VA Rating for Chronic Pain

Pain is how your nervous system tells you something is wrong. But chronic pain takes a toll on people physically and mentally, affecting their quality of life and, sometimes, their ability to work. The VA must provide disability benefits for chronic pain and chronic pain syndrome related to military service.

You can’t remember the last time you weren’t in pain. You ache when you try to do even the most basic tasks, but it seems like you hurt even more when you rest. You’re tired of being unable to do seemingly anything, let alone even consider doing what you used to do. You just want the pain to disappear, so you can live your life again. 

If you’re suffering from chronic pain syndrome and associated health and mental health conditions, you may want to consider whether you qualify for VA disability for chronic pain. 

Chronic pain and chronic pain syndrome

Chronic pain is pain that continues for longer than three months. It may come and go, or it could be consistent. You can experience chronic pain anywhere in your body, although chronic back pain is common. If you experience chronic pain, a doctor may diagnose you with chronic pain syndrome.

An interesting and frustrating thing about chronic pain is that doctors often can’t explain its cause. Sometimes there’s an apparent cause for chronic pain, like arthritis or cancer. Other times, there’s no obvious reason for the pain to exist, but it’s there. 

Chronic pain manifests as aching, burning, stiffness, stinging, or throbbing. It’s sometimes also shooting pain. It can lead to mental health issues like anxiety, depression, or severe mood swings. It often causes fatigue because people experiencing it have a difficult time sleeping.

Doctors diagnose chronic pain by running tests to attempt to pinpoint its cause. These tests may include blood tests, x-rays, MRIs, reflex and balance tests, and urine analysis. 

How doctors treat chronic pain depends on the symptoms, severity, longevity, and if it’s tied to another health issue. It’s often treated with medications along with lifestyle and diet changes.

VA research shows that veterans are more prone to experiencing chronic pain than the general population.

Establishing a service connection for chronic pain

A service connection must be established for all VA disability claims. A claim for VA disability benefits for chronic pain must include evidence that the pain manifested or worsened during your service. There are several ways to go about this.

Pain manifesting in service

Unlike many other types of VA disability claims, establishing the manifestation of pain may be straightforward for many veterans. Pain that is related to a specific physical injury may be documented in your service records and could include medical documentation about the injury and its cause. It also may have been documented because you needed accommodations for your injury, like lighter duty or recovery days. 

When filing a claim for VA disability benefits for chronic pain, these records would support a service connection for chronic pain arising from the documented incidents.

Pain aggravated by service

If you had a pre-existing condition when you joined the military, and your military service made that condition worse, you can establish a service connection for your chronic pain.

The key is to show that the worsening of the pain was not a natural progression but instead was caused by your military service. There are many ways to establish that a worsening is not natural. For example, you can use medical records to show a marked increase in medical visits for treatment. Similarly, you can use evidence such as x-rays, expert opinions, or test results to show that your condition showed a severe decline that would not be expected in a natural progression. 

Finally, you may be able to point to a specific event during your service that caused your condition to worsen immediately.

Chronic pain diagnosed after service

If your chronic pain was diagnosed after service, it can still be service-related if it manifested due to your service. For example, if your chronic back pain is caused by degenerative disc disorder but was misdiagnosed during your service as muscle strain, you should be able to establish a service connection through a doctor’s opinion letter identifying the misdiagnosis and stating that the degenerative disc disorder started during your service.

Chronic pain can result from the strain and stress on the body during military training or combat. Carrying heavy rucksacks and walking or running on uneven surfaces for prolonged periods takes a toll on a service member’s body. These circumstances may not be as well documented in your service records and may require evidence such as statements from comrades who served with you (called buddy statements) to convince the VA that your pain is service connected.

What is the VA chronic pain rating?

The VA doesn’t have a specific diagnostic code for chronic pain, but it does pay benefits for veterans who experience it. Therefore, VA disability benefits for chronic pain are based on the symptoms or impairments that result from your pain. 

Chronic pain can also be connected as a secondary condition. So, for example, chronic pain may lead to insomnia due to the inability to sleep while suffering pain. Similarly, chronic pain may lead to depression about the pain. In this example, chronic pain would be your primary service-connected disability, and depression or insomnia would be your secondary service-connected disability. 

Applying this example, the VA would first rate the source of chronic pain using the ratings schedule for the body part or system affected by the pain. The VA would then rate the mental disability (depression or insomnia) using the mental disorder ratings schedule. The VA uses these two ratings to determine an overall VA disability rating for chronic pain syndrome.

Mental health conditions and depression secondary to chronic pain

Being constantly in pain and uncomfortable can create or exacerbate mental health issues. Research links chronic pain to depression, with the existence of both disorders causing the symptoms of each to worsen. 

The VA recognizes the relationship between chronic pain and depression and other mental health disorders, like anxiety disorder. The VA rates depression at 10%, 30%, 50%, 70%, or 100%, depending on the severity of symptoms and your ability to function.

Because of the relationship between chronic pain and depression, you may consider whether it has a secondary service connection to your pain.

Gulf War veterans and chronic pain

Many Gulf War veterans experience a cluster of medically unexplained symptoms that can include chronic pain. The VA calls this illness medically unexplained chronic multisymptom illness (MUCMI). It can include fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems. 

MUCMI is a presumptive condition for any veterans serving in the southwest Asia theater of military operations.

“The reason that presumptive service connection is so important with Gulf War Syndrome claims is because there’s no nexus requirement, which means you don’t have to have a doctor say that your illness is related to your time in service. The VA will allow you to skip that element of proof,” said VA disability attorney Zack Evans.

There are only three requirements for a presumptive service connection for these claims, Evans said. First, the veteran must be a Persian Gulf War veteran. Second, they must have a qualifying chronic disability. Finally, that disability must have manifested during active service in Southwest Asia or to any degree since return from service.

Chronic pain and TDIU

Chronic pain can result in a veteran being unable to work. Total disability based on individual unemployability (TDIU) benefits are for veterans who can no longer keep a job because of their service-connected disabilities. If you can’t work because of impairments related to your chronic pain, you may qualify for VA unemployability, which pays the same monthly amount as a 100% rating of $3,737.85.

To be eligible for TDIU, you must prove that you can’t keep gainful employment because of the pain and related conditions and that those conditions are service connected. The combined effects of your pain and its side effects, such as difficulty sleeping and trouble concentrating, may make even sedentary desk work impossible. You may struggle to find a comfortable position while working, struggle with lifting or bending, or take prescription pain medicine that gives you brain fog and fatigue. If you’re currently employed, your boss may be making special accommodations to allow you to work around your pain. These can all factor into your TDIU chronic pain claim.

Schedular TDIU requires at least one service-connected disability rated at 60% or higher OR two or more service-connected disabilities with at least one disability rated at 40% or higher, with a combined rating of 70% or higher. Many of the conditions related to chronic pain, including mental health conditions or issues with range of motion, have the potential to meet these requirements. 

How our VA appeal lawyers can help

Woods and Woods has fought and won chronic pain cases. We’ve helped thousands of veterans get the VA benefits they deserve. Call us for a free case evaluation to find out how we can help. If we take your case, you only pay if you win. 

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