so
good afternoon and welcome to another edition of cck live
my name is emma peterson and i'm joined today by bethany cook and frank padula
and we're going to be talking about the most common back disabilities that veterans suffer from
so let's dive right in veterans experience a range of back disabilities related to their
military service back injuries often occur due to the stress of training or combat there could be a
vehicle accident there could be a fall sometimes even just from carrying the heavy packs and gear
or other common duties that veterans might experience while doing their military service
and as with most medical conditions va disability ratings for back pain depend
on a variety of factors so today we're going to be talking about what those factors are and how
va might go about rating your back disability as always if you have questions or comments please
leave them in the comment section and we will do our best to get back to you as soon as we can
all right frank so how does va go about rating back conditions so va rates most back conditions
under what's called 38 cfr subsection 4.71 a the schedule of ratings for musculoskeletal system
the general rating formula for diseases and injuries of the spine
the criteria are based largely on veterans range of motion and different diagnostic codes within
this formula are used to rate different back disabilities those ratings can range from 0 all
the way to 100 and generally veterans will need to attend a compensation and pension examination
to measure how far they can bend forwards backwards and side to side using a goni goniometer
and then va will then determine the severity of the back condition based on the range of motion
measurements um va must also take into account functional loss pain during motion and flare-ups
as well thanks frank so let's talk a little bit about the different types of back disabilities
that veterans might experience bethany can you walk us through lumbosacral and cervical strains
sure so lumbosacral and cervical strains are very common back and neck disabilities they are both an
injury of the ligaments tendons and or muscles of the low back or neck respectively the injury
usually results from stretching that causes a small tear in the tissues in the lower back or
neck they are also typically caused by overuse and trauma so we see these disabilities a lot
in veterans who a lot of the times a veteran with an mos that required a lot of heavy lifting
they can develop a lumbosacral or cervical strain uh we also see them commonly result commonly
result just from physical training even uh pain is a very common symptom of both disabilities
uh and it can also cause trouble bending or having limited range of motion so they're both rated by
the va uh under diagnostic code 5237 with ratings ranging from 10 to 100 and like like frank said
uh these ratings are based for the most part on forward flexion and range of motion uh although
fifty to one hundred percent ratings are based on the amount of unfavorable oculosis present
and typically that 5 50 to 100 ratings those ratings are very rare with these disabilities
that's right and it probably would not be typical to see ankylosis with a strain right bethany
right all right so but something where you could see ankylosis might be degenerative disc disease
um which is sometimes abbreviated ddd and it's not to be confused with arthritis a different
disability it usually occurs in the low back or the neck and it's a condition where the discs
between the vertebrae lose their cushioning they fragment or they herniate pain frequently occurs
with ddd although it's not in every case but in some situations it can also result
in numbness and tingling in the upper or the lower extremities depending on which part of the spine
the ddd is affecting and this is also typically rated based on the range of motion criteria that
frank discussed it's dc diagnostic code 5242 but all of these have the same criteria for the 10 the
20 the 30 and so on um it's really depending on your range of motion um and for this disability
you sometimes do see ankylosis where the spine is frozen or unable to move at certain segments
um frank but what about degenerative arthritis of the spine that's a little different right right
um so there are two two main types of arthritis at the back there's degenerative arthritis and
rheumatoid arthritis degenerative arthritis occurs when cartilage between joints erodes over time
resulting in joint stiffness limited mobility and pain this usually takes place in weight-bearing
joints for example back even the hips and the knees degenerative arthritis is diagnosed through
x-rays and it is based on limitation of range of motion of the affected joints um
and that would be under 38 cfr subsection 4.71 a and that could range at 20 or 10 percent and the
diagnostic code 5242 specifically refers to the spine in this condition that's right and if you do
have the genitive arthritis of the spine you could also get those higher ratings you know if you were
to show a more severe um range of motion picture or even had um favorable or unbeatable ankylosis
now something that we see sometimes is something called intervertebral disc syndrome
bethany can tell us a little bit about that sure so intervertebral disc syndrome ivds for short
is also known as a bulging or herniated disc it's a back condition that involves
the irritation of the nerve root and causes sharp chronic pain ivds can be very severe
it can include symptoms such as numbing or tingling in the lower extremities
weakness and oftentimes you find that it worsens if you spend an extended amount of time sitting
or bending it can also worsen as a riddle of extended standing walking and the numbness or
tingling in the lower extremities sometimes that develops to the point of sciatica it can also
lead to bladder and bowel issues as well va rates ivds under diagnostic code 524 through and this
reading criteria is a little bit different it's based on the number of incapacitating episodes
that veterans experience due to their low back pain so the readings under this diagnostic code
range from 10 to 60 percent and these readings consider the length and frequency of bed rest
it's this reading criteria is a little bit complicated because oftentimes you might
see that you get the 60 rating and it's not necessarily because your doctor
wrote a note saying i require this number of weeks i think it's six weeks of bed rest per year um but
that rating will typically come as a result of a compensation and pension examination that you
attend for the back that examiner might make a note that your ibds
is so severe that you probably are in bed around six weeks a year
extended bed rest for ivds uh while it's a part of the reading criteria it can actually
cause additional issues um it can lead to stiffening of the joints and weaken
muscles uh so while your ibds might be very severe um physicians may prescribe
physical therapy and medication for pain as alternative treatments over the extended bed rest
uh so this is a condition where those compensation and pension examinations are really important
absolutely it's definitely a tricky diagnostic code um because it does have that requirement
of prescribed bed rest so it really depends on the examiner and the rater um you know either sort of
overlooking that and looking at you know your your actual individual disability picture to see if
what you're suffering is the equivalent of that um or va looking at the range of motion testing
um but it can be tricky to get the higher ratings here because as bethany mentioned
um you oftentimes aren't going to find a doctor who's going to prescribe a bed rest for six to
12 weeks a year that's just not something you see really anymore um but something to
consider when going to those confidential exams making sure you're being really clear with your
examiner about how many times you stay in bed or how the disease prevents you from doing things
might be the equivalent of bed rest but speak to an accredited wrap an agent a vso attorney
whoever you work with on your claim if you do have ibds about the best way to maximize that rating
now something else that we mentioned that can happen due to back disabilities um include um
nerve pain whether it be in the upper extremities or lower extremities and a very common lower
extremity condition is sciatic nerve pain um that can radiate from the lower back down through the
legs and it most often occurs when the sciatic nerve has been compressed or pinched usually by
a herniated disc in the spine or an overgrowth of bone in the vertebrae symptoms can include
numbness and tingling a burning sensation and even muscle weakness and while technically it's a nerve
issue um symptoms of the sciatic nerve issues often affect your lower extremities these issues
can begin in the back and um the rating criteria for the back specifically instruct va to rate any
neurological residuals that result from your back condition in addition to whatever range of motion
rating the testing might reveal um so if you do have radiculopathy or sciatica from your lower
back condition va is supposed to rate that at the same time and you don't necessarily have to
file a separate claim for it um but diagnostic codes to be on the lookout for are um 85 20
86 20 87 20 all which deal with sciatic nerve which is a very common nerve issue that we see and
that deals with paralysis neuritis and neuralgia of the nerve and ratings range anywhere from 10
all the way up to 80 being the most severe when there's complete paralysis muscle involvement etc
um frank what are some other common secondary conditions that we see due to back disabilities
well oftentimes back disabilities can cause or aggravate a variety of other conditions
some examples include radiculopathy gastrointestinal or even stomach issues
hip leg or foot disabilities effects of medication used to treat such back disability
effects of obesity caused by a lack of ability to exercise due to such back disability and
even depression can be associated to a back disability on a secondary basis
and veterans may be able to receive secondary service commission for any of those disabilities
caused by or related to their back disability and we actually do have another um youtube
video about secondary service connection that if anyone's watching can check that out too
thanks now bethany are tell us about how a veteran with back disability might be eligible for tdiu
yes so you have noticed that uh none of the readings that we said for back disabilities
uh go up to 100 typically so it's going to be pretty rare for a veteran to get to a
combined rating of 100 due to a back disability alone um so this is where
a tdiu or a total disability rating based on individual unemployability can be really helpful
if you have a service connected back disability and are unable to work which happens a lot as
back disabilities cause limitations in sitting standing walking lifting
all of which are required in some capacity by most jobs then you may be eligible for tdiu
which would allow veterans who are unable to work due to their back disabilities uh to get
compensated at the 100 rate even if their combined schedule of reading does not add up to 100
so we have a lot of videos on tdiu how to apply and what va will look for so if that's something
that you think you might be interested in definitely check out our videos on tdiu on youtube
great thanks bethany well that pretty much covers just the quick discussion of typical
back disabilities that veterans might suffer from frank any final thoughts or recommendations for
those out there watching today um just saying you know thank you for tuning in
any more information can be found in our blog or any other videos that we have on our channel
and as always you know you can stay up to date by subscribing to our channel
great thanks frank bethany any final thoughts or recommendations for people watching
yeah i would just say that um if you have any questions on your back rating if you think
it's um not high enough definitely reach out to an accredited representative oftentimes that range of
motion testing can be difficult for cmp examiners so that's something that you'll definitely want
someone who's accredited to take a look at if you have any concerns about your back rating
thanks bethany well thanks for tuning in everyone and as frank mentioned to stay up to date on
veterans law issues please subscribe to our youtube channel and we'll see you next time
you