Military responsibilities—often involving heavy lifting, intense physical training, combat situations, and exposure to other hazardous conditions—can subject the spine to substantial stress, making back and neck injuries a common condition among veterans.
Talk to Us About Your Claim:
The good news is veterans can receive thoracolumbar spine VA ratings for conditions resulting from military service. These conditions, often caused by the physical demands of military life, include spinal arthritis, degenerative disc disease, radiculopathy, spinal stenosis, and spondylolisthesis. VA disability ratings are often based on severity and range of motion limitations.
In this article about the thoracolumbar spine VA rating:
- Thoracolumbar spine conditions
- Thoracolumbar spine VA ratings
- Thoracolumbar Conditions and the General Rating Formula for the Spine
- How to service connect thoracolumbar spine conditions
- C&P exams for spinal stenosis
- TDIU for thoracolumbar spine conditions
- How Woods and Woods can help
Thoracolumbar spine conditions
The thoracic segment of the spine consists of 12 vertebrae, T1 through T12. The thoracic segment of the spine curves slightly and attaches to the ribs. The lower spine section below the thoracic segment is called the lumbar region. It consists of five vertebrae, L1 through L5.
Thoracolumbar spine conditions refer to issues that affect the lumbar and thoracic segments of the spine.
Several thoracolumbar spine conditions, such as spinal arthritis, degenerative disc disease, radiculopathy, spinal stenosis, and spondylolisthesis, may be service-connected for VA disability compensation.
Thoracolumbar spine VA ratings
A variety of conditions can affect the joints, discs, and nerves in the thoracolumbar spine.
Many of these conditions are rated using the General Rating Formula for Diseases and Injuries of the Spine, which we explain in greater detail later.
Other thoracolumbar spinal conditions are rated using their own specific diagnostic codes and criteria. We share some common thoracolumbar conditions and how they rate below.
Arthritis in the thoracolumbar spine
Arthritis can occur between any bones of the body, including the thoracic and lumbar vertebrae in the spine.
Spinal arthritis can result from wear and tear on the body due to military service-related movements, injuries sustained during service, and other underlying health conditions.
Osteoarthritis rates using diagnostic code 5003, which rates at 10%, 20%, or a higher rating when necessary due to pain and limited range of motion. Rheumatoid arthritis rates using diagnostic code 5002 between 20% and 100%.
Intervertebral disc syndrome
Intervertebral disc syndrome is a fairly common condition that is caused by one or more discs breaking down in the lumbar spine. Discs that break down, or degenerate, can often become herniated. The condition causes pain through the back, legs, arms, and neck.
Intervertebral disc syndrome can be evaluated using the General Rating Formula for spinal conditions, or under its own formula if the veteran’s symptoms are more severe and incapacitating. The VA should use whichever formula provides the more appropriate higher rating.
|Description||VA Rating||Monthly payment (vet only)|
|With incapacitating episodes having a total duration of at least 6 weeks during the past 12 months||60%||$1,3161.88|
|With incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months||40%||$755.28|
|With incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months||20%||$338.49|
|With incapacitating episodes having a total duration of at least one week but less than 2 weeks during the past 12 months||10%||$171.23|
Radiculopathy in the thoracolumbar spine
Radiculopathy is a term used to describe pain caused by compression or irritation of nerves in the back. There is no diagnostic code in the Schedule of Ratings specifically for radiculopathy. Instead, the VA determines what code to use based on the nerves affected and whether the nerve is experiencing paralysis, neuralgia, or neuritis.
Lumbar radiculopathy, often called sciatica, impacts nerves in the lower back and is one of the most common service-connected disabilities among veterans. Thoracic radiculopathy, which affects the upper back, can lead to pain, numbness, or tingling sensations in the chest, abdomen, or around the ribcage.
Thoracolumbar Conditions and the General Rating Formula for the Spine
The VA rates many thoracolumbar spinal conditions using diagnostic code 5238 in the Schedule of Ratings using the General Rating Formula for Diseases and Injuries of the Spine.
VA disability lawyer Cecilia Ton explains this formula: “The VA uses a general rating criteria for injuries and diseases to the spine. If you look at this rating code, you’ll notice that VA has equated certain range of motion scores with certain disability ratings. One of the ways you can show the VA that you are entitled to a higher rating is to point out that your range of motion scores fit with the higher rating code.”
The General Rating Formula for Diseases and Injuries of the Spine criteria that applies to thoracolumbar spine VA ratings is as follows:
|Description||VA Rating||Monthly payment (vet only)|
|Unfavorable ankylosis of the entire spine||100%||$3,737.85|
|Unfavorable ankylosis of the entire thoracolumbar spine||50%||$1,075.16|
|Forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine||40%||$755.28|
|Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; … or, the combined range of motion of the thoracolumbar spine not greater than 120 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||20%||$338.49|
|Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; … or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; … or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height||10%||$171.23|
When determining your range of motion in the thoracolumbar spine, your degrees of motion should be rounded up or down, to the nearest five degrees.
Additionally, the VA should rate any issues in the cervical spine separately from thoracolumbar conditions. However, if the entire cervical, thoracic, and lumbar spine experience unfavorable ankylosis, this will be combined into one rating.
While there are many other conditions that can affect the thoracolumbar spine and be eligible for VA disability, we share some of the more common conditions below.
Degenerative disc disease in the thoracolumbar spine
Degenerative disc disease (DDD) is another condition that can impact the thoracolumbar spine. The discs between the bones of the spine provide cushion for the vertebrae. When those discs begin to break down, they can no longer absorb the pressure put on the spine and cause pain in the back and neck that can radiate into the arms and legs.
DDD is rated under diagnostic code 5242, which uses the criteria in the General Rating Formula for Disease and Injuries of the Spine listed above.
Spinal stenosis in the thoracolumbar spine
Nerves run from the base of the brain down into the spine and out the sides to deliver messages throughout the body. The spinal canal, the tunnel-like space within the spine, is their super highway. Spinal stenosis is a condition that occurs when that space becomes narrower, putting pressure on or pinching the nerves as they exit, resulting in pain in the neck, back, and legs.
Spinal stenosis is rated under diagnostic code 5238. Like DDD, spinal stenosis is rated using the criteria in the General Rating Formula for Disease and Injuries of the Spine, listed above.
Spondylolisthesis in the thoracolumbar spine
Spondylolisthesis is a condition that involves the shifting of one vertebra over the one below it. Imagine your spine as a stack of building blocks. In spondylolisthesis, one of these blocks slips forward or backward. This condition can happen for various reasons, such as a fracture or the degeneration of the spinal discs that provide cushioning between the vertebrae. The displacement can put pressure on the spinal nerves, leading to pain, numbness, or weakness in the legs and lower back.
Spondylolisthesis is rated under diagnostic code 5239, which uses the criteria in the General Rating Formula for Disease and Injuries of the Spine. Spondylolisthesis can be rated 10%, 20%, 30%, 40%, 50%, or 100% disabling.
How to service connect thoracolumbar spine conditions
Veterans can receive disability benefits from the VA for their thoracolumbar spine conditions once they prove that their military service caused or aggravated the condition. Common military causes may include heavy lifting, injuries during training exercises or combat, or advanced wear and tear from repetitive tasks.
Secondary service connections and thoracolumbar spine conditions
Thoracolumbar spine conditions can be a complex web of interconnected issues. If a veteran’s other service-connected condition causes or aggravates their thoracolumbar spine disability, they may be able to receive additional benefits for a secondary service connection. At the same time, spinal conditions can lead to other disabilities as well.
These connections include:
- Spinal stenosis can result in peripheral nerve disabilities and radiculopathy.
- Bulging or herniated discs can lead to radiculopathy.
- Spinal conditions can be associated with depression and anxiety.
- Veterans may experience sleep conditions in connection with their thoracolumbar spine conditions.
Other risk factors include gout, psoriasis, tuberculosis, irritable bowel syndrome, and Lyme Disease.
C&P exams for spinal stenosis
The VA will ask veterans to complete a compensation and pension (C&P) exam to receive a thoracolumbar spine VA rating for their condition.
The physician will measure the veteran’s range of motion during this exam, monitor pain, and do various testing, depending on the condition.
Veterans may undergo imaging tests such as simple spine X-rays, CT scans, or MRIs to see degeneration and other issues in the spine.
For conditions such as rheumatoid arthritis, blood tests can confirm genetic markers, or joint aspiration can test the fluid within joints.
DBQ for thoracolumbar spine conditions
Before receiving a rating from the VA for a thoracolumbar spine condition, veterans must complete a Disability Benefits Questionnaire (DBQ). Often completed as part of the C&P exam, the DBQ helps the VA gather the medical information to classify each veteran’s service-connected condition. The DBQ for thoracolumbar spine conditions is form VBA-21-0960M-14.
This DBQ includes a list of possible spinal issues plus room for other conditions you may be experiencing. There are sections for medical history and information on range of motion and functional loss. Problems like muscle strength loss in the back and radiculopathy also have their own special sections with questions unique to those conditions.
This DBQ can be used in your C&P exam for thoracolumbar spine VA rating.
“I honestly believe that:
1) Dealing with that VA requires an expertise that many of us do not possess.
2) Woods & Woods made the difference.
Their savvy expertise in dealing with the VA and their commitment to their clients exemplifies a level of professionalism and commitment that seems not to be the standard in today’s world.“
TDIU for thoracolumbar spine conditions
Veterans with severe spine conditions may be entitled to total disability based on individual unemployability (TDIU) benefits.
The effects of thoracolumbar spine conditions on mobility and functionality can make it much harder for a veteran to perform specific job tasks, and regular flare-ups of pain can lead to many missed work days. Pain and stiffness in the back can lead to trouble sleeping, which can in turn cause loss of motivation, focus, and patience at work.
TDIU provides a pathway for veterans to receive the same compensation as a 100% rating, even when their symptoms do not meet the criteria in the Schedule of Ratings.
To be eligible for TDIU, veterans typically must have at least one service-connected disability rated at least 60% OR two or more service-connected disabilities, with one condition rated at least 40% and a combined rating of at least 70%.
How Woods and Woods can help
If you need help applying for VA disability benefits or appealing a decision, contact us at Woods and Woods. Our team of VA-accredited lawyers, legal analysts, case managers, and support staff is here to assist veterans in getting the benefits they deserve. Reach out today for a free case evaluation. You only pay if we win your case.
Talk to Us About Your Claim:
FREQUENTLY ASKED QUESTIONS
Thoracolumbar spine conditions refer to any issues within the thoracic or lumbar segments of the spine. Any thoracolumbar spine condition you developed as a result of your service, including spinal arthritis, degenerative disc disease, radiculopathy, spinal stenosis, and spondylolisthesis, can be eligible for VA disability compensation.
The VA typically determines disability ratings for back pain caused by thoracolumbar spine conditions based on the severity of the condition and its impact on the veteran’s pain and loss of range of motion. Some conditions that can affect the back, like radiculopathy, have their own specific rating criteria.
VA disability lawyer
Woods and Woods
VA Accreditation Number: 44739