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Seeking A VA Increase For Back Pain: Requirements And Documentation

October 11, 2023

Back pain is a common ailment that many veterans carry with them post their service days. While the physical discomfort is evident, the process of seeking increased benefits from the VA for back pain can be complex. 

This article aims to be a beacon, guiding veterans through the intricacies of understanding back pain, its treatments, and the potential benefits the VA offers.

Overview Of VA Increase For Back Pain

Veterans often experience low back pain after their military service. Depending on the severity, low back conditions can significantly affect a veteran's ability to perform daily activities or fulfill work-related responsibilities. If veterans can prove that their low back pain is due to their military service, they may be eligible for VA disability benefits, which include monthly compensation and VA healthcare.

In April 2018, the Federal Circuit ruled that the VA must award disability benefits for pain resulting from military service. Before this decision, pain without an underlying diagnosis was not compensable. Now, even if a veteran experiences back pain due to their military service but doesn't have a specific diagnosis causing that pain, they can still receive VA disability compensation.

The VA typically uses the General Rating Formula for Diseases and Injuries of the Spine under 38 CFR § 4.71a to evaluate back conditions, including low back pain. This formula primarily focuses on the range of motion. The VA has specific ratings for back pain based on the range of motion and other factors, such as intervertebral disc syndrome (IVDS). The presence of flare-ups, which are sudden and temporary increases in symptoms, can also impact a veteran's disability rating.

Veterans unable to work due to their service-connected low back pain can apply for total disability based on individual unemployability (TDIU), allowing them to be paid at the 100 percent disability rate.

Causes Of Back Pain

Before diving into the VA's provisions, it's essential to understand the root causes of back pain. By identifying the origins, veterans can better navigate their claims and understand their conditions.

Common Causes Of Back Pain

Back pain is one of the most prevalent medical issues in the United States. The pain can vary from a dull, constant ache to a sudden, sharp sensation. Some common reasons for back pain include:

  • Muscle Or Ligament Strain: Repeated heavy lifting or sudden awkward movements can strain back muscles and spinal ligaments.

  • Bulging Or Ruptured Disks: Disks act as cushions between the spine's bones. When these disks bulge or rupture, it can press on a nerve, causing pain.

  • Arthritis: This condition can affect the lower back, leading to a condition called spinal stenosis.

  • Osteoporosis: Brittle and porous bones can lead to vertebral fractures, causing pain.

  • Ankylosing Spondylitis: Also known as axial spondyloarthritis, it's a type of arthritis affecting the spine.

Complications From Chronic Back Pain

Chronic back pain can lead to complications if not addressed. Over time, persistent pain can affect a person's mobility, leading to muscle weakness. It can also impact one's mental health, leading to depression, anxiety, and sleep disturbances.

Diagnosing The Cause Of Back Pain

Diagnosing the exact cause of back pain can be a complex process. It often involves a combination of physical examinations, medical history analysis, and imaging tests like X-rays, MRI, or CT scans. Sometimes, specific tests like electromyography (EMG) or bone scans might be required to pinpoint the cause.

Types Of Treatment For Back Pain

Back pain is a common ailment that can range from a mild annoyance to a debilitating condition. The treatment for back pain varies based on its cause, severity, and the individual's overall health. Here are some common treatments for back pain:

Medication Treatments For Back Pain

Pain Relievers: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin IB) or naproxen sodium (Aleve) can help alleviate back pain. If over-the-counter options don't provide relief, prescription NSAIDs might be an option.

  • Muscle Relaxants: For mild to moderate back pain that doesn't improve with pain relievers, muscle relaxants can be beneficial. However, they can cause dizziness and sleepiness.

  • Topical Pain Relievers: These are creams, salves, ointments, and patches applied to the skin to deliver pain-relieving substances.

  • Narcotics: Drugs containing opioids, like oxycodone or hydrocodone, might be used for a short duration under close medical supervision.

  • Antidepressants: Some antidepressants, especially duloxetine (Cymbalta) and tricyclic antidepressants like amitriptyline, have been shown to relieve chronic back pain.

Physical Therapy For Back Pain Relief

Physical therapy can be a crucial component in treating back pain. A physical therapist can:

  • Teach exercises to increase flexibility.

  • Strengthen back and abdominal muscles.

  • Improve posture.

  • Provide education on modifying movements during a back pain episode to avoid exacerbating pain symptoms while staying active.

Surgery And Other Procedures For Severe Cases

For those who don't find relief through medication or physical therapy, surgical and other procedures might be an option:

  • Cortisone Injections: An injection of cortisone and a numbing medication into the space around the spinal cord and nerve roots can help reduce inflammation and pain.

  • Radiofrequency Ablation: This procedure involves inserting a fine needle near the pain area and using radio waves to damage nearby nerves, disrupting pain signals to the brain.

  • Implanted Nerve Stimulators: Devices implanted under the skin can deliver electrical impulses to specific nerves to block pain signals.

  • Surgery: In cases where there's increasing muscle weakness or pain radiating down a leg due to herniated disks or other conditions narrowing the spine's openings, surgery might be necessary.

Benefits Of VA Increase For Back Pain Sufferers

Veterans who suffer from chronic back pain due to their military service can benefit significantly from the VA's increased focus on this debilitating condition. Here's a closer look at the benefits and the process involved:

Increased Benefits Through Disability Ratings

The VA assigns disability ratings for back pain based on the veteran's range of motion. The more restrictive the range of motion, the higher the compensation. For instance:

  • A 100% disability rating is given if there's stiffening of the entire spine.

  • A 50% rating is assigned for complete thoracolumbar spine stiffening.

  • A 40% rating is for the stiffening of the entire cervical spine.

There are also ratings of 30%, 20%, and 10% for varying degrees of partial range of motion loss due to back pain or related conditions.

For those diagnosed with Intervertebral Disc Syndrome (IVDS), the ratings differ:

  • 60% rating for at least six weeks of incapacitation over the past year.

  • 40% rating for four weeks of incapacitation over the past year.

  • 20% rating for two weeks over the past year.

  • 10% rating for one week over the past year.

Expanded Eligibility Criteria For Compensation Claims

A significant development in 2018 was the U.S. Court of Appeals ruling that pain, even without an underlying disability, could be a legitimate reason to award VA benefits. This means veterans suffering from back pain, even without a specific diagnosis, can apply for benefits if they can link their pain to their military service.

Medical Evidence Required To Receive Increased Benefits

To qualify for these benefits, veterans must provide medical records confirming they've consulted a doctor about their back pain. The documentation should ideally link the disability to their service. The VA will then conduct range of motion tests to determine the severity of the disability and assign an appropriate rating.

Filing A Claim With The VA To Receive An Increase In Benefits

The process of filing for VA compensation for back pain starts with medical documentation. A physician must diagnose the veteran with a chronic condition or pain. Subsequent range of motion tests will help the VA determine the disability's severity. Veterans can also apply for a rating increase if their pain worsens over time.

For those whose back pain severely impacts their ability to work, they can apply for total disability based on individual unemployability (TDIU). This requires proving that it's impossible to maintain a job due to the service-connected disabilities.

Veterans seeking to file a VA claim for back pain can consult with experts like the Veterans Guardian VA Claim Consulting to ensure they have all the necessary paperwork and can confidently navigate the claims process.

Understanding The VA Increase For Back Pain

With the right information and guidance, veterans can better understand their VA benefits for back pain. It's essential to remember that while the pain might be a constant, the support and resources available are vast. By staying informed and proactive, veterans can ensure they receive the care and compensation they rightfully deserve.

Learn about the process for the increase VA Disability rating form for veterans by checking out our detailed guide. Visit American Veteran and explorethe available resources to learn more.

Michael Blair contributes his expertise to help veterans access government benefits and resources. Through his informative articles and guides, he plays a vital role in empowering veterans and improving their quality of life.
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