Chronic pain can result from a number of injuries or conditions, making activities of daily living more challenging. If you were injured or fell ill due to military service, you may be eligible for veterans’ benefits through the United States Department of Veterans Affairs. However, obtaining an accurate rating for chronic pain isn’t always as straightforward as it is for other conditions.
If you’re a disabled veteran seeking VA disability benefits for chronic pain, there are some key steps you should take. This guide will break down how the VA rates chronic pain when awarding veterans disability benefits.
What Is Chronic Pain?
Pain is considered to be chronic when it is present for six months or longer.Chronic painusually begins with an injury or illness and can end up causing complications. Unfortunately, these complications can, in turn, make the chronic pain even worse. The combination of chronic pain and the resulting complications is known as chronic pain syndrome. A veteran with chronic pain frequently develops problems beyond the physical pain they endure. Chronic pain can cause symptoms such as the following:
- Reduced activity
- Sleep impairment
- Depression
- Suicidalideation
- Social withdrawal
- Irritability
- Memory and cognitive impairment
- Relationship problems
- Helplessness
- Hopelessness
- Substance abuse
- Anxiety
As the above list of symptoms shows, veterans with chronic pain suffer from more than physical pain. This is backed up by multiple medical studies proving that chronic pain has a direct effect on the brain. These studies have looked at how the persistent perception of pain interferes with the natural balance of activity in someone’sbrain. Chronic pain can result in anxiety, mood disorders, and cognitive impairments such as difficulty concentrating, difficulty focusing, and difficulty making decisions. The physical pain and resulting secondary problems associated with chronic pain significantly diminish a person’s quality of life.
Is Chronic Pain a Disability?
Yes, chronic pain is a disability. But it wasn’t always that way in the eyes of the VA.
In the past, veterans were often unable to seek disability compensation for their chronic pain. But this changed with a 2018 court case.
Saunders v. Wilkie
For years, the VA has denied service-connected claims of impairment caused by pain alone, if the pain was not a symptom of a diagnosed condition or disease. That is, not until a recent game-changer April 2018 Federal Circuit decision – Saunders v. Wilkie. [Saunders v. WilkieNo. 17-1466 (Fed. Cir. 2018)]
According to the VA’s code and regulations, basic entitlement for compensation must result from “personal injury suffered or disease contracted in line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty…” [38 USCS § 1110].
In Saunders, the Veteran filed a claim for pain from a bilateral knee disorder. During service, she was diagnosed with patellofemoral pain syndrome.VA denied her claim relying on years-long standing Veterans Court’s ruling in Sanchez-Benitez v. West explaining that “pain” could not be provided as a diagnosis and that Saunders had not demonstrated a currently diagnosed bilateral knee condition that could be linked to service. [Sanchez-Benitez v. West, 13 Vet. App. 282, 285 (1999)]
Saunders appealed that the Board erred legally in its interpretation of what constitutes a “disability” under 38 USCS § 1110. The question which the Federal Circuit resolved was whether Saunders’s patellofemoral pain syndrome is a “disability”.
The Federal Circuit concluded that the term “disability” refers to a condition that impairs normal functioning and reduces earning capacity. As such, “pain” is impairment because it diminishes the body’s ability to function. The Federal Circuit explained that medical literature and common sense supported the assumption that chronic pain can develop in the absence of gross skeletal pathology, and common causes like muscle strain and inflammation may be difficult to detect with diagnostic imaging such as MRIs or X-rays.
To summarize, this case determined that veterans could seek disability compensation for their chronic pain if the pain was service connected. This is true whether or not the veteran knows the exact source of the pain.
VA Ratings for Chronic Pain
The chronic pain syndrome VA rating isn’t always straightforward. This is because the VA does not have a specific diagnostic code for chronic pain. So, veterans don’t receive a VAdisability rating for chronic pain specifically. In order to receive VAdisability compensation for chronic pain, the symptomscaused bythe chronic pain disorder must be ratable. For example, oftentimes a veteran’s chronic pain will cause depression. In that case, the veteran’s chronic pain would be rated according to the rating criteria for general mental health disorders.
Keep in mind that, in order for symptoms of chronic pain syndrome to be ratable, the source of the chronic pain must have a service connection. For example, a veteran with a service-connectedback conditionsuffers from chronic pain. The chronic pain causes the veteran to become severely depressed. Because the chronic pain developed out of a service-connected condition, the veteran can receive VA benefits for the depression caused by his chronic pain. In other words, the depression is secondary to the veteran’s service-connected condition.
Chronic Pain VA Claims
One of the most helpful things a veteran can do for their claim is to get a private doctor to write a medical opinion. VA disability claims involving chronic pain often benefit from a medical opinion from a private health care professional due to thecomplexityof the medical condition. This opinion can serve as valuable medical evidence in the claim.
The doctor should discuss the medical research regarding the effect chronic pain has on the brain. Make sure the doctor specifically relates any symptoms of chronic pain to a service-connected condition. For example, if a veteran has a back condition that is service connected, and a shoulder condition that isnotservice connected, the doctor needs to specifically relate any symptoms associated with chronic pain to the veteran’s service-connected back condition. This does not mean that a doctor has to state a veteran’s service-connected condition is the ONLY cause of any symptoms of chronic pain.
Taking the example further, if the veteran with a service-connected back condition and non-service connected shoulder condition has depression as a result of the chronic pain he is in, it’s likely that the depression is somewhat attributable to both the shoulder and back pain. In situations like this, the veteran’s depressive symptoms are likely “inextricably intertwined” with the back and shoulder condition. In other words, it’s impossible to tell which condition is the true cause of the depressionsecondaryto the veteran’s chronic pain. As long as a doctor thoroughly explains this, the veteran can still receive service-connected for his depression secondary to chronic pain. And again, the VA will use the rating schedule for mental disorders to provide the specific percent rating.
Chronic Pain and TDIU
Lastly, it’s important to consider individual unemployability. Veterans with chronic pain not only have physical impairments that affect their ability to work, but they also have mental impairment associated with chronic pain that further impact their ability to work. As mentioned above, medical opinions are extremely important. An opinion from a private doctor can help show the functional impairment a veteran has due to their chronic pain and due to any secondary problems that are present as a result of the chronic pain.
For example, a veteran with anorthopedic conditionwill likely have limitations impairing their ability to sit, stand, lift, walk, etc. All of these factors affect their ability to secure and maintain a job. However, that same veteran may have chronic pain as a result of their orthopedic condition and develop depression. In that case, the veteran may also have mental limitations such as difficulty concentrating, anger problems, inability to get along with co-workers, etc. It is important to show how both the physical and mental limitations affect the veteran’s ability to work.
Seeking Chronic Pain Syndrome VA Disability Benefits?
Obtaining an accurate percent rating can be challenging for chronic pain sufferers. If the VA has denied your claim or awarded a lower rating than you think you deserve, the veterans disability attorneys at Hill & Ponton can help. Our law firm is committed to supporting military veterans and their families. Whether you’re seeking an increased rating or want to challenge a denied claim through the court of appeals for veterans claims, our lawyers are available to assess your case and represent you.
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FAQs
What percentage of VA disability is chronic pain? ›
A greater number of incapacitating episodes are associated with a higher VA disability chronic back pain rating. The rating percentages fall between 10% and 60%.
How do you accept chronic pain? ›- Manage your stress. Emotional and physical pain are closely related, and persistent pain can lead to increased levels of stress. ...
- Talk to yourself constructively. Positive thinking is a powerful tool. ...
- Become active and engaged. ...
- Find support. ...
- Consult a professional.
The United States Department of Veterans Affairs considers depression as one of the secondary conditions of chronic pain. So, if you're experiencing these conditions, you may be eligible for veterans disability compensation.
Is chronic pain a long term disability? ›Have you been Suffering from Chronic Pain? Are you finding it difficult to continue working because of the effects of your chronic pain? If this type of pain is interfering with your ability to function daily and is inhibiting your ability to work, you may be eligible for long-term disability benefits.
Is it hard to get disability for chronic pain? ›Social Security disability claims based on chronic pain are never easy to get approved. They require expert understanding of the above evaluation process, as well as compelling medical evidence.
At what point is chronic pain a disability? ›The SSA does not consider chronic pain to be a disability, so there is no listing for it in the SSA's Blue Book. Chronic pain, even if it is severe and disabling, does not qualify unless you can prove it is caused by a verifiable condition that lasts for at least 12 months.
When is chronic pain too much? ›Additionally, an indicator that chronic pain has become too much to handle is when it begins to greatly impact one's quality of life. This means that the pain is so severe that the person experiencing it is unable to work, socialize, find joy in going out, care for themselves independently, or function in other ways.
Does chronic pain make you tired? ›A stubborn and complex condition to treat, when chronic pain persists, it can lead to fatigue and depression. FATIGUE: Chronic pain makes it hard to get restorative sleep and the lack of sleep can have sufferers wake up in increased pain.
How much pain is too much pain? ›Severe Pain.
When it intensifies to level 8, pain makes even holding a conversation extremely difficult and your physical activity is severely impaired. Pain is said to be at level 9 when it is excruciating, prevents you speaking and may even make you moan or cry out. Level 10 pain is unbearable.
Veterans who have been injured in a trauma can develop both PTSD and chronic pain as a result of the trauma and injuries related to the trauma. In addition, people who have experienced some types of trauma and develop PTSD more likely to develop chronic pain later in life.
Can chronic pain trigger PTSD? ›
Only 2% of people who do not have chronic pain have PTSD. One study found that 51% of patients with chronic low back pain had PTSD symptoms. For people with chronic pain, the pain may actually serve as a reminder of the traumatic event, which will tend to make the PTSD even worse.
What is the VA rating for chronic back pain? ›What is the average VA disability rating for back pain? VA disability ratings for back pain can range from 10% to 100%, depending on the severity of the pain, the range of motion the veteran is left with, and the frequency of the pain.
What qualified as chronic pain? ›Chronic pain is pain that lasts more than several months (variously defined as 3 to 6 months, but longer than “normal healing”). It's a very common problem.
What is the most common chronic pain condition? ›Joint pain, typically caused by injury, infection, or advancing age, is one of the leading types of chronic pain among American adults.
What is the most approved disability? ›What Is the Most Approved Disability? Arthritis and other musculoskeletal system disabilities make up the most commonly approved conditions for social security disability benefits. This is because arthritis is so common. In the United States, over 58 million people suffer from arthritis.
How do you describe pain to a disability judge? ›Pain is often hard to describe, but you should do your best to relate your pain as specifically as possible to the judge. This would include telling the judge what type of pain you experience (burning, stabbing, etc.), how often you experience it, and how you would quantify it (for example, on a scale of 1 to 10).
Which chronic illness is responsible for most disability? ›Chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the United States.
Is permanent nerve damage a disability? ›Depending on the extent of damage to the nerve, it can heal on its own or become permanent, even with treatment. If you suffer from a condition that causes nerve damage that is so severe that it impacts your ability to work for at least a year, you may be eligible to receive Social Security Disability benefits.
Can you verify chronic pain? ›How is chronic pain diagnosed? Pain is considered to be chronic if it lasts or comes and goes (recurs) for more than three months. Pain is usually a symptom, so your healthcare provider needs to determine what's causing your pain, if possible.
What are 5 diseases that could be the cause of chronic pain? ›Disease can also be the underlying cause of chronic pain. Rheumatoid arthritis, osteoarthritis and fibromyalgia are well-known culprits, but persistent pain may also be due to such ailments as cancer, multiple sclerosis, stomach ulcers, AIDS, and gallbladder disease.
Is chronic pain worse than severe pain? ›
Acute pain happens quickly and goes away when there is no cause, but chronic pain lasts longer than six months and can continue when the injury or illness has been treated.
Is chronic pain all mental? ›Chronic, persistent pain prolongs these systemic and chemical brain changes, leading to real psychological changes. Over time, these can impact brain function, resulting in changes in behavior. Moreover, this chronic stress is not limited to psychological effects.
How does chronic pain affect you physically? ›It can affect your ability to function at home and work. You may find it difficult to participate in social activities and hobbies, which could lead to decreased self-esteem. It is also common for people with chronic pain to have sleep disturbances, fatigue, trouble concentrating, decreased appetite, and mood changes.
What are the long term effects of chronic pain? ›- Changes in the brain. Your brain is not meant to handle pain all day. ...
- Mood changes and disorders. ...
- Changes in one's physical pain response. ...
- Sleep disorders. ...
- Hormonal changes and interference with sexual function.
A person rates their pain on a scale of 0 to 10 or 0 to 5. Zero means “no pain,” and 5 or 10 means “the worst possible pain.”
What is pain level 6? ›6 – Moderately strong pain that interferes with normal daily activities. Difficulty concentrating. Severe Pain – Disabling; unable to perform daily living activities.
What is the highest level of pain? ›Pain level ten means unimaginable pain. This pain level is so intense you will go unconscious shortly. Most people have never experienced this level of pain. Those who have suffered a severe accident, such as a crushed hand, and lost consciousness due to the pain and not blood loss, have experienced level 10.
How prevalent is chronic pain in PTSD? ›PTSD and Chronic Pain
The prevalence of PTSD is substantially elevated in patients with chronic pain. A current PTSD prevalence of 35% was seen in a sample of chronic pain patients (13), compared to 3.5% in the general population (14).
As a point of comparison, people with chronic pain typically have at least double the rate of previous trauma as compared to the general population. The US Department of Veterans Affairs explains that 15% to 35% of patients with chronic pain also have Post Traumatic Stress Disorder (PTSD).
What is chronic pain due to trauma? ›Post-traumatic pain after a traumatic injury is common. In many cases, chronic pain results from nerve damage (causalgia or mimocausalgia) caused by the trauma. Nerve damage is often the reason for persistent pain even after the recovery from the physical trauma is complete.
Can chronic pain lead to mental illness? ›
People living with chronic pain are at heightened risk for mental health problems, including depression, anxiety, and substance use disorders. Chronic pain can affect sleep, increase stress levels and contribute to depression. An estimated 35% to 45% of people with chronic pain experience depression.
What are the 3 main symptoms for someone suffering from PTSD? ›Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.
What are physical signs your body is releasing trauma? ›Some may have a fight-or-flight type of response, which may include muscle tension, heart pounding and sweating because their body "believes it needs to activate," she explains. Others maybe experience a freeze response, which can look like someone who struggles to move or get out of bed.
What does the VA look for in back pain? ›Therefore, in regards to direct service connection for back pain, veterans must show evidence of the following: A current diagnosis of a back condition; An in-service event, injury, or illness; and. A medical nexus (i.e. link) between the current, diagnosed back condition and the in-service event, injury, or illness.
What type of back pain qualifies for disability? ›The back problems that qualify for disability include herniated discs, nerve root compression, degenerative disc disease. To get disability for pain problems, one of the follow conditions must be severe enough that you will be out of work for at least 12 months.
How does the VA test for back pain? ›Generally speaking, veterans will attend a Compensation & Pension (C&P) examination and the examiner will measure how far they can bend forwards, backwards, and side to side, using a goniometer.
Is chronic pain syndrome a disease? ›This is an autoimmune disease that causes painful inflammation in the joints. Back pain. This pain may stem from muscle strains, nerve compression, or arthritis of the spine (called spinal stenosis).
Is chronic pain syndrome rare? ›CRPS occurs most frequently in people of European ancestry (in about 66 to 80 percent of cases). In a study done in the United States, it was found that CRPS type I developed in 5.46 persons out of every 100,000 per year. It is estimated that CRPS affects nearly 200,000 patients annually in the United States.
What makes chronic pain worse? ›High Stress
Unfortunately, pain causes more stress, sleep difficulties, and appetite changes, all of which lead to worsened pain. It's very important to learn stress-coping mechanisms to help you reduce levels. Some ideas include: Breathing exercises.
However, tinnitus is among the easiest VA disability benefits to get approved. If you have an existing condition that has been proven to be service-connected, tinnitus can help to increase your total disability rating, granting you additional compensation. First, it's subjective. There's no definitive test for it.
What's the easiest thing to get disability for? ›
Arthritis
Arthritis and other musculoskeletal disabilities are the most commonly approved conditions for disability benefits. If you are unable to walk due to arthritis, or unable to perform dexterous movements like typing or writing, you will qualify.
- Never Be Deceptive About Your Condition. Many people will downplay their symptoms when describing their condition. ...
- Do Not Reveal that You Have Ignored Doctor's Orders. ...
- Avoid Discussing Non-Medical Information with a Disability Doctor. ...
- Do Not Threaten to Contact a Lawyer.
As of December 1, 2021, veterans with a 70 percent VA disability rating receive $1,663.06 per month in VA compensation. This monetary benefit is tax free at both the federal and state levels. The exact amount of compensation may increase or decrease each year depending on the cost-of-living adjustment (COLA).
What is 90% VA disability rate? ›What is the compensation for a 90% VA Disability Rating? The 2023 compensation rate (an 8.7% increase) for a 90% VA disability rating is $2,172.39. For more information about compensation for dependents, our 2023 VA Disability Rates and Compensation article covers all the updates for the year.
How much is a 90% VA disability? ›90 percent disability rating: $2,172.39 per month. 100 percent disability rating: $3,621.95 per month.
What is 80% VA disability? ›How Much Compensation Do Veterans Rated at 80 Percent Receive? As of December 1, 2022, veterans who are rated at 80 percent will receive $1,933.15 per month. However, this amount typically changes each year to reflect changes in the cost-of-living.
How do I increase my VA disability from 70% to 100? ›- Method 1: Appeal the Decision or File a New Claim. The most straightforward approach is to appeal VA's decision on the original claim. ...
- Method 2: Prove Individual Unemployability (TDIU) ...
- Method 3: File for a Secondary Service Connection. ...
- Assistance with Your Claims and Appeals.
Your VA benefits will last for your whole life. Even if your disability is classified as less than total and not permanent, if you've been collecting benefits for 20 years or more, the amount of your benefit won't go down.
Can I still work if I have 70% VA disability? ›Yes, in most cases, a veteran can work while receiving VA disability.
What are the easiest VA claims to get approved? ›- Tinnitus.
- Mental Health Conditions.
- Musculoskeletal Conditions.
- Scars.
- Presumptive Conditions.
What will 2023 VA disability rates be? ›
Effective December 1st, 2023, the monthly veterans disability payment amounts for veterans with no dependents are as follows: $165.92 per month for 10% disability. $327.99 per month for 20% disability. $508.05 per month for 30% disability.
Will veterans get a raise in 2023? ›The 2022 COLA hike was 5.9%. The adjustment for 2023 means a disabled veteran with a 10% VA rating can expect to see about $13.28 more each month, and a 100% disabled veteran with no dependents will receive $300 more per payment.
What is the most approved VA disability? ›A 100% VA Disability Rating is the highest combined rating a veteran can receive for VA Disability. It is also known as a Total Rating.
How to go from 80 to 100 VA disability? ›All you need to do to seek an increase in your VA disability rating is to request the VA review your rating and provide evidence that your condition is worsening.
Does VA disability count as income? ›Disability benefits received from the VA should not be included in your gross income.