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08:50 What is ankylosis?
11:35 40% VA rating for the lumbar spine
17:15 Incapacitating episodes
24:50 fluoroscopy-guided caudal epidural
37:05 20% VA rating for the lumbar spine
39:00 How VA math works
53:16 Somatic Symptom Disorder is associated with Chronic Pain
1:04:30 There is no limit on secondary service connection VA claims
VA uses the General Rating Formula for diseases and injuries of the spine which fall under 38 CFR 4.71a.
The general rating formula measures range of motion, incapacitating episodes and pain on movement. Incapacitating episodes are when a doctor gives you bed rest. This is not when you think you need to rest in bed.
Secondary Service connections for the lower back are radiculopathy down your legs, chronic pain syndrome, and somatic symptom disorder. Filing a VA claim for IBS as a result of the pain killers or a claim for GERD for the NSAIDs.
Lets define the term ankylosis - abnormal stiffening and immobility of a joint due to the fusion of the bones.
VA Disability Ratings for Back Pain
100% VA Rating for the lumbar spine
Unfavorable ankylosis of the entire spine
50% VA Rating for the lumbar spine
Unfavorable ankylosis of the entire thoracolumbar spine (lower back)
40% VA Rating for the lumbar spine
Unfavorable ankylosis of the entire cervical spine or Forward flexion of the thoracolumbar spine at 30 degrees or less Favorable ankylosis of the entire thoracolumbar spine.
30% VA Rating for the lumbar spine
30% forward flexion of the cervical spine (neck area) of 15 degrees or less or favorable ankylosis of the entire cervical spine
20% VA Rating for the lumbar spine
Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, the combined range of motion of the cervical spine not greater than 170 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis
10% VA Rating for the lumbar spine
Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, forward flexion of the cervical spine greater than 30 degrees but not greater than 40 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, combined range of motion of the cervical spine greater than 170 degrees but not greater than 335 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 0 percent or more of the height.”
Incapacitating Episodes For VA Back Claims
60% – with incapacitating episodes having a total duration of at least 6 weeks during the past 12 months
40% – with incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months
20% – with incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12
months
10% – with incapacitating episodes having a total duration of at least one week but less than 2 weeks during the past 12 months”
Pain on movement - Pain on movement is factored into your overall rating. You could get a rating like I did for my feet for Chronic Pain Syndrome. If you file a claim for Somatic Symptom Disorder at the same time you file a VA claim for lower back pain then you could be awarded a mental health rating for Somatic Symptom Disorder which if properly filed you will receive a Mental Health rating at 0 10 30 50 70 or 100 percent
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