Lumbar strain is a common health condition experienced by veterans and can be caused by the wear and tear that comes from the physical demands of military service, as well as an injury. A lumbosacral strain refers specifically to the lumbosacral region of the back and a strain in the muscles and ligaments there, which connect the lumbar to the sacral vertebrae. This condition often results in pain on one side of the lower back, as well as loss of motion.
This guide provides a detailed overview of how the VA evaluates lumbar strains (including lumbosacral), the criteria used for rating lumbar spine disease, and how veterans can effectively present their case for VA disability benefits.
How the VA Rates Lumbosacral Strain
Lumbosacral strain VA disability ratings range from 10% to 100%, depending on the severity of the symptoms, the limitation to the range of motion and the impact on the veteran’s daily life. The VA rates lumbar spine disabilities under diagnostic code 5237.
Criteria for Rating
- Range of Motion: The degree of motion limitation in the thoracolumbar spine is a key factor in the rating, from 10% to 40%.
- Ankylosis: Immobilization of the spine is referred to as ankylosis and can account for higher ratings from 40%-100%.
- Incapacitating Episodes: Alternatively, for veterans diagnosed with intervertebral disc syndrome, the frequency and duration of episodes that incapacitate the veteran may determine the rating, from 10% to 60%
- Nerve Pain: An assessment of associated nerve pain or secondary conditions can provide separate ratings for each affected extremity
Key to determining the VA rating for lumbosacral strain is the degree of limitation in forward bending of the individual’s lower back. The greater the limitation and more extreme the impact on the person’s daily activities, the higher the VA rating.
What Are the VA Ratings for Lumbosacral Strain?
- Minor limitation to range of motion and minimal impact – 10% rating
- Moderate limitation to range of motion that impacts functions, which can include muscle spasms and an altered gait – 20% rating
- Severe limitation to range of motion or favorable ankylosis – 40% rating
- Unfavorable ankylosis of the thoracolumbar spine – 50% rating
- Unfavorable ankylosis of the entire spine – 100% rating
Establishing Service Connection
In addition to receiving a diagnosis for a lumbar spine disease, veterans must also establish service connection to the condition in order for a VA disability rating to be awarded. A successful VA claim depends on demonstrating that the lumbosacral strain and its complications are related to the person’s military service. In addition, if secondary conditions arise due to the lumbar spine disability, they can be considered for additional VA benefits.
Secondary Service Connection
Veterans can claim lumbar spine disease as a secondary condition to an existing disability when submitting a VA claim, especially when related to a back injury or other condition impacting the veteran’s movement or posture that could cause it. For instance, limping from an ankle or knee disability can cause lumbosacral strain.
Back injury and back pain can also cause secondary conditions that can affect a person’s daily life, including lumbar radiculopathy, sciatica, and limited mobility. To build an effective claim for a secondary condition, medical evidence linking the primary and secondary conditions is key.
Conditions Related to Lumbar Strains
Lumbar (or lower back) strains are the most common cause of pain in the lower back. This is because these muscles are used for twisting and turning, and the lower back area supports the upper body’s weight. Residual conditions linked to lumbar strain include weight gain, sleep apnea, depression, degenerative arthritis, and sciatica.
Lumbosacral Strain Secondary Conditions
Secondary conditions that can develop as a result of a lumbosacral strain (and potentially be claimed as disabilities) include:
- Radiculopathy
- Intervertebral Disc Syndrome
- Degenerative Disc Disease
- Herniated discs
- Sciatica
- Bladder or bowel incontinence
Get the VA Rating You Deserve
Veterans should ensure their VA disability claims for lumbosacral strain are comprehensive and well-documented. It’s important to gather sufficient medical evidence to support the claim before filing. This includes medical records, service records, and any evidence of how the condition affects the individual’s daily life.
How to File a VA Claim
Are you eligible for VA disability benefits? The two main requirements are:
- A documented illness or injury + active duty service
- Received injury or got sick during service, or had a condition that service made worse
Collect the evidence to submit your claim:
- Service medical records, VA medical records and/or hospital records
- Service records (DD214 or other separation documents)
- Supporting statements (buddy statements) that describe the condition
Complete the claim online or by mail (or in person).
- Ensure all forms are filled out completely and accurately
- Include all supporting documentation
Get our free ebook to guide you through the process →
How to Appeal a Denied Claim
If a veteran’s disability claim is denied, or the individual receives a rating that is lower than they expected, the veteran has the right to appeal the claim. The VA claims appeals process is detailed and lengthy. Understanding the process and how to present additional evidence to help improve the chances of a favorable outcome for the veteran are key.
Here’s what to consider when appealing a VA disability claim:
- Figure out why the claim was denied (via the denial letter)
- Gather additional evidence to support the appeal
- File a Decision Review Request (DRR) to begin the formal appeal process
- Connect with help to improve your chances of success
Get a free evaluation of your case →
How to Increase Your Lumbosacral Strain VA Rating
The VA rating for lumbosacral strain increases along with the amount of limitation to the spine and range of motion. For example, the difference between a forward bend of 15% or less to 30% or less is an increase from a VA rating of 30% to 40%.
When the individual’s range of motion is impacted by immobilization of the spine, or ankylosis, the rating increases to between 50% and 100%. Spinal conditions often continue to worsen with age, so as the condition worsens, a veteran should consider applying for increased ratings.
Providing clear evidence of the veteran’s condition, symptoms, and impacts on daily life can help increase the VA rating – including medical records and employment records. Nerve pain and/or other secondary conditions that are linked to the lumbosacral strain can also increase the veteran’s combined ratings.
Can You Get TDIU or SMC Benefits for Lumbosacral Strain?
Veterans may qualify for additional disability benefits, including Total Disability Individual Unemployability (TDIU), if their lumbosacral strain significantly impacts their ability to work. Getting TDIU requires:
- Inability to hold a steady job that provides financial support because of a service-connected disability.
- Either at least 1 service-connected disability rated at 60% or more, OR 2 or more service-connected disabilities with at least 1 rated at 40% or more and a combined rating of 70% or more.
Housebound veterans can also apply for Special Monthly Compensation (SMC), which is provided by VA in addition to the base lumbosacral strain VA disability benefits rating. This program is for veterans whose service-related disabilities are above and beyond the average case and supports the extra care and assistance necessary.
Similarly, if the veteran’s lumbar condition necessitates the veteran having assistance with performing activities of daily living such as bathing, cooking, toileting, or dressing, the veteran may apply for SMC for Aid and Attendance.
Get the Support You Need
Successfully navigating the VA rating system for lumbosacral strain requires a clear understanding of the criteria and the VA claims processes involved. Veterans can seek assistance from experienced veterans’ disability lawyers to ensure their claims are accurately presented and fully supported with the evidence required to receive the disability benefits they deserve.
Content Reviewed by
Shannon Brewer, a senior attorney with Hill & Ponton, reviewed the information provided in this post.
