Back injuries are some of the most common conditions that veterans incur in military service. Veterans who have a service-connected back condition can receive disability benefits from VA.
But, veterans have to prove that they meet certain standards set by VA to receive benefits. Those standard are set in VA’s diagnostic codes which are in the Code of Federal Regulations.
The diagnostic codes cover a range of disability rating for a back condition from 10 percent to 100 percent. I have discussed the higher disability ratings for a back condition in other articles. In this article, I will focus on establishing that you qualify for at least a 10 percent rating for your back disability.
What is the difference between back and thoracolumbar?
VA uses the term “thoracolumbar” in its diagnostic codes and in its decisions. Thoracolumbar is really just a medical term that refers to your thoracic spine and lumbar spine. Most people refer to this area as their middle and low back.
How do I qualify for a 10% VA rating for my back condition?
VA defines the different standards for qualifying for a 10 percent rating in its diagnostic codes. There are five basic ways to qualify for a 10% rating:
- Forward flexion of your thoracolumbar spine of less than 85 degrees
- A combined range of motion of your thoracolumbar spine of less than 235 degrees
- Muscle spasms, guarding, or localized tenderness
- A fractured vertebra which causes a loss of height of 50% or more
- Intervertebal disc disorder causing incapacitating episodes of at least one week during the last year
Now, let’s talk a little bit about what each one of these different standards means.
Forward flexion of your thoracolumbar spine of less than 85 degrees
Forward flexion is a pretty straighforward category. It measures how far you can bend forward at the waist. If your forward flexion is less than 85 degrees, then you should qualify for at least a 10 percent rating.
A combined range of motion of your thoracolumbar spine of less than 235 degrees
The combined range of motion combines the forward flexion measurement with several other measurements. In addition to forward flexion, it measures:
- Extension (how far backward you can bend
- Lateral flexion and extension (side to side movement)
- Rotation (rotating your spine)
If your combined range of motion of your thoracolumbar spine is less than 235 degrees, you should qualify for at least a 10 percent rating.
Muscle spasms, guarding, or localized tenderness
Muscle spasms in your back would often be diagnosed by your doctor. The spasms are involuntary contractions of you muscles.
Guarding is a reaction that occurs when you are afraid to touch a painful area or worried that that something is going to cause pain to you. For example, you might guard during a physical examination by a doctor if you were afraid that some part of the examination was going to cause you pain.
Localized tenderness will usually be tenderness that you doctor can find and put a finger on during the examination.
Any of these three things can qualify you for a 10 percent rating. Guarding and muscles spasms can actually qualify you for a higher rating (20 percent) if they result in an abnormal gait or abnormal spinal contour.
A fractured vertebra which causes a loss of height of 50% or more
This will usually be diagnosed by x-ray. It is not enough to just have a fractured vertebra. The fractured vertebra must have a loss of at least 50 percent of height to qualify for a 10 percent rating.
Intervertebal disc disorder causing incapacitating episodes of at least one week during the last year
Incapacitating episodes basically means bedrest ordered for your back condition by a doctor. If you have a total of at least a week of ordered bedrest in a year for your intervertebral disc disorder, then you should qualify for a 10 percent rating.
Can I get a higher rating than the 10 percent if my back condition is more severe?
Most of the five categories mentioned above allow you to get a higher rating than 10 percent by showing that your condition is worse. The one category where you cannot do this is the fractured vertebra category. But, the other four have higher ratings that could allow you to get a rating of 20, 40, 50, 60, or 100 percent depending on how severe you back condition is.
How can I get help dealing with VA?
If you would like help dealing with VA, we are happy to discuss your claim with you to see if we can help. The best way to do that is through our free consultation process. This article explains how that process works.
If you decide that you want to set up a free consultation, it is easy to do so. Just call our office at (770) 214-8885 or complete and submit the consultation request form on this page.