For a lot of veterans, the disability they struggle with isn’t constant but flares up in the form of incapacitating episodes. These episodes can happen weekly or monthly, or even just a few times a year. The frequency of and the severity of an incapacitating episode is often the key factor in deciding by how much to increase your VA rating.
In This Article About the VA and Incapacitating Episodes:
What is an Incapacitating Episode?
When it comes to VA disability ratings, many veterans are confused about their coverage.
The percentage that’s covered will depend on the number of incapacitating episodes the veteran experiences related to their condition. An incapacitating episode is characterized by doctor-ordered bed rest.
There are a variety of conditions that qualify for VA disability ratings. These are:
- Chronic pain in the spine
- Chronic illness that begins at least one year after serving
- Illness caused by being a prisoner of war
- Illness caused by hazardous chemicals
Let’s take a closer look at these conditions.
Mental Illness Disabilities Can Be Incapacitating
Many veterans experience illness as a result of being exposed to hazardous chemicals or being a prisoner of war.
These illnesses take the form of:
- Psychosis
- Persistent depressive disorder
- PTSD or another form of anxiety
- Damage from frostbite
- Posttraumatic osteoporosis
- Stroke or stroke complications
- Hypertensive heart or valve disease
These illnesses or conditions must be caused by your experiences serving your country in order to have them covered by the U.S. Department of Veteran Affairs.
Mental illness can cause difficulty in maintaining relationships, completing daily activities, and functioning in public. If your service has left you unable to cope effectively, you are entitled to get coverage for necessary medications and therapy.
Burn pits were some of the biggest causes of respiratory and other problems for Persian Gulf vets. Here one of our VA disability lawyers talks about you to get benefits for those disabilities.
Back Pain is Often Incapacitating
Back pain is a common condition for veterans to suffer from.
Since back pain is so versatile, it can be confusing to understand what conditions are covered by VA disability.
The back can be categorized into two categories. These are the middle and lower back. The thoracolumbar spine is composed of two parts as well. These parts are known as the thoracic spine and the lumbar spine.
Also, the neck can be considered part of the spine. Many veterans experience pain in these areas of the spine as a result of specific conditions.
One of our VA disability lawyers talks about Back Pain and VA disability.
1. Vertebral Fracture or Dislocation
A vertebral fracture or dislocation is often the result of trauma to the spine.
Since VA disability covers the thoracolumbar parts of the spine, you can get a VA rating for a vertebral fracture or dislocation. Unfortunately, many veterans who have osteoporosis don’t realize when they have a spinal fracture or dislocation.
Since they’re so accustomed to the pain from osteoporosis, the pain from the vertebral injury may not be as noticeable. Luckily, osteoporosis can be covered under VA disability ratings as well.
Not only can a fracture or dislocation cause pain for the veteran, but the injury can also cause neurological complications. It can also cause deformity and difficulty walking or standing. This makes living a normal life nearly impossible for the veteran.
Symptoms of a vertebral fracture or dislocation include:
- Back pain that happens suddenly
- Pain that’s worsened by walking or standing up
- Feeling of relief when laying on the back
- Loss in height
- Spine mobility dramatically reduced
If a fracture is present, the individual will notice a sudden pain when using routine movements. Bending over to lift something can trigger pain, as well as falling. If you’re experiencing these symptoms, it would be wise to consult your physician.
Their observation will impact the percentage that’s covered for the injury, so it’s important to keep them in the loop.
2. A Cervical or Lumbosacral Strain
A lumbosacral strain is a pain in the lower back.
The lumbosacral is between the lower back and the ribcage. On the other hand, a cervical strain is an injury to the neck. This can also be referred to as “whiplash.”
While these injuries impact different parts of the spine, your ability to have them covered by your VA disability rating is promising. The extent of the pain and toll it has on your ability to do daily activities will also play into your disability rating.
With a lumbosacral strain, the pain often favors one side. Also, it tends to get worse with movement. This makes cleaning, cooking, and going for walks difficult for the veteran.
The cervical strain can impact an individual’s ability to sleep, as well.
The symptoms of a cervical strain are:
- Pain that resonates in the neck, shoulders, or upper back
- Stiffness of the neck
- Irritability
- Difficulty concentrating
- Frequent headaches
A cervical strain should be evaluated by a doctor each time it flares up. This will improve your disability ranking, and your doctor may be able to create a plan to help the pain.
If you’re suffering from a lumbosacral strain, the symptoms are:
- Inability to move freely
- Redness in the affected area
- A feeling of warmth coming from the skin of the affected area
- Swelling
Consult your doctor if a lumbosacral strain is impacting your ability to do daily activities. They may be able to prescribe medication or offer stretches that can help.
Note any periods of incapacitating events, because it’s hard to remember how often they occur if you only go to the doctor once every 6 months. If you can give them a well-written record showing the frequency of your incapacitating events, you will have a more believable case for the VA and be more likely to get a higher rating.
3. Spinal Stenosis
Spinal stenosis occurs when the spaces between your spine start to narrow.
This condition often occurs in the neck and lower back. As the spaces between the spine start to narrow, this puts more pressure on the surrounding nerves.
Since spinal stenosis can impact the strength you have in your muscles, your odds of qualifying for coverage are high. Plus, since spinal stenosis lies within the spine, it falls under the VA disability rating guidelines.
There are two types of spinal stenosis:
Cervical stenosis- When the parts of your spine in your neck start to narrow, this is known as cervical stenosis.
Lumbar stenosis- When the spine area in your lower back experiences narrowing, this is lumbar stenosis.
Spinal stenosis is most commonly caused by excessive wear and tear in the spine. Spinal stenosis and osteoporosis are often linked, as spinal stenosis may be a result of osteoporosis complications.
If spinal stenosis has progressed too far, surgery may be required to correct it. It’s important to keep in contact with your doctor if this is the case. Without proper treatment, the injury will only get worse.
Without a doctor’s observation, you won’t have as high of a percentage covered.
Symptoms of spinal stenosis include:
- Numbness or tingling in one of your legs, arms, or hands
- A feeling of weakness in one or both legs, arms, or hands
- Difficulty walking and balancing as you walk
- Pain in the neck
- Cramping in legs as you walk
- An urgency with releasing bowels or bladder (usually only in extreme cases)
While most people experience symptoms, some won’t feel any of the symptoms. If these symptoms are present, your doctor will perform an MRI to get a definitive cause. Once symptoms do present themselves, they will only get worse over time without proper treatment.
4. Ankylosis
Ankylosis is a form of arthritis that causes stiffening and difficulty moving.
VA disability ratings often focus on ankylosis, or the inability to move. If you’re experiencing ankylosis, you’ll receive a higher percentage of coverage for your disability.
Ankylosis is a life-long disease, and it typically begins in the lower back. As a result of this condition, you may have difficulty taking deep breaths, pain that’s worse after sitting still, and a feeling of exhaustion.
This makes daily activities, like going for a walk much more difficult. Unfortunately, one of the best ways to ease symptoms is to exercise. The pain and complications from the condition make it much more painful to do.
Symptoms of ankylosis include:
- Pain or stiffness in multiple areas of the body
- A spine that is inflexible and may even curve forward
- Swelling in the joints
- Shortness of breath
- Pain that’s worse in the morning or after sitting for a long time
Each veteran’s symptoms will differ, as will their progression of the condition. Along with difficulty moving and breathing heavily, ankylosis can cause pain and inflammation in the:
- Eyes- A large chunk of people with ankylosis have difficulty seeing or a blurred vision as a result of the inflammation. This inflammation can also cause your eyes to be sensitive to bright lights.
- Spine- If your case has progressed, you may develop weak vertebrae in the spine. This loss in vertebrae strength will make the area more susceptible to fractures and breaks.
Also, the nerves at the bottom of your spine may be impacted. This can cause difficulty in controlling the bladder, bowels, or genitals.
- Heart valve- In rare cases, ankylosis can cause an enlarged aorta, which is essential for the functioning of the heart. This will cause the heart to stop beating as efficiently, which will lead to less energy and shortness of breath.
In addition to functionality issues, ankylosis can cause an increased risk of cancer in the affected individual. This is why it’s vital to talk to your doctor and receive the coverage you deserve for this incapacitating condition.
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How VA Disability Rankings Are Determined
The amount of coverage you receive for your condition is not only determined by the condition itself.
A large part of your coverage depends on the number of incapacitating episodes you experience as a result of the condition. The more episodes you have, the more coverage you’ll receive.
Here is how the coverage is determined:
Percentage by Incapacitating Episodes
The percentage that covers your condition is determined by your number of incapacitating episodes.
For example, you may receive full coverage if ankylosis is impacting the functionality of your entire spine. Or, you may get half of the coverage if the entire thoracolumbar spine is affected.
From here, the percentages will go down. As the range of motion for each part of the spine rises, your coverage will decrease. For example, if you can move your neck 15 degrees to the left, you’ll receive more coverage than if you can move your neck 30 degrees to the left.
Your incapacitating episodes, as well as your ability to function while performing daily activities, will impact the amount of coverage you receive for your condition.
Combined Rating System
If you suffer from multiple incapacitating conditions, your ratings will be combined based on VA math.
Use our VA disability calculator to estimate your
combined VA rating and monthly payment
To determine this, you’ll need to rank the disabilities in order by severity. Then you’ll find the intersection between the two by using the table on this page or with our easy-to-use VA Disability Calculator. The final number you’ve reached by intersecting the two will be rounded to the nearest 10%.
If you have more than two disabilities, you’ll perform the same action you did, starting with your highest rating and working your way down. You can even fill in your dependents on our calculator. If you are adding up your VA ratings manually, you’ll also want to add in the bilateral factor (which our calculator does automatically) and talk to your case manager about getting SMC for any 0% ratings.
Getting the Coverage You Deserve
If you’ve been left with conditions that impact your life, yet, you aren’t receiving fair compensation for them, we’re here for you.
We will file your appeal so you can fight for coverage. We also review every case to see if you could try to get 100% TDIU. You don’t always have to get your rating up to 100% to get the 100% level of payment.
We’ve been fighting for the rights of veterans since 1985. We understand that the sacrifice you’ve made to serve your country may have left you with health complications. So, we will fight to ensure that you don’t have to handle these complications yourself.
You are only charged a fee from our lawyers if you win your appeal. We don’t ask for any money from you upfront, and we’ll make sure that you get the best lawyer to represent your case.
Even if you haven’t applied for disability compensation yet, we have no problem helping you through the process. If you’re ready to take the next step to receive the compensation that you deserve, don’t hesitate to act.
We’re committed to getting you the VA disability ratings you need to live a more comfortable life. For a free quote or more information about our services, reach out to us today!