How Do I Win a Back Pain Case at the VA?
By Douglas I. Friedman of Friedman Law Firm, P.C.
Tuesday, September 15, 2020
Why Winning is Hard.
Winning a back pain case with the VA is difficult. The VA does not award total disability for back pain alone. Usually, you must also have limited range of motion, as well. The VA rates joint pain, including back pain, at 10%, which is about $140/month in 2020– It’s not much!
What the VA is looking for.
If the pain is severe enough to keep you in bed, the VA will look at the number of “incapacitating” episodes you have had in the last twelve months. An incapacitating episode means that your doctor prescribed bed rest, along with treatment from the doctor. So, the back condition has to be pretty bad to meet these requirements.
What should I do?
You can’t just crawl into bed and tough it out. Your doctor must be aware of what is going on, and must treat you. And the doctor’s records should reflect that they told you to stay in bed.
Also, go ahead and submit all of your medical records to the VA from your private physicians. Don’t rely on the VA to obtain these records for you.
You might also consider keeping a diary of how you feel each day, and if your activities are limited, how and to what extent.
Other considerations.
The most important part of your claim is going to be the examination that the VA schedules for you about your back– the Compensation and Pension (C&P) Exam. This exam is conducted by a medical professional who has not treated you. The examiner fills out a form that corresponds to the requirements of the VA back rating criteria. These criteria often are not discussed in the treating physician’s records, so this will often be the only information the VA has on these criteria.
The VA puts great weight on these exams, and, obviously, your treating doctor knows you better than someone who has never met you. See if your medical provider, at the VA or elsewhere, would be willing to complete the form, called a Disability Benefits Questionnaire. This could help your case greatly.
The VA used to encourage veterans to submit DBQs from their own doctors, but recently the VA has removed the DBQs from their website. So, now it's harder to find the forms, but they are available in other places online.
Contact us with questions or for assistance.
If you have questions about C&P exams or your claim for back conditions, you can reach us at 205-879-3033 or Lifehealth@FriedmanFirmPC.com.
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