Key Snippets
- VA typically codes radiculopathy based on the most severely affected nerve or nerve group. The extent of the impairment (sensory loss or motor weakness) and if it resulted in total paralysis will determine the percentage rating.
- In order to get an increased rating due to radiculopathy, you need to provide documentation (lay and/or medical) as well as your own descriptions of how severe the effects are and what they have done to limit your functioning. You should also clearly document all of this at every time you go in for a VA exam.
- If radiculopathy has been caused or worsened by one of your service-connected conditions, then you could possibly receive Secondary Service Connection. If your radiculopathy alone or along with your other service-connected conditions totally prevent you from working and earning money, then you can file for Total Disability Individual Unemployability.
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Understanding VA Radiculopathy Ratings
Radiculopathy is a disease process that causes nerve pain and numbness as an end result of the cervical, lumbar, or thoracic nerves being damaged within the spinal column. The VA utilizes certain diagnostic codes and criteria from the Schedule for Rating Disabilities to determine how severe radiculopathy is. Each VA rating case of radiculopathy is rated by the VA according to the diagnostic code of the specific nerve or nerves involved.
The potential percentages that may be given in a rating are dependent upon the level (nerve) of radiculopathy that has been found and the degree of impairment caused to the individual’s nervous system. This determination will be made dependent upon how severe the radiculopathy is and the degree it impacts the veteran’s ability to move. While a formal medical diagnosis can serve as valuable evidence that an individual has developed radiculopathy, it is not always necessary for the VA to provide a formal medical diagnosis of radiculopathy when the individual has sufficient symptoms that have resulted in impaired functioning, and the remaining criteria for entitlement to compensation due to service-connected injury/illness are satisfied.
Evaluating Different Types of Radiculopathy
The nature of an individual’s cervical or lumbar radiculopathy could result in a diagnosis being coded using a variety of diagnostic codes depending upon which specific nerves are involved as well as the specific radicular groups that are impacted; for example, Codes 8510/8610/8710 address the upper radicular group and Codes 8520/8620/8720 address the sciatic nerve.
Cervical radiculopathy occurs when a nerve is “pinched” in the neck area, which can cause a variety of symptoms including sharp pains, weakness, and/or numbness to radiate from the neck through the arm into the hands.
Lumbar radiculopathy (commonly referred to as Sciatica) occurs when the sciatic nerve is irritated, which can produce pain or numbness in the leg(s) from the lower back/lumbar region.
Thoracic radiculopathy, while the least common form of radiculopathy, produces similar symptomatology as the other forms, but the areas affected by pain, numbness, and/or tingling are limited to the torso regions (chest, abdominal or around the rib cage).
Bilateral Factors in VA Disability Compensation
When a compensable disability exists in each of the paired upper extremities (bilateral) or each of the paired lower extremities (bilateral), the bilateral factor may apply based on VA’s favorable calculations for veterans.
When radiculopathy occurs on the left and right sides (bilateral), each side will have its own rating for disability. This could result in a higher total disability rating.
Veterans who experience radiculopathy bilaterally should take note of the bilateral factor, as this may increase their combined disability rating. The Bilateral Factor is based upon the accuracy of medical evidence that shows the degree or extent of the impairment to each affected upper/lower extremity. Also important is whether there is a showing by other evidence as to the loss of use (function) of the respective impaired extremities.
How to Increase Your VA Radiculopathy Rating
Veterans may be able to increase their potential for a successful VA Radiculopathy claim by arranging for diagnostic testing as well as a trusted medical provider to evaluate them prior to the VA examination. The potential VA rating for service connected disabilities is dependent upon the nature of the evidence submitted. Thus, relevant medical and lay testimony/evidence, which describe the extent/degree of disablement, can be important.
However, medical evidence is not the only important piece of evidence that will support a Veteran’s VA Radiculopathy claim. In order for the VA to assess the degree of the neurological damage, a Veteran’s description of how radiculopathy has limited his/her ability to function on a day-to-day basis will be important. The Veteran can make these descriptions by way of lay statement(s) and/or at any time that a VA examiner conducts a Compensation & Pension Examination.
Providing Strong Medical Evidence
A Veteran who provides an accurate description of the severity of his symptoms and resulting functional limitation(s) may have a stronger VA radiculopathy claim. Any type of imaging (CT Scan, MRI, etc.) that supports a finding of radiculopathy is helpful. However, there is no specific imaging study required in each case. The medical documentation supporting the VA radiculopathy claim may include specific records from all Compensation and Pension Exams, in addition to medical opinions regarding the extent of the veteran’s radiculopathy condition, when available or necessary.
In addition to providing thorough medical documentation, veterans should accurately explain how radiculopathy symptoms limit their ability to perform activities and how severely those symptoms affect their functioning during the C&P examination. The thoroughness and accuracy in describing symptoms may allow the VA to assign an appropriate disability rating to the veteran. Medical records, along with testimony from knowledgeable third parties (e.g., family members), friends, etc., and service treatment records may also add significant credibility to a Veteran’s VA Radiculopathy claim.
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Demonstrating the Impact on Daily Life
Radiculopathy is caused by damage to a nerve root. Radiculopathy symptoms like pain, numbness, and weakness may cause significant impairment in completing everyday tasks and therefore will be evaluated by the Department of Veterans Affairs (VA) based on the extent of interference those symptoms have with daily life. Examples include:
- reduced ability to move
- limited ability to use fine motor skills
- inability to pick up or carry objects
- limitation in ability to maintain one’s balance and/or coordination
- the degree to which they interfere with an individual’s daily life
Lumbar radiculopathy symptoms may worsen when an individual walks or stands for long periods of time. It is essential that the effects of this worsening of symptoms on an individual’s daily activities including walking/standing for long periods of time, are documented in the examination report and in all documentation.
Secondary Service Connection and Radiculopathy
If the veterans’ radiculopathy is directly due to a service connected condition, they may be eligible for additional compensation based on secondary service connection. The eligibility for secondary service connection may apply if radiculopathy was created or worsened by a service-connected disability, with special rules governing compensation for aggravation.
When a veteran has both radiculopathy and at least one other service-connected condition, VA typically does not add the separate percentages to create a combined rating; instead, it uses its Combined Rating Table.
Examples of Common Secondary Conditions
Secondary radiculopathy is most commonly found in patients with primary spinal issues. The following list includes some of the many causes for secondary radiculopathy.
- Back strain
- Spinal injury
- Degenerative disc disease
- Degenerative arthritis
- Osteoarthritis
- Spinal stenosis
Veterans may experience radiculopathy due to spinal stenosis, which is when the spinal column narrows and puts pressure on a nerve. Herniated or bulging disks also put pressure on nerves, leading to radiculopathy. Understanding what caused your medical issues, such as an injury to your back, possible damage to your spinal cord, or the compression of a nerve root can assist you in identifying all aspects of your medical history.
TDIU Benefits for Veterans with Radiculopathy
TDIU may be an option for vets who are rated less than 100% disabled, but their radiculopathy prevents them from working gainfully.
A veteran may meet the schedular TDIU threshold with one qualifying disability rated at least 60 percent or higher, or with a combined rating of at least 70 percent and one qualifying disability rated at least 40 percent or higher; veterans below those thresholds may apply to be considered for extraschedular TDIU.
A TDIU claim requires to include proof that shows that the veteran’s service-connected disabilities are so severe as to prevent them from securing or following substantially gainful employment.
Filing a Successful VA Radiculopathy Claim
To file your VA Radiculopathy claim, you will need to document as much information as possible about your diagnosis, medical history, service time, and may have to schedule a C&P Exam if needed to decide the claim. There are several ways that you can file your VA Disability Claim for Radiculopathy: online, by mail, in person, or by fax. An Intent to File may preserve an earlier potential effective date if VA receives the completed qualifying claim within one year from filing the intent-to-file document; however, all other provisions of the VA’s effective-date regulations are still in effect.
You generally need to provide evidence establishing that the radiculopathy is due to military service or showing that a service-connected disability was responsible for causing the radiculopathy or aggravating it as a basis for entitlement to benefits on a secondary basis.
You may be required to take additional claims examinations once you’ve filed. If VA denies the claim, a veteran may be able to choose a Supplemental Claim, Higher-Level Review, or Board Appeal, but each option has different evidence rules and deadlines, including a one-year deadline for most Higher-Level Reviews and Board Appeals.
Working with a VA Disability Attorney
A veteran’s attorney who handles radiculopathy (nerve damage) denial cases can work to demonstrate a veteran is eligible for disability compensation for radiculopathy. A VA-accredited attorney can help navigate the VA’s complex appeal process regarding radiculopathy and assist with completing required paperwork and meeting deadlines.
Additional resources such as the “Veteran’s Guide” have been established by organizations to provide additional information to veterans about filing a claim as well as obtaining legal representation for disabilities related to radiculopathy.
Frequently Asked Questions
What is the average VA rating for radiculopathy?
Cervical radiculopathy typically has an average VA rating for the degree of impairment that varies depending on how severe the symptomatology of the radiculopathy. If the radiculopathy is very severe, it will have a much higher VA Rating.
What is radiculopathy secondary to?
Cervical radiculopathy is most commonly caused by degenerative changes occurring in intervertebral discs; degeneration in these disc spaces creates spinal instability as well as other problems such as bulging or protruding (herniated) discs or spinal stenosis.
What is considered severe radiculopathy?
Cervical radiculopathy is considered severe when there are significant sensory and/or motor deficits present along with severe pain. These findings indicate that the radiculopathy has had a major effect upon both movement and sensation, helping to determine the extent of the individual’s impairment.
Can you get disability for radiculopathy?
Veterans with cervical radiculopathy that results from their service may qualify for VA disability compensation, and those whose service-connected disabilities prevent substantially gainful employment may also qualify for TDIU.
What is the average VA disability rating for cervical radiculopathy?
The VA ratings for cervical radiculopathy vary depending on which nerves or radicular groups are affected, the severity of impairment, and, in some cases, whether the affected limb is dominant.
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