Chronic pain and depression are common conditions among veterans, often occurring together. In fact, nearly 33% of veterans visiting VA clinics exhibit symptoms of depression. The VA only started rating chronic pain in 2018, so many veterans may not be aware that they can also file for a VA depression secondary to chronic pain rating.
You aren’t alone if you’re dealing with chronic pain and depression. Chronic pain is one of the most common issues veterans deal with daily. The VA reports:
- Persistent pain – 1 out of 5 veterans
- Severe persistent pain – 1 out of 10 veterans
- Chronic pain – 1 out of 3 veterans
Chronic pain has the potential to create a variety of issues that lead to depression, such as sleeplessness and stress. Chronic pain and its consequences can wear you down over time, affecting your mood. Read on to learn more about how you can file a winning VA claim if your pain has led to depression.
Table of Contents
- Is depression secondary to chronic pain?
- What is the VA disability rating for chronic pain?
- How does the VA rate depression secondary to chronic pain?
- How to Win your Claim for VA Depression Secondary to Chronic Pain Rating
- What type of evidence do you need to win a secondary service connection claim for depression?
- What happens if the VA doesn’t approve my depression secondary to chronic pain claim?
- NEED MORE ASSISTANCE?
- About the Author
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Is depression secondary to chronic pain?
Yes, depression can absolutely be rated by the VA as secondary to chronic pain.
Many veterans who experience chronic pain also suffer depression due to their chronic pain. This is called secondary service connection when dealing with depression that isn’t directly caused by your military service but instead caused by your chronic pain.
If you’re taking medications to help deal with your chronic pain, you could be at a higher risk of developing depression. The University of Alabama has connected the long-term use of opioids with an increased risk of depression.
If a veteran can show that their chronic pain led to the development of depression, they may be eligible for secondary service connection. So, if you have a service-connected condition that causes pain, and the pain leads to depression, the VA will rate you for your depression accordingly.
To win your claim for depression secondary to chronic pain, you must show that your service-connected chronic pain directly led to your depression. But first, let’s define what the VA considers chronic pain.
What is the VA disability rating for chronic pain?
Chronic pain is usually caused by an injury or illness that left complications. The pain can be constant or intermittent and range from mild to severe. Chronic pain can significantly impact a veteran’s quality of life and lead to depression.
To be considered chronic, your pain must last between three to six months (minimum).
Chronic pain can include, but isn’t limited to:
- Joint pain, including arthritis
- Back pain
- Neck pain
- Pain due to cancer
- Headaches, including migraines
- Testicular pain
- Pain in scar tissue
- Muscle pain all over, including fibromyalgia
Until recently, the VA didn’t recognize chronic pain as a ratable disability. This is because pain is hard to measure, and it can be challenging to confirm pain intensity, frequency, and daily impact.
However, this all changed in 2018. The U.S. Court of Appeals declared the VA must provide VA disability benefits for veterans with chronic pain and chronic pain syndrome even if you can’t specify the specific cause of the pain as long as the pain is connected to an in-service event.
This is great news for veterans dealing with chronic pain, as living in pain can take a severe toll on you physically and mentally.
Your rating will vary based on the body part where you’re experiencing chronic pain.
You won’t receive a VA rating for “chronic pain,” as this isn’t considered a disability on its own. Instead, you’ll be rated for your symptoms related to the body part where you’re experiencing the pain. For example, you could have a service-connected knee condition if you’re dealing with chronic knee pain.
The VA can award you a disability rating for chronic pain anywhere from 0-100%, depending on several factors.
These factors include:
- How your pain impacts your daily life based on your symptoms
- Joint pain
- Muscle aches
- Loss of mobility
- Social withdrawal
- Relationship issues
- Range of motion measurements
For example, if chronic pain limits your range of motion in certain body parts, you’ll be rated accordingly. The maximum rating for a range of motion limitation in your thigh is 40%, while knees range of motion limitations can be rated up to 60%.
Read our article on chronic pain to learn more about the criteria you must meet to earn a chronic pain VA rating.
Remember, once you’re rated for chronic pain, you can always file secondary claims for new conditions your chronic pain causes. If you’re dealing with constant pain, this pain can take a toll on your mental health. Let’s look at how the VA rates depression from chronic pain.
How does the VA rate depression secondary to chronic pain?
The VA rates depression just like other mental health conditions. Depression is rated at 0%, 10%, 30%, 50%, 70%, and 100% according to your ability to function.
You’ll receive a rating based on how much your depression interferes with your ability to have an everyday social life and your ability to work (the VA calls this occupational and social impairment). We can take the qualifying levels and apply them directly to a VA depression secondary to chronic pain rating.
According to the method the VA uses to rate depression, at the 0% rating level, you may have a diagnosis of depression, but your symptoms don’t rise to the level where they impact your life.
If you’re given a 0% rating for depression, you won’t qualify for monthly compensation for your depression. However, at this rating, you’ll still be eligible for other benefits, including healthcare, travel reimbursement, employment, and life insurance.
On the other hand, a 100% rating usually means you aren’t able to function socially or maintain a job, period.
Here are the thresholds you need to meet for each rating level:
- 0% secondary service connection rating for depression
- Even though you are diagnosed with depression, your symptoms aren’t interfering with work or your ability to function socially.
- 10% secondary service connection rating for depression
- At this level, the VA considers your symptoms mild. Mild, meaning your work efficiency and ability to perform occupational tasks only suffers during significant stress.
- If you’re taking medication continuously to control your symptoms, you may qualify for a 10% rating at a minimum.
- 30% secondary service connection rating for depression
- You have occasional impairment socially and at work because of your depression. This includes anxiety, depressed moods, or panic attacks (at least once weekly).
- 50% secondary service connection rating for depression
- You have difficulty in establishing and maintaining work and social relationships.
- You can also have difficulty understanding complex commands and have impaired short and long-term memory.
- You may also see disturbances in your mood and motivation.
- Panic attacks that occur more than once a week could qualify you for a 50% rating.
- 70% secondary service connection rating for depression
- You have frequent impairment socially and at work. This impairment would appear in most of your day-to-day activities, and would affect family relations, judgment, thinking, or mood.
- You have severe depression symptoms such as suicidal thoughts or obsessive rituals that interfere with your everyday life. This includes near-continuous panic attacks and the ability to function independently.
- If you have frequent difficulties establishing and maintaining effective relationships, you could qualify for a 70% rating.
- 100% secondary service connection rating for depression
- You have total impairment socially and at work.
- You may have delusions or hallucinations.
- You are in constant danger of hurting yourself or others.
- You also only have an intermittent ability to function and perform day-to-day activities.
- Memory loss of names of close relatives, time, or place may also qualify you for a 100% VA disability rating for depression.
How to Win your Claim for VA Depression Secondary to Chronic Pain Rating
Remember, there are three criteria you must provide to the VA to prove service connection. These include:
- A current diagnosis of your disability
- An in-service event, injury, or illness that caused or aggravated the injury
- A medical link (or nexus) between your current diagnosis and the incident
You need all three criteria above to be granted a rating for chronic pain. To be approved for secondary service connection for depression, you must prove:
- Your chronic pain is a service-connected disability
- You have a diagnosis of depression that isn’t already service-connected
- A doctor has medically linked the two conditions together with a nexus
Your goal when filing a VA depression secondary to chronic pain is to link the chronic pain you’re already rated for to your depression. You must show that the pain you experience is causing your depression.
We need medical evidence linking your depression to your chronic pain to prove this claim.
What type of evidence do you need to win a secondary service connection claim for depression?
Documentation of the depression symptoms you’re dealing with right now that aren’t resolving is critical to winning your VA claim. This documentation must include medical evidence.
A few different types of medical evidence can be used to support a VA claim for depression secondary to chronic pain. First, you will need to have a diagnosis of depression from a qualified mental health professional. This diagnosis can be in the form of a psychological evaluation or psychiatric assessment.
This could come from your private doctor or a VA doctor.
When submitting your claim, it will be helpful to provide a nexus from a qualified medical professional who links the development of your depression to your chronic pain. You’ll also need to show how your chronic pain has impacted your life and led to the development of depression. You can submit a personal statement that discusses the impact on your life.
Timing is also an important consideration. If medical evidence shows you developed depression before you began experiencing chronic pain, it will be difficult for you to prove that your chronic pain caused the depression. However, some veterans experience chronic pain and don’t get seen for this until symptoms of depression begin to develop.
Make sure you’re going to the doctor to get your chronic pain diagnosed and alleviated if possible. This includes current service members. If you’re currently serving on Active Duty and experiencing pain, now is the time to be seen by a provider. Waiting until after separation could make it challenging to prove service connection.
What happens if the VA doesn’t approve my depression secondary to chronic pain claim?
If your claim for a VA depression secondary to chronic pain rating doesn’t get approved, or you disagree with their decision, you have options.
Here are your choices when the VA comes back with its decision. You can:
- Accept the decision as is
- File one of three ways to get the VA to review your initial claim
- Higher Level Review – Your case is reviewed by a higher authority at your regional VA office
- Supplemental Claim – Option to include new evidence to support your claim
- Appeal to the VA Board of Appeals – A Veterans Law Judge reviews your case
- Accept the decision but file a new VA claim for new or additional disabilities
The rationale the VA gives you in your decision letter can help you choose what to do next.
Remember that many veterans wish to have their case reviewed by a Veterans Law Judge, but wait times with the VA Board of Appeals are significantly longer than a Higher Level Review or a Supplemental Claim.
If you’re a veteran suffering from depression secondary to chronic pain, the expert coaches at VA Claims Insider can help you file for a VA rating. We will work with you to gather the necessary evidence and documentation and help you present your case in the most favorable light possible. Contact us today to learn more about how we can help.
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About the Author
Founder & CEO
Brian Reeseis a VA benefits expert, author of the #1 Amazon Bestseller You Deserve It: The Definitive Guide to Getting the Veteran Benefits You’ve Earned, andfounder of VA Claims Insider–“The Most Trusted Name in Education-Based Resources for Veterans.”
His frustration with the8-step VA disability claims processled him to create“VA Claims Insider,”which provides U.S. military veterans with tips, strategies, and lessons learned for successfully submitting or re-submitting a winning VA disability compensation claim.
Brian isalso the CEOofMilitary Disability Made Easy, which is the world’s largest free searchable database for all things related to DoD disability and VA disability claims and has served more than 4,600,000 military members and veterans since its founding in 2013.
His eBook, the“9 Secrets Strategies for Winning Your VA Disability Claim”has been downloaded more than 300,000 times in the past three years and is the #1 rated free VA disability claims guide for veterans.
He is aformer active duty Air Force officerwith extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from theUnited States Air Force Academy, Colorado Springs, CO and he holds an MBA from Oklahoma State University’s Spears School of Business, Stillwater, OK, where he was a National Honor Scholar (Top 1% of Graduate School class).
How does the VA rate depression secondary to chronic pain? ›
The Veteran receives a disability rating for their depression secondary to back pain of 20%. The VA calculates the 20% of the 30% disabled rating above. That is, 20% of 30% is six percent. Adding up 30 and six equals 36%.Can I claim depression secondary to chronic pain? ›
Chronic pain can result in other serious, secondary conditions. One of these is depression. The United States Department of Veterans Affairs (VA) considers depression a ratable illness, and it's possible for veterans to file a claim for disability benefits if they suffer from depression as a secondary condition.Is depressive disorder due to chronic pain syndrome VA? ›
When physical pain causes depression the VA may grant a secondary rating for Depression from Chronic Daily Pain. The foundation of the Chronic Daily Pain Claim must be physical pain. Tinnitus or hearing loss does not qualify.How hard is it to get VA disability for depression? ›
100% VA Rating for Depression
This is difficult to obtain because the symptoms need to be so severe that they totally impair the veteran's life, to the point they are unable to function. The jump from 70 to 100 percent is significant. There is a substantial decline in cognitive and emotional function.
Another two conditions that I think we commonly see secondary to depression include restless leg syndrome and erectile dysfunction. So, perhaps you can walk us through those two conditions. Alex Gamache: Yeah, so regarding the first one of restless leg syndrome.What does the VA look for in depression? ›
The VA defines clinical depression as a condition “characterized by low self-esteem, lack of motivation, lack of interest in social activities, and low energy levels,” and it's a common issue for veterans after they're discharged from service.Can you get VA compensation for depression secondary to knee pain? ›
Yes. The VA allows Veterans to receive disability benefits for secondary conditions, provided they can tie those secondary conditions to their service-connected injury or illness. In this example, a Veteran would have to prove that their secondary condition was caused because of their knee pain or injury.Is sleep apnea a secondary condition to depression? ›
The bottom line? Sleep apnea and mental health conditions like anxiety and depression are oftentimes more connected than Veterans assume. Because of this, sleep apnea often qualifies as a secondary condition to depression or anxiety — and vice versa.What is chronic pain secondary to? ›
Chronic pain (sometimes known as long-term pain or persistent pain) is pain that lasts for more than 3 months. Pain can be secondary to (caused by) an underlying condition (for example, osteoarthritis, rheumatoid arthritis, ulcerative colitis, endometriosis). Chronic pain can also be primary.What percentage of people with chronic pain have depression? ›
Table 2: Prevalence of depression in patients with chronic pain. The lifetime prevalence of depression in chronic pain patients was also estimated in two other studies. The result increased from 12% to 32% in the first study and 32.4% to 56.8% in the second study .
Is depression a permanent disability VA? ›
100% Individual Unemployability (TDIU)
In some cases, a veteran's depression and anxiety are so severe that they are unable to secure and maintain substantially gainful employment. Here, veterans can apply for total disability based on individual unemployability (TDIU) benefits.
Some of the more common secondary conditions include depression, hypertension, chronic pain, skin sores, fractures, contractures, urinary tract infections, respiratory infections, unwanted weight gain, excessive fatigue, and social isolation (Simeonsson & McDevitt, 1999).What is a 70 percent VA rating for depression? ›
A 70 percent rating, may be assigned for occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, ...How much does the VA give for depression? ›
Depression VA Ratings depend on the severity of a veteran's mental health symptoms, meaning, the more severe your symptoms, the higher the VA rating for Depression. The average VA Rating for Depression is currently at 70%, but veterans can be rated from 0% to 100% with breaks at 10%, 30%, 50%, 70%.Can you get SMC for depression? ›
The Veteran receives SMC benefits based on loss of use of both lower extremities with additional independent 100 percent rating for depression; this includes compensation for regular aid and attendance.What is one of the two main criteria for depression? ›
The DSM-5 outlines the following criterion to make a diagnosis of depression. The individual must be experiencing five or more symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure.What is the difference between primary and secondary depression? ›
The Difference Between Primary and Secondary Depression
In primary depression, symptoms are often more severe and more persistent. This type of depression tends to run in families. Secondary depression occurs because of something. For adults with ADHD, it can develop after years of low-self esteem.
Anxiety may occur as a symptom of clinical (major) depression. It's also common to have depression that's triggered by an anxiety disorder, such as generalized anxiety disorder, panic disorder or separation anxiety disorder. Many people have a diagnosis of both an anxiety disorder and clinical depression.How often does the VA reevaluate depression? ›
Basically, the VA can reevaluate your disability rating every 2 to 5 years unless your rating is permanent or protected. Depending on the results of the reexamination and reevaluation, you may see a reduced rating.What is the VA rating for erectile dysfunction? ›
Erectile dysfunction is rated under 38 C.F.R. § 4.115b, Diagnostic Code 7522. Under DC 7522 a 20 percent rating is warranted for deformity of the penis with loss of erectile power. This is the sole disability rating provided under this diagnostic code provision.
How does the VA test for anxiety? ›
A VA rating for anxiety, depression, and/or adjustment disorder is stated as a percentage, from 0% to 100%. These ratings mainly look at your occupational and social functioning, although your ability to take care of yourself (hygiene, grooming) is also considered.What conditions are secondary to knee pain? ›
Other Orthopedic Conditions
For example, knee pain may cause you to favor one leg over the other. The extra stress on the favored leg can then lead to new issues such as hip injuries, foot injuries, or ankle injuries.
Veterans who experience chronic pain due to fibromyalgia may become less active and more withdrawn, which can lead to depression. Veterans who develop depression secondary to fibromyalgia may be eligible for VA compensation. VA rates depression using the General Rating Formula for Mental Disorders.Do you get back pay for secondary VA disability? ›
VA payments can increase because of a VA rating increase on a worsened or secondary disability, or because of an increase in the VA compensation rate. The VA then calculates and pays out any retroactive VA disability back pay owed to you.What sleep problem is most associated with depression? ›
Depression and sleep problems are closely linked. People with insomnia , for example, may have a tenfold higher risk of developing depression than people who get a good night's sleep. And among people with depression, 75 percent have trouble falling asleep or staying asleep.Is insomnia secondary to depression a VA disability? ›
A veteran whose psychiatric condition causes insomnia can qualify for insomnia as a secondary service-connected condition. If a veteran is service-connected for insomnia and then develops depression related to their lack of sleep, they may be eligible for VA disability benefits for depression on a secondary basis.What type of sleep disorder is common for people with major depression? ›
Insomnia, in particular terminal insomnia, is classically associated with major depressive disorder. The relationship between insomnia and mood symptoms is bidirectional in that poor sleep can precede an episode of major depressive disorder, and depressed mood can disrupt normal sleep patterns.What are examples of secondary chronic pain? ›
Examples of chronic secondary pain are chronic pain related to cancer, surgery, injury, internal disease, disease in the muscles, bones or joints, headaches or nerve damage.Which is a good example of chronic pain? ›
It can be constant or intermittent. For example, headaches can be considered chronic pain when they continue over many months or years – even if the pain isn't always present. Chronic pain is often due to a health condition, like arthritis, fibromyalgia, or a spine condition.
- Back Pain.
- Joint Pain.
- Nerve Pain.
Is there a medication that treats both depression and pain? ›
Tricyclic antidepressants are the most common type of antidepressant used for pain. They include: Amitriptyline. Nortriptyline (Pamelor)What is the most painful mental illness? ›
Borderline personality disorder (BPD) has long been believed to be a disorder that produces the most intense emotional pain and distress in those who have this condition. Studies have shown that borderline patients experience chronic and significant emotional suffering and mental agony.How much of chronic pain is psychological? ›
Approximately 1/2 to 2/3 of all patients diagnosed with chronic pain manifest to various levels of psychological distress.How do I increase my VA mental health rating? ›
- 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.
If your application is approved, your secondary condition will be rated with the VASRD (Veteran Affairs Schedule for Rating Disabilities) scale that is used to apply ratings to all disabilities based on the severity of symptoms.What are some secondary VA claims? ›
You can file a secondary claim to get more disability benefits for a new disability that's linked to a service-connected disability you already have. For example, you might file a secondary claim if you: Develop arthritis that's caused by a service-connected knee injury you got while on active duty, or.Which is a common secondary condition with persons with disabilities? ›
For people with disabilities, it also means knowing that health problems related to a disability can be treated. These problems (also called secondary conditions) can include pain, depression, and a greater risk for certain illnesses.What is the 55 year old rule for VA disability? ›
Based on the results of the exam, your disability rating may increase, decrease, or stay the same. Once you turn 55, you are typically "protected" and will no longer have to attend an exam to prove that your condition has not changed unless there is reason to suspect fraud. This is sometimes called the 55-year rule.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 much is 80 percent VA disability? ›
Veterans that obtain an 80 percent VA Disability rating receive $1,933.15 a month from the Veterans Administration. Eligible disabled veterans may also be able to receive extra monthly compensation for dependent children and parents.
Can you get VA Dbq for chronic pain? ›
VA does not have a specific diagnostic code or rating criteria for chronic pain. To receive VA disability benefits for chronic pain, the symptoms resulting must be ratable. In other words, VA assigns ratings based on the functional impact from the service-connected condition.What is the VA rating for adjustment disorder with anxiety and depressed mood? ›
The Veteran's service-connected adjustment disorder with mixed anxiety, depressed mood, and headaches has been rated as 50 percent disabling throughout the appeal period. Disability ratings are based upon VA's Schedule for Rating Disabilities as set forth in 38 C.F.R. Part 4.Do veterans have higher rates of depression? ›
The elevated risk of depression persists after a person's military service ends. Veterans, particularly those who have served in combat, have experienced more trauma in their life than non-veterans. Research shows the following: Depression affects 20% of veterans.How does the VA test for depression? ›
The VA relies on the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) to rate all mental health conditions. As long as a veteran's symptoms meet the frequency, duration and severity outlined in the DSM-5, they should receive a diagnosis of depression.Do you get back pay for SMC? ›
Receiving Back Pay
If a veteran does not receive special monthly compensation when they apply for VA benefits, a successful appeal may entitlement them to back pay of the compensation they should have received while their claim was pending.
2022 VA SMC Rates.
|SMC Level||SMC Monthly Amount in 2022 COLA|
70% VA Rating for Depression and Anxiety
The 70 percent disability rating criterion for depression and anxiety is the most inclusive insofar as it represents a wide array of symptoms, including a progression of symptoms noted in the lower disability ratings.
If your application is approved, your secondary condition will be rated with the VASRD (Veteran Affairs Schedule for Rating Disabilities) scale that is used to apply ratings to all disabilities based on the severity of symptoms.Is chronic pain a mental health VA rating? ›
VA Ratings for Chronic Pain
So, veterans don't receive a VA disability rating for chronic pain specifically. In order to receive VA disability compensation for chronic pain, the symptoms caused by the chronic pain disorder must be ratable. For example, oftentimes a veteran's chronic pain will cause depression.
The bottom line? Sleep apnea and mental health conditions like anxiety and depression are oftentimes more connected than Veterans assume. Because of this, sleep apnea often qualifies as a secondary condition to depression or anxiety — and vice versa.
Which is not a symptom of depression? ›
During a depressed period, you may feel sadness, hopelessness, and loss of interest in activities. But then it will switch to a period of mania, when you feel euphoric, energetic, or irritable. Those are not symptoms of clinical depression.Do you need a Nexus letter for secondary condition? ›
All secondary conditions or conditions caused by military exposure/circumstances not included on the Presumptive List benefit from a Nexus Letter supporting the claim.Do secondary conditions increase VA rating? ›
A secondary condition can influence the disability rating that a Veteran receives from the VA. If a Veteran is suffering from mental or physical problems stemming from a service-related disability, these problems can lead to an increase in the disability rating that the Veteran receives from the VA.