When it comes to the guidelines set forth by the VA for those with back disabilities, understanding it may be confusing. Claiming back conditions for VA disability is possible. Whether your back pain is severe or even causing impairment, you may still be wondering if your VA rating should be higher. This guide will provide you with a list of frequently asked questions that will explain how VA rates veterans with back disabilities.
FAQs About Back Disability and VA Ratings
How does the VA rate veterans with back conditions?
There are various regulations that are followed when the VA rates veterans with back conditions. These guidelines can be found in the Code of Federal Regulations. Depending on the medical condition you have, the diagnostic code will vary. For example, for veterans that have a disability of the spine, the diagnostic code may be anywhere between 5235 and 5243.
These codes cover the following conditions:
- Spinal stenosis
- Intervertebral disc syndrome
- Vertebral fracture and dislocation
- Degenerative arthritis of the spine
- Lumbosacral or cervical strain
When it comes to rating back disabilities, the VA uses the codes between 5235 and 5242. These codes cover the thoracolumbar and cervical parts of the spine.
Is it possible to rated higher than 40 if my range of motion is good?
For veterans that have a thoracolumbar disability, there is another formula that the VA can be used for diagnosing purposes. This code is 5243 and is used for intervertebral disc syndrome.
Even if you have episodes where you feel incapacitated, you may still qualify for a 40 percent or higher VA rating. However, these episodes must occur over a 4-week period and last at least 12 months. You can receive a rating as high as 60 percent if your episodes last at least 6 weeks over a 12-month period.
What will happen if I experience additional symptoms that occur from my back disability?
If you are experiencing additional symptoms related to your back condition, those conditions will be rated separately by the VA. For instance, there are different diagnostic codes that the VA uses to rate those experiencing neurological symptoms including bladder or bowel issues, and radiculopathy pain.
Is it possible to receive a 100 percent rating for a back disability?
It is possible to receive a 100 percent VA rating for a back disability. However, your tests must show that you have ankylosis of the entire spine. Ankylosis of the spine means that you are unable to move any part of your spine when being bent forward. Both your cervical spine and thoracolumbar spine wouldn’t function at all. Additionally, you may still be eligible to receive a 100 percent rating if your back disability has an impact on your employment.
Having a 40 to 60 percent thoracolumbar spine rating indicates you have significant back limitations. This means that your limited range of motion is extremely limited or that the episodes you experience cause you to stay on bedrest for at least 4 weeks in a 12-month period. Veterans with this type of limitation will likely find it challenging to find or keep a job.
