Lumbosacral strain ranks among the most prevalent musculoskeletal injuries experienced by U.S. veterans, due to the rigorous physical demands of military service. Understanding how this injury impacts your daily life and how the VA evaluates it is crucial for securing the benefits you deserve.
In this guide, we will explore what lumbosacral strain is, how it’s rated by the VA, related secondary conditions, and strategies for increasing your rating. Armed with the right information, you can better navigate the claims process and protect your rights.
What Is Lumbosacral Strain?
Lumbosacral strain refers to a soft tissue injury affecting the lower back, specifically in the lumbosacral region, the area between the bottom of the ribcage and the top of the buttocks. This part of the spine is essential for body support, movement, and the protection of spinal nerves. When the muscles, tendons, or ligaments in this region become overstretched or torn due to overuse, trauma, or improper movement, the result is a lumbosacral strain.
Risk Factors in Veterans
For many veterans, this injury is directly tied to their service. Military duties often involve repetitive bending, lifting, carrying heavy loads, or operating in combat or physically demanding environments, all of which significantly increase the risk of lumbar strain. Over time, these physical demands can cause microtears or inflammation in the soft tissues of the lower back, leading to chronic pain, stiffness, and a reduced ability to perform daily tasks.
Symptoms of Lumbosacral Strain
Common symptoms include:
- Persistent or intermittent pain targeting the lower back
- Muscle stiffness or spasms affecting the lumbar area
- Difficulty bending, twisting, or lifting
- Reduced range of motion
- Tenderness or swelling in the affected area
- Radiating pain into the hips or legs (if nerves are involved)
In some cases, veterans may also experience numbness or tingling in the lower extremities, especially when the strain impacts nearby nerves.
Treatment for lumbosacral strain usually involves physical therapy, pain management with medication, hot and cold therapy, and in severe cases, injections or surgery.
Does the VA Recognize Lumbosacral Strain as a Disability?
Yes, because of the physical and emotional toll that lumbosacral strain can take, it’s a condition that can qualify for a VA disability rating and compensation, potentially ranging from 10% to 100% based on severity.
To secure benefits, veterans must establish a service connection by proving:
- A current diagnosis of lumbosacral strain.
- An in-service event, injury, or accident that triggered or worsened the back injury. This can include evidence such as deployment records (DD214), accident reports, service treatment records, or statements from fellow service members.
- A medical nexus linking the lumbar spine injury to your time in service. The independent medical examiner must clearly explain in the letter that your lumbosacral strain is “at least as likely as not” connected to your service.
Often, the VA will also schedule a Compensation & Pension (C&P) exam, where an examiner assesses your back’s range of motion, flexibility, pain levels, and functionality.
Understanding Lumbosacral Strain VA Ratings
The VA assigns ratings for lumbosacral strain using Diagnostic Code 5237 under 38 CFR § 4.71a, which covers the General Rating Formula for Diseases and Injuries of the Spine. Ratings typically range from 10% to 100% based on the severity of your symptoms and limitations on motion.
Here’s an explanation of how the VA rating for lumbosacral strain is assigned:
- 10% VA Rating: Forward flexion of the thoracolumbar spine between 60-85 degrees; minor pain and tightness without major functional loss.
- 20% VA Rating: Forward flexion between 30-60 degrees, or moderate muscle spasms causing an abnormal gait or posture.
- 40% VA Rating: Forward flexion of the spine limited to 30 degrees or less, or the presence of favorable ankylosis, where the spine is stiff but remains properly aligned.
- 50% VA Rating: Unfavorable ankylosis of the thoracolumbar spine, where the spine is stuck in a harmful bent position.
- 100% VA Rating: Unfavorable ankylosis affecting the entire spine, resulting in complete immobility with the spine locked in an abnormal posture.
The lumbosacral strain VA rating is primarily based on how much the veteran’s spine flexibility is impaired, but additional factors like nerve involvement, muscle weakness, and incapacitating episodes requiring prescribed bed rest are also critical.
When conditions such as ankylosis or radiculopathy are present, veterans may qualify for separate ratings, potentially increasing overall compensation.
Lumbosacral Strain With Degenerative Disc Disease VA Rating
In many cases, a lumbosacral strain leads to or accompanies Degenerative Disc Disease (DDD), a condition where the cushioning discs between vertebrae wear out over time.
Lumbosacral strain with degenerative disc disease VA rating can be assessed either under the General Rating Formula or the Formula for Rating Intervertebral Disc Syndrome (IVDS), whichever offers the higher benefit.
If Intervertebral Disc Syndrome is diagnosed, VA disability ratings are assigned based on the duration of incapacitating episodes:
- 60% Rating: Incapacitating episodes lasting 6 weeks or more over the past year.
- 40% Rating: Episodes lasting at least 4 weeks but less than 6 weeks over the past year
- 20% Rating: Episodes lasting at least 2 weeks but less than 4 weeks over the past year
- 10% Rating: Episodes lasting at least 1 week but less than 2 weeks over the past year
In cases where Degenerative Disc Disease causes frequent hospitalizations or doctor-prescribed bed rest, ratings up to 60% are possible under IVDS.
Understanding whether your lumbosacral strain caused secondary conditions like IVDS or DDD can help maximize your VA rating.
Lumbosacral Strain With Degenerative Arthritis VA Rating
If your lumbosacral strain is complicated by degenerative arthritis, you may also be rated under Diagnostic Code 5003 for degenerative arthritis of the spine. This condition causes painful motion and loss of flexibility due to the deterioration of the joints themselves.
To qualify for a higher VA rating, the following must be documented:
- Confirmed diagnosis of degenerative arthritis through X-ray or imaging
- Evidence of limited range of motion or pain during movement
- Functional loss affecting daily activities or employment
- Chronic symptoms such as stiffness, weakness, or flare-ups
When motion is limited but not significantly impaired, a minimum rating of 10% may be given. However, if the combination of strain and arthritis leads to serious restrictions, the rating can be increased significantly.
For example, a veteran who had initially received a 10% VA rating for lumbosacral strain layer was diagnosed with degenerative arthritis, causing additional stiffness, pain and reduced motion. With forward flexion limited to 55 degrees and documented functional loss, the combination led to an increased 20% VA rating to reflect the worsened condition.
Considerations For Filing Your Lumbosacral Strain VA Claim
- Gather Evidence: Collect service treatment records, private medical records, a nexus letter linking the lumbar spine pain to military service, and buddy statements supporting your condition.
- Complete VA Form 21-526EZ: Fill out the VA disability claim application form accurately.
- Submit Your Claim: File online at VA.gov, by mail, or in person at a VA regional office.
- Attend a C&P Exam: Be prepared for a Compensation & Pension exam to evaluate your back pain symptoms.
- Track Your Claim Status: Monitor your VA claim through eBenefits or VA.gov for updates.
- Respond Quickly to VA Requests: Submit any additional evidence the VA asks for without delay to avoid processing delays.
Submitting thorough documentation at each step helps maximize your chances for VA disability benefits.
Secondary Conditions Related to Lumbosacral Strain
Many veterans develop additional conditions directly caused by or aggravated by their lower back injury. These secondary conditions to lumbar spine injury can greatly increase your total VA disability rating if properly claimed and documented. Here are the most common conditions linked to lumbosacral strain:
1. Lower Back Pain
Persistent lower back pain is the hallmark symptom of lumbosacral strain, often worsening over time due to continuous muscle strain and inflammation.
2. Radiculopathy
Radiculopathy occurs when the lumbosacral strain causes nerve root compression, resulting in sharp pain, numbness, and weakness radiating down the legs. According to Johns Hopkins Medicine, compression or inflammation at the lumbar or sacral nerve roots (L4-S1) is a common cause of radiculopathy.
3. Sciatica
Sciatica develops when the sciatic nerve is irritated by inflamed tissues or displaced discs associated with chronic lumbosacral strain, causing shooting pain down the lower extremities.
4. Degenerative Disc Disease (DDD)
Over time, the stress from an unresolved lumbosacral strain can cause spinal discs to deteriorate, leading to degenerative disc disease and worsening mobility loss. Research shows 131,986 active duty service members were diagnosed with degenerative disc disease (DDD) between 2001 and 2010 during hospitalization or at least two outpatient visits.
5. Intervertebral Disc Syndrome (IVDS)
Lumbosacral strain can predispose veterans to IVDS by weakening spinal structures, making the discs more prone to bulging or herniation, which limits spinal motion and causes severe episodes of incapacitation.
6. Bladder or Bowel Incontinence
Severe cases of nerve damage due to untreated lumbosacral strain may interfere with bladder and bowel control, qualifying for additional VA compensation under secondary conditions.
7. Depression and Anxiety
Chronic pain and physical limitations from lumbosacral strain often lead to mental health issues like depression and anxiety, especially when a veteran’s daily independence is significantly reduced.
8. Sleep Disorders
Pain associated with a lumbosacral strain can make it difficult to find comfortable sleeping positions, leading to insomnia or sleep apnea over time.
Obtaining a nexus letter from a qualified medical professional can be crucial in linking these secondary conditions to your primary lumbosacral strain, strengthening your VA disability claim and helping you secure the benefits you deserve.
Tips on Increasing Your Lumbosacral Strain VA Rating
If you believe your lumbosacral strain VA rating does not accurately reflect your current level of disability, it’s important to know that you have options to seek an increase. Taking the right steps can lead to higher monthly compensation and access to additional VA benefits.
1. Request a Re-Evaluation Based on Worsening Symptoms
If your back condition has deteriorated, such as experiencing worsened mobility, increased flare-ups, or new symptoms such as nerve pain, you should request a new Compensation and Pension (C&P) exam to reassess your condition.
At the exam, be honest about your pain levels and movement limitations. Make sure your C&P exam notes any signs of painful motion, instability, flare-ups, or the use of assistive devices like canes, walkers, or back braces, which can directly impact your final VA rating.
2. File VA Form 21-526EZ to Request an Increased Rating
To formally seek a higher disability rating, you must file VA Form 21-526ez (Application for Disability Compensation and Related Compensation Benefits). Filing this form starts the process for re-evaluation of your lumbosacral strain by the VA.
3. Gather Fresh and Detailed Medical Evidence
Submit updated medical records, MRIs, physical therapy notes, or any surgical reports that document how your condition has worsened. Evidence showing increased pain, reduced range of motion, or additional diagnoses (such as degenerative disc disease or radiculopathy) may strengthen your case.
4. Document Functional Loss and Daily Limitations
Keeping a daily journal or collecting buddy statements can illustrate how your lumbosacral strain impacts your ability to work, perform basic household tasks, exercise, or even carry out personal care, helping you justify an increased rating for severe functional impairments.
5. Identify and File for Secondary Conditions
If your lumbosacral strain has caused or worsened conditions like degenerative disc disease, radiculopathy, sciatica, or mental health issues, you can file additional secondary claims, which can significantly boost your combined disability rating.
6. Obtain a Medical Nexus Opinion
If your symptoms have significantly worsened, consider obtaining an updated nexus letter from a qualified medical professional that links your increased severity directly to your service-connected lumbosacral strain and clarify worsening of symptoms. While these are never required they may be helpful in some circumstances. Follow up with an accredited VA legal professional as needed for guidance.
Our team specializes in providing high-quality Independent Medical Opinions and nexus letters to help strengthen your VA disability claim.
7. Understand the VA’s Rating Thresholds
Knowing that bending your thoracolumbar spine to only 30 degrees or less can qualify for a 40% VA rating or that ankylosis (spinal fusion) could qualify for 50% or even 100%, helps ensure you and your medical providers focus on meeting the specific criteria necessary for higher ratings.
8. Consider TDIU If You Can No Longer Work
If your lumbosacral strain has worsened to a point where it is impossible to hold substantially gainful employment, applying for TDIU benefits can provide you with compensation at the 100% disability rate, even if your schedular ratings are lower.
TDIU and Special Monthly Compensation (SMC) for Severe Cases
Severe lumbosacral strain can sometimes prevent veterans from maintaining substantially gainful employment. If that’s your situation, you may qualify for Total Disability based on Individual Unemployability (TDIU).
Requirements for TDIU:
- One service-connected disability rated at least 60%, or
- Two or more disabilities with a combined VA disability rating of 70% (one at least 40%).
Additionally, Special Monthly Compensation (SMC) may be available if you require regular aid and attendance or suffer from severe conditions impacting your daily life.
These additional benefits ensure that severely disabled veterans receive the full financial support they deserve.
Got a Denied Claim for Lumbosacral Strain? Here’s How to Appeal
The VA appeals modernization act discusses several avenues. Receiving a claim denial or a lower lumbar strain VA rating can be frustrating for struggling veterans. Fortunately, you have multiple appeal options:
- Supplemental Claim: This option allows you to submit new and relevant evidence that wasn’t previously considered.
- Higher-Level Review: You can request a more experienced VA reviewer to reexamine your case.
- Board Appeal: You have the right to escalate your case to the Board of Veterans’ Appeals, where you may request a formal hearing before a Veterans Law Judge.
Hiring an accredited VA disability attorney or working with a veterans service organization (VSO) can significantly improve your chances of success, especially if your case involves complicated secondary service connections or TDIU.
Final Thoughts
Securing a fair VA rating for lumbosacral strain can improve your quality of life and financial stability. Focus on clear medical documentation, highlight functional limitations, and understand how secondary conditions can increase your total benefits. A detailed, proactive approach can make the difference between an underwhelming rating and the full compensation you deserve. Stay persistent, advocate for your health, and remember, your service entitles you to every benefit available under the law.
FAQs
What is a 20% lumbosacral strain?
A 20% VA rating for lumbosacral strain is awarded to a veteran when forward flexion of the thoracolumbar spine falls between 30 and 60 degrees or when muscle spasms result in an abnormal gait or posture.
How much is the average VA rating for the lumbar spine injury?
The average VA rating for lumbar spine conditions like lumbosacral strain typically ranges between 10% and 20%, depending on pain, flexibility, and functional loss.
What happens during a VA C&P exam for a lumbosacral strain?
A C&P (Compensation and Pension) exam for lumbosacral strain evaluates your back’s range of motion, pain levels, and functional impairment to determine your VA disability rating.
What are the VA disability rating percentages for back strain?
The VA disability rating for back strain can range from 10%, 20%, 40%, 50%, to 100%, based on the severity of symptoms like reduced motion, pain, muscle spasms, or spinal ankylosis.
What are the lumbosacral strain VA secondary conditions?
Common secondary conditions to a lumbosacral strain VA claim include radiculopathy, sciatica, degenerative disc disease, depression, bladder issues, and sleep disorders.
How is a VA rating determined for a lumbosacral or cervical strain?
A VA rating for lumbosacral or cervical strain is based on the severity of symptoms like limited range of motion, pain, functional loss, and supporting medical evidence under Diagnostic Code 5237.
Also read: Hip Pain Secondary to Back Pain in VA Disability
At Prestige Veteran Medical Consulting, a veteran-owned company, we specialize in Independent Medical Opinions (IMOs) known as Nexus letters.
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Understanding the unique challenges veterans face, our commitment lies in delivering exceptional service and support.
Leveraging an extensive network of licensed independent medical professionals, all well-versed in the medical professional aspects of the VA claims process, we review the necessary medical evidence to incorporate in our reports related to your VA Disability Claim.
Prestige Veteran Medical Consulting is not a law firm, accredited claims agent, or affiliated with the Veterans Administration or Veterans Services Organizations. However, we are happy to discuss your case with your accredited VA legal professional.
