VA Disability Rating for Neck Pain (Cervicalgia), Cervical Spine Pain, & Neck Arthritis
The Department of Veterans Affairs (VA) views conditions of the spine through two main categories—neck and back. Back pain typically refers to injuries in the lower half of the spine or the thoracolumbar section. Neck pain refers to the top seven vertebrae of the cervical spine. Pain in the neck—or cervicalgia—is recognized by VA as a disability that should be compensated if caused by military service.
Before receiving a VA disability rating for neck pain, a veteran must prove service connection through the use of official statements and records.
How to Establish Service Connection for Neck Pain
To receive compensation for a neck injury disability, veterans must be able to prove that their neck pain was caused or aggravated by their time in the military. Only individuals with chronic neck pain will be eligible for VA benefits. Veterans are not awarded compensation for neck issues that were present at one time but have since healed or gone away. Veterans are eligible for VA benefits if they had a neck condition prior to their time in the service that was aggravated by an event or continuous stressors.
Similar to VA compensation for most other conditions, service connection requires three separate pieces of evidence. Veterans must present a current diagnosis, a document detailing an in-service event, and a medical nexus that connects the current diagnosis to the in-service event or cause.
Receiving Neck Pain Disability Benefits Without a Diagnosis
Unlike other disabilities recognized by VA, service connection for neck pain does not necessarily require a current diagnosis. A Federal Circuit court ruling in April of 2018 decided that VA can award disability benefits for undiagnosed pain if it is linked to an injury, symptom, or in-service event. This erases the need for an official opinion from a medical professional.
Although this benefits some veterans, it also increases the amount of evidence required to link the pain to the in-service event. If there is no diagnosis, a veteran will still need to show VA that connection. This process starts with the veteran submitting evidence that they experience chronic neck pain. VA disability will not be awarded to those who cannot prove they have long-lasting or recurring issues.
The veteran continues to prove service connection by submitting evidence that proves their neck pain interferes with their daily life. Other valuable types of evidence are lay statements and buddy statements. Lay statements come from family members or the veteran themselves, and simply detail more information about how the veteran’s daily life is affected by the disability. Buddy statements provide the same type of information but come from other veterans who may have served with the claimant.
Military records that explain an activity or incident which may have led to neck pain can also help establish a relationship between service and the neck condition. The important part is that the veteran proves the pain is not merely subjective. There must be clear evidence that the veteran’s pain causes functional impairment or loss. This occurs when a veteran is unable to perform with the same strength and endurance as before the condition.
How Is VA Disability Rating for Neck Pain Decided?
A cervicalgia VA rating will be decided based on the severity of symptoms and how much they limit an individual’s movement or range of motion. VA ratings for neck problems go up fast because so much goes on inside your cervical spine. The more you are immobilized, the more your VA rating will increase. Most neck injuries follow the same diagnostic criteria.
VA Disability Rating for Neck Pain Criteria
VA uses 38 CFR § 4.71a, General Rating Formula for Diseases and Injuries of the Spine to evaluate most neck pain conditions. Some examples of cervical conditions that are rated under this code include the following:
Diagnostic Code 5237 Cervical Strain — A torn tendon or muscle in the neck
Diagnostic Code 5238 Cervical Spine Stenosis — The spinal canal narrowing for one reason or another
Diagnostic Code 5242 Degenerative Arthritis of the Spine — Pain from the degeneration of the cervical vertebrae
This rating criterion is primarily based on a range of motion measurements. Currently, VA rates neck pain severity on the following values:
0% rating — Forward flexion of the cervical spine over 40 degrees
10 % rating — Forward flexion of the cervical spine over 30 degrees, but less than or equal to 40 degrees; or a combined range of motion of the cervical spine above 170 degrees but not causing abnormal spine contour or abnormal gait
20% rating — Forward flexion of the cervical spine over 15 degrees, but less than or equal to 30 degrees; or a combined range of motion of the cervical spine above 170 degrees
30% rating — Forward flexion of the cervical spine less than or equal to 15 degrees; or favorable ankylosis of the entire cervical spine, which occurs when the spine is stuck, but in a position that does not heavily interfere with an individual’s daily activities
40% rating — Unfavorable ankylosis of the entire cervical spine, which occurs when the spine is stuck in a position that makes daily activities extremely difficult
50% rating —NOT APPLICABLE to the cervical spine, only assigned to individuals with unfavorable ankylosis of the entire thoracolumbar spine
100% rating — Unfavorable ankylosis of the ENTIRE spine
Secondary conditions such as an altered gait, trouble eating, or difficulty swallowing can also contribute to a higher VA disability rating.
Common Types of Neck Injuries That Qualify for VA Compensation
Although the diagnosis might matter when it comes to conditions that deteriorate with age, such as problems with spinal discs or variations of arthritis, VA typically focuses on symptoms when assigning ratings.
Certain conditions can cause lasting issues that don’t get worse over time. These injuries can be caused by a variety of factors. Any injury that is documented while an individual is enlisted is eligible for service connection. Combat and deployment do not factor into this decision, so even car wrecks that happen on leave are considered viable.
Some of the common neck injuries which VA will cover include the following:
Disc Injuries — These are injuries that affect the discs between vertebrae in the spine. Disc injuries like herniated discs cause weakness, pain, and numbness.
Nerve Pinches — This condition occurs when too much pressure is applied on a nerve. The surrounding muscles, bones, and tendons can cause muscle weakness, sharp pain, and numbness. This injury can even require surgery to relieve the pain.
Whiplash — Whiplash happens when the neck experiences a forceful back and forth motion that causes lasting pain. The quick and intense movement can traumatize the surrounding muscles and tendons, resulting in cervical strain.
Repetitive Strains — These injuries can cause aching, cramping, pain, throbbing, and tingling in the upper back. Symptoms often get worse over time and are caused by an individual performing the same action over and over again.
Spinal Cord Injuries — These are very serious injuries that can result in a loss of motion or feeling in the body. In most cases, the spinal cord is damaged but still intact so the individual merely loses some However, the spinal cord can sometimes be severed completely or traumatized by gunshot wounds, serious falls, and car accidents.
Degenerative Disc Diseases — This degeneration happens when the discs between spinal vertebrae break down over time, which can cause pain in the back, arms, neck, and legs. This condition can be diagnosed by a medical professional.
Intervertebral Disc Diseases — Similar to generative disc disease, these conditions affect the discs between vertebrae, causing pain in the back, arms, neck, and legs.
Foraminal Stenosis — This is a form of spinal stenosis (narrowing of the spine) that involves the tightening of foramen between bones in the spine. Foramen are the openings between discs.
Neck injuries can even be caused by sitting still for too long. Veterans nowadays may have to sit for multiple hours a day. If you experience back or neck pain from sitting in a chair for too long, you shouldn’t be embarrassed to apply for VA benefits. Regardless of the cause, VA disability for neck pain is awarded to those injured while serving.
VA Disability Rating for Neck Arthritis
Veterans are exposed to numerous events which can cause lasting neck injuries. Many natural conditions are also accelerated by time spent in the service. For example, as a veteran begins to develop arthritis in the neck, old neck injuries from the military can start to cause more pain. Bone spurs or osteophytes can grow on bones and cause joints to enlarge. The older the veteran gets, the more of these they will have. These cervical bone spurs can cause neck pain and weakness in the shoulders and arms.
Neck arthritis can also spread to affect other parts of the body. Although it’s not always fast, sometimes it can spread within just a few months. Veterans who start the application process right away are more likely to get a VA disability rating for their neck pain.
VA Disability Rating for Spondylosis
Cervical spondylosis, or cervical osteoarthritis, is another serious medical condition that veterans suffer from. Although cervical spondylosis is just a term to explain aging, if it happens faster than it’s supposed to, you may be eligible for VA compensation. Sometimes neck injuries do not cause a problem at the time of the incident. It can also be difficult if there is no record of the injury you received. However, that injury may accelerate the aging of your neck. If you’re only 45 years old but it feels as though your neck is 80, it may be beneficial to speak with a doctor about applying for a VA disability rating.
Neck pain can also be caused by pinching from disc compression or the growth of osteophytes. Both of these conditions can contribute to the accelerated aging of your cervical spine.
VA Disability for Neck Pain TDIU
Sometimes a veteran will not receive a 100% VA disability rating due to diagnostic criteria, but the conditions they have will prevent them from working. If this is the case, the veteran may be eligible for Total Disability based on Individual Unemployability, or TDIU. TDIU benefits are equivalent to those of a 100% disability rating and are awarded when one or more disabilities render a veteran unable to secure and keep substantially gainful employment. Substantially gainful employment is any non-temporary, non-seasonal job that provides enough money for an individual to live a certain quality of life.
Getting TDIU for neck pain is often difficult because most of the rating tiers fall below 50%. This means that your VA disability rating for neck pain will likely not be the primary rating involved in your TDIU, but it may supplement another more severe condition.
Compensation and Pension (C&P) Exams for Cervical Pain
To assess a veteran’s neck pain and the potential connection to an in-service event, VA is allowed to request a compensation and pension (C&P) exam. C&P exams are typically carried about by a VA physician or other VA-approved health professional. During the C&P exam, the practitioner will ask questions about the condition to see how it has changed over time.
The examiner will also test physical range of motion using a goniometer. This device accurately assesses how far individuals are capable of bending or moving their joints. After all these assessments, the test practitioner will send VA an opinion about whether or not they believe your condition is related to your time in the military. A favorable C&P decision will support a service connection for your disability, while an unfavorable decision will negatively affect your chances of proving a service connection.
VA Rating for Neck Pain Secondary Conditions
When a veteran files a claim for their disability, they must establish a primary service connection—with or without a diagnosis. There is another level to VA disability if the veteran experiences secondary conditions. Veterans must prove secondary service connection if their first service-connected condition causes a different disability or makes an existing disability worse. These secondary conditions can be claimed for additional benefits if the veteran is able to prove that they resulted from the primary condition.
It is common for secondary conditions to occur from orthopedic disabilities. Neck pain is known to cause migraines, sleep issues, and radiculopathy. While many conditions can be caused by cervical strain or neck pain alone, it’s important to check with a doctor because other conditions may also be linked to more serious health issues. Hire a VA disability lawyer to help you determine whether or not a secondary condition is eligible for VA service connection.
What to Do if Your Claim Is Denied?
If your VA claim is denied and you believe a mistake was made, you are allowed to appeal the decision. If you believe you can make an argument to change VA’s mind, it may be worthwhile to pursue a different decision. Sometimes VA accepts your claim but assigns a lower rating than you may have hoped for. You can also appeal this decision to fight for a higher VA disability rating for your neck pain.
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