Spinal stenosis simply refers to the narrowing of the spinal canal which results in pain, weakness, and numbness when nerves are compressed. This narrowing can be caused by physical injury or degeneration of the spine. Spinal stenosis can cause a variety of symptoms depending on the location of the spinal stenosis and the compressed nerve. The effects of spinal stenosis, whether they manifest themselves in the back or elsewhere, can be the basis of a VA disability rating for spinal stenosis.
In this article about veterans with spinal stenosis VA disability:
VA Disability Rating for Spinal Stenosis Depends on Range of Motion
Spinal stenosis can arise from both degenerative conditions (such as arthritis, bulging discs, and herniated discs) and physical injury, such as bone fragments, dislocated vertebrae, or swollen tissues. VA disability rating rules treat all forms of spinal stenosis the same way, with the cause being irrelevant to the actual VA disability rating for spinal stenosis.
Regardless of the underlying cause, spinal stenosis leads to pressure on nerves running through the spinal canal. When the nerves are compressed, electrical signals passing along those nerves can become disrupted. This disruption can cause strange sensations and loss of muscle control in the affected areas.
Spinal stenosis can cause symptoms throughout the body. When it occurs in the cervical spine (the neck and upper section of the back), symptoms may include pain, muscle spasm and weakness, numbness, and tingling in the neck, hands, arms, legs, and feet. Conversely, when the lumbar spine (the lower section of the back) is affected, symptoms may cause pain and nerve sensations in the back, legs, and feet. In extreme cases, spinal stenosis can cause incontinence or constipation if the compressed nerve controls the muscles surrounding the bladder or bowel, respectively.
Given this variety of symptoms, it is easy to understand how spinal stenosis can be misdiagnosed. For example, after a fall or motor vehicle accident, a military doctor may attribute leg and foot pain to a leg injury rather than spinal stenosis. This misdiagnosis can affect a later disability claim for spinal stenosis, although it can be countered by evidence showing the diagnosis was, in fact, made in error.
Spinal stenosis is typically diagnosed with x-rays or MRIs of the spine showing a narrowing of the spinal canal. However, the VA disability rating for spinal stenosis is calculated exactly the same as other spinal diseases and injuries. For example, 5241 spinal fusion VA rating and 5238 spinal stenosis VA rating are calculated entirely on the range of motion (ROM) of your back even though spinal fusion and spinal stenosis are very different conditions.
Symptoms of Spinal Stenosis
1. Spine is Frozen
If your spine is frozen due to spinal stenosis, meaning that you have no Range Of Motion, you may qualify for a relatively high VA disability rating. The exact VA disability percentage for spinal stenosis that has caused a frozen spine depends on the position where the spine is frozen. A favorable position means that the spine is frozen at the baseline position or 0% flexion. An unfavorable position means that the spine is frozen in a position other than the natural upright position. For example, if the spine is frozen tilted to one side or leaning forward, that would constitute an unfavorable position.
If the entire spine is frozen in an unfavorable position, the disability rating may be as high as 100%. This makes sense because a spine frozen in an unfavorable position would place the greatest stress on the body and have the greatest impact on the veteran’s ability to work.
If the spine is frozen in a favorable position, the disability rating may be capped at 40%. The disability rating may be even lower depending on the segment of the spine that is frozen. For a cervical spine that is frozen in a favorable position, the disability rating may be capped at 30%.
2. Range of Motion (ROM)
If your spine is not frozen, the VA disability rating for spinal stenosis will depend on the ROM measurements using a goniometer. These measurements are taken while bending the neck and back forward and backward, tilting the neck and back from size to side, and rotating the neck and back to each side. The ROM measurement is the maximum angle that you can move in each direction before reaching your physical limits or experiencing severe pain. This test results in six measurements taken while moving the neck for the cervical spine and six measurements taken while moving the back for the lumbar spine.
The VA disability rating for spinal stenosis will be based on both individual ROM measurements and the total ROM measurement. The total ROM measurement is merely the sum of the individual ROM measurements for each of the spine segments. For example, if the cervical spine ROM measurements are 15°, 30°, 0°, 30°, 45°, and 45°, the total ROM would be 165°.
The disability rating is the highest rating produced by the rating tables. Thus, if the flexion ROM measurement produces a 40% VA disability percentage and the total ROM measurement produces a 30% VA disability percentage, the VA disability percentage for spinal stenosis would be 40%.
3. Alternate Ratings
Because the symptoms of spinal stenosis are not limited to back pain and ROM, you can investigate whether there are alternate options for obtaining a fair VA disability rating. For example, if your spinal stenosis is caused by a bulging disc, herniated disc, or other degenerative disc condition, you may get a better rating for intervertebral disc syndrome (IVDS). Under the IVDS schedule, a VA disability rating can be obtained based on the number and frequency of incapacitated episodes in which bed rest is ordered by a physician. Thus, when a bulging or herniated disc in the cervical spine region causes six weeks of incapacitating episodes per year, you would be eligible for a 60% VA disability rating for neck pain.
When spinal stenosis causes additional disabilities, those problems may qualify as secondary service-connected disabilities. For example, if spinal stenosis causes nerve pain or other issues in the peripheral nerves of the arms, hands, legs, or feet, you may be able to obtain a higher VA disability rating through an independently ratable peripheral nerve disability. However, these secondary service-connected disabilities are not cumulative. Rather, they are added using VA math. This means that a 10% VA disability rating for spinal stenosis plus 60% VA disability rating for peripheral nerve disability in an arm will produce an overall VA disability rating of 60%.
More importantly, when both the lumbar spine and cervical spine are affected by spinal stenosis, the two may be separately rated unless both are frozen in an unfavorable position. In that case, a lumbar spine and cervical spine frozen in an unfavorable position is given a VA disability rating of 100%.
In all other cases, the ROM measurements of the lumbar spine are rated separately from the ROM measurements of the cervical spine. These ratings are added together using VA math for an overall VA disability rating for spinal stenosis. For example, a cervical spine with forward flexion of 15° produces a VA disability percentage of 30% and a lumbar spine with a total ROM of 120° produces a VA disability percentage of 20%, for an overall VA disability rating of 40%.
Finally, the general VA disability ratings table for spinal injuries and diseases allows ratings based on muscle guarding, muscle spasm, or tenderness in your back. Muscle guarding occurs when muscles react to prevent pain or discomfort. Muscle spasms are involuntary contractions or extensions of muscles. If spinal stenosis causes involuntary muscle reactions like these, a doctor can note them in your records and the VA can use them to arrive at a VA disability rating.
Under the VA regulations, you may request an extra-schedular rating for your disability. These only occur in extraordinary cases in which the VA ratings formula does not account for the effects or consequences of your disability. For example, if your disability requires frequent hospitalization or substantially interferes with your ability to earn a living, you may request a special disability rating from the VA.
Your Condition Must be Connected to Your Service to Obtain a VA Disability Rating Spinal Stenosis
Disability benefits are paid for service-connected disabilities. Service-connected disabilities are disabilities that manifested during your service, regardless of when your diagnosis occurred, or was diagnosed prior to your service and was worsened by your service.
1. In-service Disability
When your medical disability occurred during your service, it is almost always presumed to be service-connected. The most straightforward pathway to fulfilling this criterion is a diagnosis of spinal stenosis in your military records.
This can sometimes be difficult to establish. As mentioned above, spinal stenosis is typically diagnosed with x-rays or MRIs that show a narrowing of the spinal canal. However, military doctors and corpsmen may be reluctant to order an x-ray or MRI if they think a diagnosis can be made without one. This can lead to a misdiagnosis of spinal stenosis.
Even if your diagnosis of spinal stenosis occurred after your honorable discharge, you may still be eligible for VA disability benefits if your spinal stenosis arose during your time in the military, but was misdiagnosed. As discussed above, nerve pain in the leg may be diagnosed as a leg injury rather than spinal stenosis. A post-service diagnosis of spinal stenosis can sometimes be used to show that the condition was misdiagnosed during your time in the service. When this evidence is presented to the VA, it may be possible to obtain VA disability benefits.
2. Condition Worsened by Service
Another way to connect your disability to your service is to show that you had been diagnosed with spinal stenosis prior to your service, and the condition worsened during your service. Typically, this would be established by medical records from your time in the military showing that your condition worsened. If these records do not exist, it may also be possible to support a claim with post-service medical records that show a significant worsening.
The VA can reject a claim that your condition was made worse during your service if it believes that the worsening was a natural progression of the condition. This type of rejection can sometimes be overcome if you can point to a specific incident that worsened your condition. For example, if your spinal stenosis is caused by a bulging disc, dislocated vertebrae, or bone fragments, you may be able to identify an accidental fall, vehicle collision, or any other physical injury incurred during your military service that worsened your condition. It will also help if someone else in your division remembers what happened. Their testimony can mean the difference between an approval or a denial of your case.
Challenging an Incorrect VA Disability Rating for Spinal Stenosis
A fair VA disability rating for spinal stenosis can be difficult to obtain. If your case of spinal stenosis does not result in limits on your ROM, you may receive a low VA disability rating even though your condition interferes with your quality of life and earning capacity.
Under the VA’s rules, you can challenge a VA disability rating by asserting that the VA misapplied its schedule. For example, if your VA disability rating for spinal stenosis is based on total ROM but ignores a flexion ROM that would result in a higher VA disability rating, it can be challenged by pointing out the mistake and asking for a review at the same level or by a higher-level authority.
Similarly, you can challenge a VA disability rating that could be increased through the submission of additional evidence. For example, if you receive a VA disability rating based on a general spinal injury but could have received a higher VA disability rating for IVDS, you can submit additional evidence showing that your spinal stenosis is caused by a bulging, herniated, or degenerated disc and request a re-calculation. Spinal stenosis caused by IVDS qualifies for a separate IVDS disability rating and you are entitled to the higher of the two ratings.
If you are concerned that your VA disability percentage for spinal stenosis fails to account for the extent of your disability, you may wish to speak to a VA benefits lawyer. These types of lawyers have experience dealing with the laws and rules that govern the VA and may have ideas and suggestions for increasing or challenging your VA disability rating. Your call is always free, and we won’t charge you until after we have won your case.
How Can a VA Lawyer Help with a VA Disability Rating for Spinal Stenosis?
Spinal stenosis can make it tricky to obtain a fair VA disability rating. Unlike a back injury that is caused by muscle, ligament, or bone damage, the effects of spinal stenosis are felt primarily in the nerves of the spinal cord. This means that the effects of spinal stenosis are not limited to the back.
When spinal stenosis manifests in the form of back pain and a frozen spine, obtaining a fair VA disability rating for spinal stenosis is primarily a matter of obtaining accurate ROM measurements of the cervical spine and lumbar spine.
However, in many cases, spinal stenosis causes symptoms elsewhere in the body besides the back. In fact, occasionally, the back pain associated with spinal stenosis may be dwarfed by the nerve pain experienced in the legs, feet, arms, and hands. All the disabilities stemming from spinal stenosis should be accounted for in a fair VA disability rating. This is particularly true because nerve pain in the extremities can severely impact your earning ability. A VA lawyer can run through all the scenarios with you for obtaining a fair VA disability rating that reflects the ways spinal stenosis affects you.
Spinal stenosis can be a difficult disability to deal with because of the breadth and variety of symptoms you may experience. Whether it manifests itself in your back or through nerve pain throughout your extremities, a VA attorney can help you to obtain the medical examination and collect the records to support your VA disability claim. Contact a VA attorney who can assist you wherever you live and without regard to whether you were deployed.
Yes, you can. If we can show that you had spinal stenosis while in the service but you were misdiagnosed, you might even get some substantial back pay. It’s never too late to apply for VA benefits.
Yes, but you should talk to a VA Disability law attorney first. It is possible to have your rating lowered if you happen to do better on another C&P exam, so discuss your case and your condition with a VA attorney first.
Not necessarily, but it’s worth looking at your C-File to see if you had spinal stenosis during your service and it was incorrectly diagnosed. Experienced nexus doctors know how service-connected disabilities work, so they know what to look for in your file.