With military service comes hard work.
Current and former members of the armed forces have to engage in a variety of activities that could result in lower back injuries, such as carrying and lifting heavy equipment, extended periods of standing and repetitive motions, rifle training, combat, and parachuting from aircraft.
These physical demands take their toll on the spine, and it is not uncommon for our veterans to find themselves dealing with back pain that hinders their quality of life.
Veterans who have had spinal fusion surgery are potentially eligible for VA benefits relating to the spinal fusion. Unfortunately, constant changes to regulations have resulted in a process that can be confusing to many former service members.
This article will detail how spinal fusions factor into VA disability ratings and how you can get benefits for your service-related spinal fusion injury.
What is Spinal Fusion?
Spinal fusion is when two or more vertebrae in the spine are fused together as a surgical technique.
This is done to decrease the damage, pain, and discomfort that a disease or injury causes. Successful spinal fusion results in the stoppage of motion at these places with the potential use of plates, rods, and screws, providing the patient with stability and back pain relief.
Spinal fusion, or ankylosis, comes in two forms; favorable and unfavorable.
- Favorable ankylosis is when the spinal fusion does not result in changes to posture or standing/sitting form.
- Unfavorable ankylosis occurs when spinal fusion causes posture changes such as hunched back or leaning to the side.
Unfavorable ankylosis can result in symptoms such as:
- Difficulty walking
- Difficulty breathing
- Neurological issues
Common Causes of Spinal Fusion
Veterans may find themselves dealing with back pain during their enlistment, or it could develop months to years after their separation from the armed forces. Dealing with back and spine ailments are hugely detrimental to one’s quality of life, and spinal fusion could be a potential solution to some of those symptoms.
Common ailments that may necessitate spinal fusion include:
- Scoliosis and other spinal deformities: Spinal deformities like scoliosis cause the shape of the spine to be unnatural, curved, and/or twisted. These deformities can occur as a result of service-related tasks and injuries and cause pain and discomfort.
- Herniated discs: Because the discs between your vertebrae act as your body’s shock absorbers, they are under considerable stress when performing strenuous activities or when on the receiving end of an injury. Herniation occurs when these discs rupture and can no longer provide cushioning for your vertebrae.
- Arthritis: Repetitive or irregular motion in the back can result in an uneven use of the muscles and vertebrae. This can cause arthritis, which is a chronic inflammation of the facet joints in the spine or sacroiliac joints between the spine and pelvis. Arthritis can also exacerbate other back-related injuries.
Establishing a Service-related Connection to Spinal Fusion
Before understanding how VA ratings for spinal fusion work, you will first need to understand how to connect the spinal fusion to a service-related injury to be eligible for VA benefits. This is because the VA will only pay benefits for injuries that occurred during or as a result of military service.
The VA requires the following to establish an injury’s connection to military service:
- A current diagnosis for a spinal condition that necessitates spinal fusion as treatment
- Evidence that the injury or accident that caused the condition that necessitates the spinal fusion occurred while on duty
- A documented medical nexus or link between the diagnosed condition and the service-related injury or event
You will need to ensure that you have the medical nexus as it is absolutely necessary to establish the connection. Without it, your claim will be automatically denied.
Gathering all of your medical documents that detail the development of your pain and symptoms should be your first step.
You will need to gather
- Information regarding the incident that led to your injuries
- Any evidence that supports your statements of what happened
- Support from others, such as a buddy statement.
It’s crucial to note any discomfort or pain in the area that may have existed before your enrollment because your service may have significantly worsened or reinjured a prior injury.
How the VA Rates Spinal Fusions
VA ratings for spinal fusion follow the same process as other spinal conditions and are based on the range of motion defined in 38 CFR § 4.71a. The ratings range from 10% (minor afflictions) to 100% (significant impairment of the entire spine).
When judging the veteran’s range of motion, doctors measure the maximum angle of movement before you experience pain. The range is determined based on forward, backward, left, and right angles of movement. Essentially, the more limited you are, the higher your rating will be.
You can find these VA ratings below.
Back Pain VA Rating Table
| Back Pain Symptoms | VA Rating |
|---|---|
| Forward flexion of the thoracolumbar spine up to 85° or of the cervical spine up to 40° OR the combined range of motion at 120°-235° for thoracolumbar or 170°-335° for cervical. This level can also have muscle spasms, muscle guarding, and pain without abnormal gait or curves. | 10% Disability Rating |
| This level is basically less flexion: 30°-60° of flexion for the lower to the middle back and 15°-30° for your neck. Combined thoracolumbar less than 120° or cervical combined less than 170° or muscle spasms or guarding enough to cause abnormal gait or an abnormal contour of your spine. | 20% Disability Rating |
| Cervical spine forward flexion of 15° or less or favorable ankylosis of the entire cervical spine. | 30% Disability Rating |
| Unfavorable ankylosis of the entire cervical spine, forward flexion of the thoracolumbar spine of 30° or less, or favorable ankylosis of the entire thoracolumbar spine area. | 40% Disability Rating |
| Unfavorable ankylosis of the entire thoracolumbar spine. | 50% Disability Rating |
| Unfavorable ankylosis of the entire spine. | 100% Disability Rating |
For a specific example, if you have 120° of combined range of motion in your thoracolumbar spine (everything from the middle of your back down), you will receive a rating of 20%. It’s imperative to understand these ratings as they determine the benefits you are entitled to.
If you receive a rating of 20% or below, you will not be eligible for a higher rate if you have a dependent, spouse, or child in the way you would with a 30% or higher rating.
You will, however, be eligible for these monthly compensation rates:
- 10% – $152.64
- 20% – $301.74
Those with higher ratings will receive modified rates based on their dependents.
Spinal Fusion VA Disability Rating 30-60%
| Dependent Status | 30% | 40% | 50% | 60% |
|---|---|---|---|---|
| Veteran alone (no dependents) | $476.39 | $673.28 | $958.44 | $1,214.03 |
| With spouse (no parents or children) | $522.39 | $747.28 | $1,050.44 | $1,325.03 |
| With spouse and 1 parent (no children) | $566.39 | $806.28 | $1,124.44 | $1,414.03 |
| With spouse and 2 parents (no children) | $610.39 | $865.28 | $1,198.44 | $1,503.03 |
| With 1 parent (no spouse or children) | $511.39 | $732.28 | $1,032.44 | $1,303.03 |
| With 2 parents (no spouse or children) | $555.39 | $791.28 | $1,106.44 | $1,392.03 |
Disability rates for the 70% to 100% ratings differ a bit from the 30-60% ratings in how bonuses are allocated based on dependents.
Spinal Fusion VA Disability Rating 70-100%
| Dependent Status | 70% | 80% | 90% | 100% |
|---|---|---|---|---|
| Veteran with child only (no spouse or parents) | $1615.95 | $1877.43 | $2109.52 | $3456.3 |
| With 1 child and spouse (no parents) | $1754.95 | $2035.43 | $2287.52 | $3653.89 |
| With 1 child, spouse, and 1 parent | $1858.95 | $2154.43 | $2421.52 | $3802.99 |
| With 1 child, spouse, and 2 parents | $1962.95 | $2273.43 | $2555.52 | $3951.09 |
| With 1 child and 1 parent | $1719.95 | $1996.43 | $2243.52 | $3605.40 |
| With 1 child and 2 parents (no spouse) | $1823.95 | $2115.43 | $2377.52 | $3754.50 |
Since symptoms can improve and worsen over time, veterans are encouraged to have their rating re-evaluated every couple of years as ratings are not permanent. It’s important to ensure that your ratings are accurate, especially if they worsen, as an increase as small as 10% is the difference between thousands of dollars a year.
