Radiculopathy VA Rating: Combining Back and Leg Ratings

A back problem doesn't always stay in the back. A herniated disc or another spine condition can press on or irritate a nerve and send pain, numbness, tingling or weakness down the leg. If you are a veteran with a service-connected back condition and symptoms like these, a back rating alone may not capture them. The VA may be able to rate your back and your leg separately, then combine those ratings into one overall rating.

At Friedman Law Firm, we help veterans with VA disability claims. Here is how these ratings work.

How Back Conditions and Leg Symptoms Are Connected

Back conditions include lumbar strain, degenerative disc disease and herniated discs. Some mainly involve the muscles and ligaments. Others involve the discs and the nerves next to them.

Radiculopathy, often called a pinched nerve, is what happens when a nerve root is compressed or irritated where it leaves the spine. Sciatica refers to pain, weakness, numbness or tingling in the leg caused by injury to or pressure on the sciatic nerve. A herniated disc is one common cause.

Not every back condition causes nerve problems. The question in your claim is whether the medical evidence connects your leg symptoms to your back condition.

How the VA Rates the Back

The VA rates most spine conditions under its General Rating Formula for Diseases and Injuries of the Spine. Lumbar strain, degenerative disc disease and intervertebral disc syndrome all fall under this formula. For the lower and middle back, the rating depends largely on how far you can bend forward:

Lower and middle back (some of the criteria)

• 10%: Forward bending greater than 60 degrees but not greater than 85 degrees, or muscle spasm, guarding or localized tenderness that does not cause an abnormal walk or spinal shape
• 20%: Forward bending greater than 30 degrees but not greater than 60 degrees, or muscle spasm or guarding severe enough to cause an abnormal walk or spinal shape
• 40%: Forward bending of 30 degrees or less, or favorable ankylosis (fixation) of the entire thoracolumbar spine
• 50%: Unfavorable ankylosis of the entire thoracolumbar spine
• 100%: Unfavorable ankylosis of the entire spine

A herniated disc that compresses or irritates the nearby nerve root may be rated as intervertebral disc syndrome, which has a second option. That method looks at incapacitating episodes, meaning periods of acute symptoms that require bed rest prescribed by a physician and treatment by a physician. It provides ratings from 10% to 60%. The VA uses whichever method gives the higher result once all of your disabilities are combined.

How the VA Rates Radiculopathy and Sciatica

The spine formula says that associated objective neurologic abnormalities are evaluated separately under their own diagnostic code. This is what allows a leg rating alongside a back rating.

The word "objective" matters. The back formula already applies with or without pain, "whether or not it radiates." So it helps when the medical record documents nerve findings and not only a report of pain.

There is no single code for radiculopathy. The VA looks at which nerve is involved. When it is the sciatic nerve, the VA uses Diagnostic Code 8520, and each leg is rated on its own:

Sciatic nerve (one leg)

• 10%: Incomplete paralysis, mild
• 20%: Incomplete paralysis, moderate
• 40%: Incomplete paralysis, moderately severe
• 60%: Incomplete paralysis, severe, with marked muscular atrophy
• 80%: Complete paralysis

"Incomplete paralysis" means function is lost or impaired substantially less than in complete paralysis. When the problem is wholly sensory, the rule says the rating should be for the mild or, at most, the moderate degree.

Part of the Back Condition, or a Secondary Condition?

A nerve problem that comes from the back condition. The spine formula itself calls for rating the neurologic abnormality separately. This isn't rating the same disability twice, which the VA's rule against "pyramiding" forbids. The back rating and the nerve rating are meant to reflect different effects. But the same symptom can't be counted under both.

A secondary condition. A secondary condition is a separate disability that a service-connected condition caused or made worse. For example, a veteran might claim a hip or knee problem as secondary if a doctor links it to the way a back condition has changed how they walk. A claim like this generally needs medical evidence of that link. If the condition already existed and the back made it worse, the VA also looks for evidence of how severe it was before it worsened.

You may see radiculopathy described either way in VA paperwork. Either way, a leg rating is a separate percentage that goes into the combined calculation. Both routes start from a service-connected back condition, so if your back isn't service connected yet, that is the first issue to address.

How Back and Leg Ratings Combine

VA ratings don't simply add together. The VA starts with the highest rating, then applies each lower rating only to the part of you it treats as not yet disabled. It rounds to the nearest 10 once, at the very end, and a value ending in 5 rounds up. We explain this further in How Are VA Ratings Added Together?

Example 1: back and one leg. Say a veteran has a 40% back rating and a 20% rating for the right leg.

• 40% leaves 60% remaining.
• 20% of that 60 is 12.
• 40 + 12 = 52, which rounds to a 50% combined rating, not 60%.

Example 2: back and both legs. When each leg has a rating of at least 10%, the bilateral factor applies. Say the same veteran has 20% for each leg.

• The two legs combine first: 20 and 20 make 36.
• The bilateral factor adds 10% of that value: 36 + 3.6 = 39.6, treated as 40.
• Then 40 (back) and 40 (legs): 40% of the remaining 60 is 24, and 40 + 24 = 64, which rounds to a 60% combined rating, not 80%.

These numbers are only illustrations. Your own ratings depend on your medical evidence and the VA's decision.

Evidence That Can Help

• Medical records that diagnose the back condition and document the leg symptoms, including findings on strength, reflexes and sensation.
• Your C&P exam. Tell the examiner about your leg symptoms as well as your back, and describe your bad days too.
• Your own statement about how the symptoms affect walking, standing, sitting and working.
• A medical opinion when the link between conditions is in question, especially for a secondary condition.

If your leg symptoms were never rated, you may be able to file a claim for them using this same kind of evidence. If the VA denied your claim, there are appeal options.

Increasing a Back or Leg Rating When Symptoms Worsen

Back and nerve conditions can get worse over time, and you can ask the VA to increase your rating when that happens. The evidence needs to show a change that fits the rating criteria. For the back, that might be forward bending that has dropped from above 60 degrees to 60 degrees or less. For the sciatic nerve, it might be a move from mild to moderate or higher. Because wholly sensory problems stop at the moderate level, records of weakness or muscle wasting can matter.

An increase on one condition also changes the combined math. In our first example, raising the leg from 20% to 40% moves the combined value from 52 to 64, which rounds to 60%.

Expect that the VA may schedule a new C&P exam, and be sure to attend. Timing matters too. The increase may reach back to when the evidence shows it happened, but only if the VA receives your complete claim or intent to file within one year of that date. Otherwise, it generally starts when the VA receives your claim.

Individual Unemployability for Back and Leg Conditions

If your service-connected conditions keep you from working, Individual Unemployability can provide payment at the 100% rate without a 100% rating. The VA asks whether those conditions leave you unable to secure or follow a substantially gainful occupation. It also has percentage requirements: one disability rated at 60% or more, or two or more disabilities with at least one rated at 40% or more and a combined rating of 70% or more.

For those requirements, disabilities of one or both legs count as one disability, and so do disabilities from a common cause. That can matter when a back condition and leg nerve problems share a cause.

Our examples show the limits. The first, at 50%, falls short either way. The second, at 60%, does not reach 70%. It could meet the 60% requirement only if the back and both legs are treated as one disability, and you would still have to show you cannot work. Veterans below these percentages may still be considered in some cases.

Frequently Asked Questions

Can I get separate VA ratings for back pain and sciatica?

Possibly. If medical evidence shows objective nerve findings connected to your service-connected back condition, the VA's spine formula calls for evaluating them separately from the back.

What is the VA rating for radiculopathy?

It depends on the nerve and the severity. For the sciatic nerve, the rating is 10%, 20%, 40% or 60% for incomplete paralysis and 80% for complete paralysis, per leg.

Do my back and leg ratings add together?

No. The VA combines them using its combined ratings table. A 40% back rating and a 20% leg rating come to 52, which rounds to 50%.

What is a nexus letter, and why could it be important?

A nexus letter is a written medical opinion linking a condition to your service or to a service-connected condition. Claims generally need a medical opinion on that link, but it doesn't have to come in a separate letter. Your diagnosis, treatment notes, discharge summary, or a specialist's report can contain one. A nexus letter can be especially important when the link is in question, such as whether your leg symptoms come from your back. It doesn't guarantee a result, and as we explain in our post on negative VA opinions, an opinion carries more weight when it gives reasons.

Talk to Friedman Law Firm

If you have a service-connected back condition and pain, numbness or weakness in your legs, or you think your rating is too low, Friedman Law Firm wants to hear your story. Contact us to talk about your VA disability claim.