If you are a veteran suffering from neck pain or other cervical injuries connected to your military service, you can make a claim for VA disability benefits. Unfortunately, the VA disability process can be complex, and VA disability claims decisions are not always what they should be.
If the VA has denied or underrated your VA disability claim for cervical injury, you have appeal options that could increase your VA disability rating. This article discusses the cervical injuries VA disability claims process and ways to handle a VA disability rating dispute regarding your cervical disability.
The VA Disability Rating process
As a brief overview, veterans with current and service-connected disabling conditions can apply for VA disability benefits, tax-free monetary payments.
The first step is to file an Application for Disability Compensation and Related Compensation Benefits (VA Form 21-526EZ). The VA will review your application, your service and medical records, and decide if (1) you have a disabling condition; (2) if it is service-connected; and, if so, (3) what the disability rating is (a number from 0% to 100%), and (4) what the effective date is (usually the date the claim was filed). If you have more than one disability, the VA will also provide a combined or overall disability rating which will be used to calculate monthly benefits.
Statistically, over 70% of initial claims are denied. However, many of the reasons those claims are denied can be fixed or overcome on appeal of that initial decision. Per VA reporting, over 70% of VA claim appeals either result in an allowed claim or a remand (or another review).
If you disagree with the initial decision on your VA disability claim, you can file one of three types of VA disability appeals (the VA calls these “decision reviews”) within one year. This is the process for seeking an increased VA disability rating. You can ask for a Higher Level Review (same information reviewed by a more experienced claim reviewer), a Supplemental Claim (you can add additional evidence), or a Board Review (with a live hearing before a Veterans Law Judge).
Although you cannot hire an attorney to assist with preparing and filing your initial claim, you can hire a VA disability claim attorney for your appeal. In most cases, an experienced VA disability claims appeal attorney will only get paid when you get paid.
Common cervical injuries for veterans and how the VA rates them
Some of the more common cervical injuries include cervical sprain, degenerative disc disease/degenerative joint disease (DDD/DJD), and Intervertebral Disc Syndrome (IVDS) of the neck.
All diseases and injuries of the spine, including cervical (neck), are rated on the same scale from 10% to 100%, except for IVDS, which has its own separate formula and a scale of 10% to 60%.
The formula for rating IVDS is based on the duration of incapacitating episodes you have had in the past 12 months. For example, incapacitating episodes with a total duration of at least six weeks during the past year would be rated at 60%, but incapacitating episodes of 1-2 weeks in the past 12 months would be rated at only 10%. See a rating sheet for IVDS here. Importantly, if your IVDS is rated under the Diagnostic Code 5243 rating criteria, you will not be able to be rated separately for radiculopathy, where if you are rated based on range of motion alone, you can get them under separate evaluations.
The rating formula for other cervical injuries is based primarily upon degrees of bending movement (flexion) and immobility (ankylosis). Some other considerations are specific ranges of motions, muscle spasms, guarding, localized tenderness, or bone fracture.
An increase in your VA disability rating can be requested through the appeal (decision review) process with the VA.
What should you expect monetarily for cervical disabilities?
Monthly VA disability benefit payments are based on your overall rating number. Click here for a VA benefits calculator.
The VA doesn’t consider your marital status or dependents for overall disability ratings of 10% or 20%.
For VA disability ratings of 30% thru 60%, however, monthly rates are calculated dependent of whether you have a dependent spouse, parents, and/or children and with certain add-ons. For example, a single veteran with no dependents and a 60% disability rating will get $1,214.03, but with a spouse and two dependent children, the monthly amount is $1,462.03.
For VA disability ratings of 70% – 100%, monthly rates are also calculated with reference to the veteran’s family structure. For example, a married veteran with a 70% disability rating and one child can expect $1,754.95, and for a 100% rating would receive $3,653.89. (Note that the exact dollar amounts are adjusted annually by the VA.)
Can you receive TDIU for cervical disabilities?
Yes, a Total Disability Individual Unemployability (TDIU) finding can be made by the VA with respect to any disability that meets the TDIU criteria, including disabling cervical conditions.
TDIU requires meeting both of the following conditions: (1) the veteran must have at least one service-connected disability rated at 60% or more, or 2 or more service-connected disabilities (at least one of which is 40% of higher) with a combined disability rating of 70% or more, AND (2) the veteran must be able to show that he/she cannot maintain substantially gainful employment (a steady job that supports them financially) because of the service-connected disability. Learn more about TDIU claims here.
Has your cervical VA disability claim been denied or underrated by the VA? Veterans Law Group has helped thousands of veterans to get the VA disability benefits they deserve, and they may be able to help you too. Click here for a free evaluation of your case.