For many veterans, the physical demands of military service, including rigorous training, combat, and repetitive motions, can lead to significant spine-related injuries.
Spinal fusion surgery, a common intervention for chronic back pain and instability, can have a profound impact on a veteran’s life and mobility. Understanding how spinal fusion affects VA disability ratings and what steps to take can help veterans access the benefits they deserve.
Understanding Spinal Fusion and Its Impact
Spinal fusion involves surgically joining two or more vertebrae to eliminate painful motion or to stabilize the spine. This procedure is often necessary for conditions like herniated discs, scoliosis, and arthritis, which may be exacerbated by or result from military service.
There are two types of spinal fusion outcomes:
- Favorable ankylosis, where the fusion doesn’t adversely affect posture or mobility.
- Unfavorable ankylosis, leading to significant posture changes, such as a hunched back, and can severely impact a veteran’s quality of life.
Symptoms and complications from unfavorable ankylosis might include difficulty walking, breathing challenges, and neurological issues.
The L5-S1 Fusion Disability Rating
The L5-S1 spinal segment, where the lumbar spine meets the sacral region, is a common site for injuries and subsequent fusion surgery. Like with other spinal conditions, the L5-S1 VA disability ratings range from 10 to 100% and are determined based on the residual effects of surgery, such as range of motion limitations, pain, and the ability to perform daily activities.
Veterans with L5-S1 fusion should be particularly mindful of how their condition is evaluated and consider the following:
- Documenting symptoms and limitations thoroughly.
- Understanding the criteria used by the VA to rate spinal conditions, focusing on the impact on mobility and daily function rather than the fusion itself.
Establishing a Service-Related Connection
To secure VA benefits for spinal fusion, veterans must demonstrate that their spinal condition is connected to their military service.
Essential steps include:
- Providing a current diagnosis necessitating spinal fusion.
- Evidence of the injury occurring or being aggravated during service.
- A medical nexus linking the spinal condition to military service.
Accurate medical documentation and any corroborative evidence, like buddy statements, are crucial. It’s also vital to disclose any pre-service discomfort that may have been exacerbated by service activities.
How the VA Rates Spinal Fusions
Spinal conditions, including post-fusion outcomes, are rated under 38 CFR § 4.71a, focusing primarily on the resultant range of motion and functional limitations.
VA assigns spinal fusion ratings of 10%, 20%, 30%, 40%, 50% or 100%, reflecting the extent of the condition’s impact on the veteran’s life.
Veterans should understand that:
- Ratings are based on the objective measurement of range of motion and the subjective experience of pain.
- Both favorable and unfavorable outcomes of spinal fusion will be considered in light of how they affect function.
Securing Your Rightful Rating
For veterans undergoing spinal fusion surgery, especially at critical junctions like the L5-S1, the path to obtaining a fair VA disability rating involves a lot of steps.
These are some of them you should remember:
- Regular medical evaluations to document the status and impact of your spinal condition.
- Be proactive about reporting new symptoms or worsening conditions, as spinal issues can evolve over time.
- Consider the role of secondary conditions, such as chronic pain or mobility restrictions, in your overall disability claim.
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Get a Free Case EvaluationVeterans facing the challenges of life after spinal fusion surgery have avenues to secure VA disability benefits that reflect their service-connected conditions.
Understanding the nuances of spinal fusion ratings, especially for specific segments like L5-S1, L4-L5 or C5 C4 C6-C7, and effectively navigating the claims process are critical steps toward ensuring veterans receive the support they deserve.
Cassandra Crosby, an Accredited Agent and claims advocate for Matthew Hill & Shelly Mark’s teams, reviewed the information provided in this post.
