be eligible, veterans must submit documentation, if not already on file, indicating that they meet one of the following criteria: Experiencing extreme financial hardship.How long does it take to get disability for back pain? ›
If you have chronic back pain, and it has prevented you from working for at least 12 months, you may be eligible for Social Security Disability benefits. However, few claims for chronic back pain are approved, and applying for Social Security Disability benefits is a long process that can take months to years.What is the easiest VA disability to claim? ›
Tinnitus. Tinnitus, otherwise known as “Ringing-in-the-Ear-Syndrome” is by far the #1 easiest VA disability to claim. Tinnitus is when you experience ringing, hissing, buzzing, or other noises in one or both of your ears.
The maximum SSDI will provide in back payments is 12 months. Your disability would have to start 12 months before you applied to receive the maximum in SSDI benefits.How far back is disability retroactive? ›
Retroactive SSI benefits may be paid from the month after the Protective Filing Date (PFD) and Retroactive SSDI benefits may be paid from the established date of onset of disability plus the 5-month waiting period.What is the highest VA rating for arthritis of back? ›
Arthritis of the back will be rated at 10 or 20 percent based upon the number of joints/joint groups affected and the level of incapacitation. VA requires that limitations of motion be confirmed by observations such as swelling, muscle spasms, or evidence of painful motion.What is the VA rating for high blood pressure? ›
The VA uses the following criteria to rate hypertension: 60% rating is given if your diastolic pressure is 130 or higher. 40% rating is given if your diastolic pressure measures between 120 and 129. 20% rating is given if your diastolic pressure is 110-119, or your systolic pressure is 200 or higher.What VA claims are automatically approved? ›
VA automatically presumes that certain disabilities were caused by military service. This is because of the unique circumstances of a specific Veteran's military service. If a presumed condition is diagnosed in a Veteran within a certain group, they can be awarded disability compensation.Is high blood pressure a VA disability? ›
Yes, a veteran can receive disability for high blood pressure, either as a primary disability or with a secondary connection to another medical issue that's service related.