Is Cervicalgia a VA Disability?
The Department of Veterans Affairs (VA) categorizes spinal conditions into two primary groups: neck and back. Back pain predominantly pertains to injuries located in the lower portion of the spine or the thoracolumbar region. On the other hand, neck pain specifically targets the upper seven vertebrae of the cervical spine. Within the VA’s framework, neck pain, also known as cervicalgia, is acknowledged as a compensable disability if it can be traced back to military service.
For a veteran to obtain a VA disability rating related to neck pain, it is essential to establish a link to military service. This linkage necessitates the presentation of official statements and records that substantiate the connection.
Cervicalgia and Service Connection
Establishing a service connection to cervicalgia is possible with the right proof and documentation. Here’s a look at the process.
- Proof of Military Connection for Neck Injury Compensation:
- Veterans seeking compensation for a neck injury disability need to demonstrate that their neck pain was either caused or worsened during their military service.
- VA benefits are exclusively available for individuals dealing with persistent or chronic neck pain.
- Compensation is not granted for neck problems that were once present but have since healed or resolved.
- Eligibility Criteria for VA Benefits:
- Veterans can qualify for VA benefits if they had a pre-existing neck condition before joining the military, which was subsequently aggravated by an event or continuous stressors during their service.
- Components of Service Connection:
- Similar to how VA compensation is established for various other conditions, proving service connection for neck injuries requires the following three key pieces of evidence:
- 1. Current Diagnosis: Veterans must provide a documented diagnosis confirming their existing neck injury or condition.
- 2. In-Service Event Documentation: A record detailing an incident during military service that contributed to the neck injury is essential.
- 3. Medical Nexus: A medical nexus must be established, connecting the present diagnosis to the documented in-service event or underlying cause. This demonstrates the direct link between the injury and military service.
- Similar to how VA compensation is established for various other conditions, proving service connection for neck injuries requires the following three key pieces of evidence:
What If I Don’t Have a Diagnosis of Cervicalgia? Can I Get VA Benefits?
Distinguishing itself from the criteria applied to other VA-recognized disabilities, the process of establishing service connection for neck pain presents distinct features. Notably, a contemporary diagnosis is not an absolute prerequisite. This departure stems from a pivotal decision handed down by a Federal Circuit court in April 2018, reshaping the landscape by permitting VA to bestow disability benefits for uncharted, undiagnosed pain, provided it can be unmistakably linked to an injury, symptom, or event that occurred during military service. This revolutionary stance effectively dispenses with the traditional necessity for an official medical professional’s opinion to validate the claim.
However, this shift, while advantageous to certain veterans, simultaneously amplifies the evidentiary demand to forge a seamless connection between the pain and the event of service. Even in the absence of a formal diagnosis, a veteran must navigate the process of presenting persuasive evidence to establish this linkage with VA. This procedural phase is inaugurated by the submission of substantiating evidence highlighting the veteran’s enduring experience of chronic neck pain—a prerequisite for securing VA disability benefits. The eligibility hinges upon the verifiable demonstration of sustained, recurring struggles.
Evolving the discourse further, the veteran’s endeavor to demonstrate service connection continues through furnishing evidence that illuminates how the neck pain intrudes upon and disrupts their everyday life. Within this context, two types of corroborative evidence emerge as invaluable assets: lay statements and buddy statements. The former springs from the articulations of family members or the veteran themselves, enriching the narrative with nuanced insights into how the disability tangibly alters daily existence. Meanwhile, the latter sources its potency from fellow veterans who have crossed paths with the claimant, their shared experiences offering a corroborative perspective.
Intricately woven within this evidentiary tapestry are military records that serve to elucidate incidents or activities that could plausibly underlie the emergence of neck pain. Paramount in this endeavor is the substantiation of the fact that the pain transcends mere subjectivity. The crux lies in unearthing resounding evidence that unequivocally portrays the pain’s transformative impact, manifesting as functional impairment or diminishment. Such impairment becomes pronounced when the veteran’s capacity to perform tasks with the same vigor and endurance as before the onset of the condition is demonstrably compromised.
What Kind of Neck Pain Often Qualifies for VA Benefits?
When it comes to conditions that exhibit age-related deterioration, like spinal disc issues or various forms of arthritis, the significance of diagnosis can become more pronounced. However, in the context of VA assessments, the emphasis often centers on the symptoms presented rather than the diagnosis itself.
Certain conditions can result in enduring complications that do not progressively worsen with time. These injuries can stem from a range of causes. Notably, any injury documented during an individual’s enlistment period is eligible for service connection. Notably, factors like combat involvement or deployment do not influence this determination; even incidents like car accidents occurring during leave are deemed relevant.
Among the array of neck injuries that fall within the purview of VA coverage, several stand out:
- Disc Injuries: These encompass disruptions affecting the intervertebral discs within the spinal column. Conditions like herniated discs engender weakness, pain, and numbness.
- Nerve Pinches: This ailment emerges when excessive pressure bears down on a nerve. Muscles, bones, and tendons in the vicinity can induce muscle weakness, sharp pain, and numbness. In extreme cases, surgical intervention might be necessary to alleviate the discomfort.
- Whiplash: Characterized by forceful back-and-forth neck motion, whiplash leaves a lingering trail of pain. The rapid and intense movement can traumatize nearby muscles and tendons, culminating in cervical strain.
- Repetitive Strains: These injuries lead to persistent aching, cramping, pain, throbbing, and tingling in the upper back. Symptoms often escalate over time, propelled by the repetition of specific actions.
- Spinal Cord Injuries: These grave injuries can result in diminished motion or sensation in the body. Frequently, the spinal cord sustains damage but remains partially intact, resulting in partial impairment. Yet, instances can arise where the spinal cord is severed or significantly traumatized due to gunshot wounds, severe falls, or car accidents.
- Degenerative Disc Diseases: This degradation unfolds as the discs between spinal vertebrae progressively deteriorate, culminating in pain across the back, arms, neck, and legs. A clinical diagnosis can confirm this condition.
- Intervertebral Disc Diseases: Similar to degenerative disc disease, these conditions target the discs between vertebrae, ushering in pain across the back, arms, neck, and legs.
- Foraminal Stenosis: This variant of spinal stenosis involves the constriction of foramen—the openings between spinal bones. These contractions can lead to pain and discomfort in the back, arms, neck, and legs as a result of the narrowing.
VA Ratings and Percentages for Neck Pain
The evaluation of most neck pain conditions by the Department of Veterans Affairs (VA) is guided by 38 CFR § 4.71a, which outlines the General Rating Formula for Diseases and Injuries of the Spine. Various cervical conditions fall within the ambit of this code and are assessed accordingly. Some notable examples of cervical conditions subject to rating include:
- Diagnostic Code 5237 – Cervical Strain: This encompasses instances of torn tendons or muscles within the neck.
- Diagnostic Code 5238 – Cervical Spine Stenosis: This pertains to the narrowing of the spinal canal in the cervical region due to various causes.
- Diagnostic Code 5242 – Degenerative Arthritis of the Spine: This code applies to cases of pain stemming from the degeneration of cervical vertebrae.
The criteria for determining these ratings are primarily grounded in measuring the range of motion. At present, the severity of neck pain, as appraised by the VA, is gauged based on the following benchmarks:
- 0% rating: Forward flexion of the cervical spine exceeding 40 degrees.
- 10% rating: Forward flexion of the cervical spine over 30 degrees but not surpassing 40 degrees; alternatively, a combined range of motion of the cervical spine exceeding 170 degrees without causing abnormal spine contour or gait abnormalities.
- 20% rating: Forward flexion of the cervical spine surpassing 15 degrees but not exceeding 30 degrees; or a combined range of motion of the cervical spine above 170 degrees.
- 30% rating: Forward flexion of the cervical spine not exceeding 15 degrees; or favorable ankylosis of the complete cervical spine, indicating that the spine is immobile yet positioned in a manner that does not substantially impede daily activities.
- 40% rating: Unfavorable ankylosis of the entire cervical spine, signifying that the spine’s immobility significantly impedes day-to-day activities.
- 50% rating: NOT APPLICABLE to the cervical spine, reserved solely for individuals with unfavorable ankylosis of the complete thoracolumbar spine.
- 100% rating: Reserved for cases of unfavorable ankylosis affecting the ENTIRE spine.
These stipulated criteria and ratings delineate the varying degrees of impairment arising from cervical conditions, allowing for a comprehensive and consistent evaluation process by the VA.
Getting an Attorney Involved for VA Cervicalgia
If you have been denied benefits due to your service-related neck pain or cervicalgia, an attorney can improve your chances of getting approved. Contact us today to get match with an experienced VA attorney for your case.