Pain is considered to be chronic when it is present for six months or longer. Chronic pain usually 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
- Impaired sleep
- Suicidal ideation
- Social withdrawal
- Memory and cognitive impairment
- Relationship problems
- Substance abuse
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’s brain. 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.
VA Ratings for Chronic Pain
The VA does not have a specific diagnostic code for chronic pain. 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. 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 be a service-connected condition. For example, a veteran with a service-connected back condition suffers 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.
Evidence for Your Claim
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 getting a medical opinion from a private doctor due to the complexity of the condition. 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 is not service connected, the doctor needs 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 conditions. 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 depression secondary to 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.
Lastly, don’t forget applying for individual unemployability. Veterans with chronic pain not only have physical impairments that affect their ability to work, they also have mental impairments 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 specific limitations 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 an orthopedic condition will 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.