Did you receive back or neck injuries connected to your military service? Are they still interfering with your work and your life? Has the VA denied or underrated your VA disability claim for back injury or neck injury? Do you want to increase your VA disability rating?
This article discusses what you can expect in terms of back and neck VA disability claims and ways to handle a VA disability rating dispute regarding your back and neck VA disability.
The VA Disability Rating process
As a brief overview, veterans with other than dishonorable discharges who have a current disabling condition connected to their military service can apply to receive monetary benefits. These benefits aim to help mitigate the financial impact those conditions have on their ability to work and support themselves and their families.
The process begins with filing an Application for Disability Compensation and Related Compensation Benefits (VA Form 21-526EZ). Don’t let the “EZ” designation lead you to think the process will be easy because it often is not. However, that first step frequently establishes a starting point (“effective date”) for payment of benefits, assuming you are eventually paid. This Application, along with supporting documents including your service records and medical records, will be reviewed by the VA to see if (1) you have a current disabling condition; (2) if it was caused by, or made worse by, your military service; and, if so, (3) what the disability rating is (a number from 0% to 100%), and (4) what the effective date is (usually the date the claim was filed, but there are some exceptions).
As of the writing of this article, the VA claims its average time to provide its initial VA disability benefit claims decision is around four months, but it can often take longer. Some claims are initially granted and at an appropriate rating number. However, statistically, over 70% of initial claims are denied. The good news, however, is that many of the reasons those claims are denied can be fixed or overcome on appeal of that initial decision. In fact, per VA reporting, over 70% of appeals either result in an allowed claim or a remand (or another review).
If you disagree with the initial decision on your VA disability claim, you can file one of three types of VA disability appeal (the VA calls these “decision reviews”) within one year of the initial decision letter. In VA claim appeals, you can ask for a Higher Level Review (same information reviewed by a more experienced examiner), a Supplemental Claim (allows you to add additional evidence to support your claim), or a Board Review (which will allow you a live hearing before a Veterans Law Judge.
All of these appeals can challenge any aspect of their decision, including a challenge to the VA disability rating number. The VA disability process can be complicated, however, and thus you may want to explore hiring an experienced VA disability claim attorney to represent you on the appeal level
Common back and neck injuries for veterans and how the VA rates them
Some of the more common back and neck injuries include lumbar strain (back pain), degenerative disc disease/degenerative joint disease (DDD/DJD) and Intervertebral Disc Syndrome (IVDS).
Diseases and injuries of the spine, whether labeled cervical (neck), thoracic (upper back), or lumbar (lower back) are all rated on the same scale from 10% to 100%, except for IVDS, which has its own separate formula.
IVDS is rated under Diagnostic Code 5243, and the formula for rating this condition ranges from 10% – 60%, based upon the duration of incapacitating episodes within the past 12 months. For example, incapacitating episodes with a total duration of at least one week but less than two weeks in the past 12 months is rated at 10%, whereas incapacitating episodes of at least six weeks during the past 12 months would be rated at 60%. See a rating sheet for IVDS here. Importantly, if your IVDS is rated under Diagnostic Code 5243 rating criteria, you will not be able to be rated separately for radiculopathy (nerve issues), where if you are rated based on range of motion alone, you can get them under separate evaluations.
The rating formula for other cervical injuries is based primarily upon degrees of bending motion (flexion) and immobility (ankylosis). See a ratings sheet here. For example, a 10% rating can be: (1) specific ranges of motions of various parts of the spin, (2) muscle spasm, guarding, or localized tenderness affecting your walking, or (3) bone fracture in vertebrae. A 100% rating is given for unfavorable ankylosis (immobility) of the entire spine.
What should you expect monetarily for back and neck disabilities?
Monthly VA disability benefit payments are based on your overall VA disability rating number, regardless of whether your disability is the result of back and neck injuries, PTSD, or anything else. An overall disability rating combines the ratings for each of your conditions (many veterans have multiple conditions as part of their disability claim) through a complicated formula for a final, single number. To make things easier, click here for a ratings calculator.
For 10% or 20% ratings, the VA doesn’t consider your marital status or number of dependents. For 2022, a 10% rating equates to $152.64/mo and 20% will get you $301.74/mo.
For VA disability ratings of 30% thru 60%, monthly rates vary depending on whether you have a dependent spouse, parents, and/or children and with certain add-ons. For example, a single veteran with no dependents and a 30% disability rating will get $463.39. But with a spouse, one child, and two dependent parents, the monthly amount is $651.39. If you have additional children, or a spouse receiving Aid and Attendance benefits, there are additional add-ons to that amount.
For VA disability ratings of 70% – 100%, monthly rates also depend on your family structure. A married veteran with no dependent parents or children and a 70% disability rating can expect $1,659.95/mo, and for a 100% rating would receive $3,517.84.
Can you receive TDIU for back and neck disabilities?
Yes, a TDIU (Total Disability Individual Unemployability) finding can be made with respect to any disability that meets the TDIU criteria, including back and neck-related conditions. Generally, you can be eligible for TDIU if two conditions are both met: (1) you have at least one service-connected disability rated at 60% or more, or 2 or more service-connected disabilities (at least one of which is 40% of higher) with a combined disability rating of 70% or more, AND (2) you can’t maintain substantially gainful employment (a steady job that supports you financially) because of the service-connected disability. Occasionally, TDIU can also be applied with a lower disability rating. Learn more about TDIU claims here.
Has your back or neck injury claim been denied or underrated by the VA? Veterans Law Group has helped thousands of veterans to get the VA disability benefits they deserve, and you could be next. Click here when you are ready for a free evaluation of your situation by our experienced VA disability attorneys.
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