“Sciatica is one of the most common conditions among the general population. Around 40% of people will experience it in their lifetimes. However, military service increases one’s risk of developing the condition.”
“As previously mentioned, 4 out of 10 people will experience some form of sciatica in their lifetime. Most of the time it will be temporary or manageable, but chronic and more severe forms can be debilitating. As a matter of fact, veterans are 12.2% more likely to suffer from sciatica.
“I’m Zack Evans, a VA accredited attorney at Woods and Woods, a law firm that represents veterans and their VA disability appeals. Today we are talking about VA disability claims for sciatica.”
What is sciatica?
“Sciatica is a term used to describe either inflammation or damage to certain nerves along the spine. I think it might be helpful to discuss the anatomy of the spine whenever we’re talking about radiculopathy and sciatica.
Your spine is segmented into vertebrae. These are bones. Bones are separated by intervertebral discs. So, imagine little tubular bones stacked on top of one another, and you have a little spongy disc in between.
“Your discs also maintain little openings for your tiny nerves to escape the spinal column and transmit signals to the rest of your body. These little keyholes are called foramina. If the nerves that pass through these holes get pinched, you end up with pain shooting down the path that nerve travels. For the sciatic nerve, that pathway is down the leg.
“The sciatic nerve is the largest and longest nerve in the human body and is made up of several nerve roots that escape the spine through those little keyholes in your spine, and they join up near the hip. The sciatic nerve runs through the pelvis and down the back of the leg and splits behind the knee to serve the lower leg and foot. These nerves disperse and run all the way to your toes. This is why severe cases of sciatica impact your ability to flex your foot upward. And sometimes, those who suffer from sciatica can experience foot drop.”
Veterans and sciatica
“Many people experience temporary sciatica, which, while uncomfortable, is unlikely to affect one’s quality of life in the long term. It might just be something that you deal with for a few days at a time or that resolves in a few weeks. However, chronic sciatica can be debilitating. It’s a very serious condition. Sciatica causes back pain and potentially weakness or paralysis of the lower extremities.
“Sciatica can also impact someone’s ability to work, no matter what kind of work you do — whether it’s manual labor or desk work with administrative tasks.
“For a veteran’s case specifically, before the VA, sciatica can contribute to a finding of total disability based on individual unemployability, or TDIU. There are a lot of different ways that sciatica might manifest itself in terms of a difficulty maintaining employment.
“In a work environment, dealing with sciatica can cause an inability to lift heavy objects. It can also cause trouble sitting for long periods of time, either at a desk or in a vehicle.
“I have a lot of veteran clients that have worked administrative jobs that did desk work or management level work where they were required to sit and generate or review reports for long periods of time, hours at a time. If you have severe enough sciatica, after a couple of hours, sometimes after just a few minutes, you can start to feel some of those shooting pains going down your legs, and then when you go to stand up from the chair, you can feel really unstable on your feet.
“Medications used to treat the pain can also impact your focus, mental clarity and ability to operate heavy machinery.
“When you claim service connection for sciatica, part of the process often involves going to a compensation and pension exam, a C&P exam as they are commonly known. These exams very intentionally avoid discussing these types of workplace impacts, but a good lawyer can help you develop evidence that truly tells the story of your limitations and can help you successfully pursue a TDIU rating at 100%.”
How to service connect sciatica
“The key for most veterans looking to get their sciatica service connected is to service connect the underlying injury that is typically the cause. If it’s a car accident causing a hip injury where the sciatic nerve is injured, where it passes through the pelvis, that’s what you want to pursue — the injury to the hip and the car accident itself. But if it’s a back problem, which is what we see most commonly, you need to service connect the back problem.
“Sciatica is best thought of as a symptom or residual, not its own free-standing condition. So, we have to get into your story of your time in service.
“So, that leads us to what kind of job did you do in the military? What was your MOS? What kinds of things did you go to sick hall for? Were you ever placed on light duty or reassigned due to a back injury?
“It didn’t have to be during a deployment or even on base. If you got into a car accident on leave back home, that’s still an in-service injury. If you injured your back after service during a civilian occupation and don’t think you can’t win your case, I’ve won those, too.
“The key is telling your story about when all of this started, especially if you had on and off problems with it over time.
“Of some of the things I’ve seen in veterans’ files that have led to sciatica, one of the most common is a lifting injury. Anytime you’re lifting heavy loads for long periods of time, there’s a risk of a back injury there. You know, maybe that 38th time that you pick up something heavy is not quite perfect form. You might be a little sloppy, you might be tired, you might be in a hurry, and that’s typically when injuries occur.
“Another example would be long ruck marches. So, if you spent a lot of time in the infantry, in the Marines, maybe following your crucible march, your back was never really the same.
“Another one would be working long hours in confined spaces. Think about our naval veterans. You might be in a really confined space for a long period of time, trying to pull cable along or trying to make cuts or splice wires. Over time, after years of service, doing that kind of work can have a significant impact on your low back and the nerves that are trying to escape your spinal column to communicate with your legs.
“Another type of injury I see in service for my veteran clients are impact injuries, whether it’s a one-time impact injury or repeated impact injuries. A good example of this would be paratroopers.
“Another one is hard falls from vehicles. Think about guys that have MOSs in vehicle maintenance up-armored Humvees, Bradley Fighting Vehicles, mechanics. If they take a hard fall and they land on the lower back or they land even on their feet in the wrong way or on their backside, that is a that’s a prime candidate for a back injury.”
Sciatica VA rating
“The VA uses diagnostic codes 8520, 8620, and 8720, the most common of them being 8520 for paralysis of a peripheral nerve. The ratings for that are as follows.
“We’ve got 80%, and that is equivalent to a complete inability to use the lower leg. That means your foot dangles and drops, and you have no active movement possible of muscles below the knee or flexion of the knee is weakened or sometimes lost completely.
“A severe incomplete paralysis rating is rated at 60% and is a little bit easier to identify than some of the lower ratings. That’s because there’s a very recognizable visual component to this, and that’s marked muscular atrophy.
“Below that is a moderately severe rating at 40%. At the 40% level, we’re looking for consistent problems walking and bearing weight with instability.
“The firm got me to 70%, and I was happy. Individual unemployability was awarded to me and to this day, I’m so grateful. My future is no longer bleak. These people work very hard for you.”
R.C., a Navy veteran in Hawaii
“Then you move down to moderate and complete paralysis, and that’s rated at 20%. What we’re looking for here is an intermittent instability that comes and goes. It’s not something that you’re dealing with constantly, but your flare episodes might have a significant impact on your ability to walk.
“Then we move down to a mild incomplete paralysis rating of 10%. Typically, these ratings are in place whenever veterans’ symptoms are limited to sensory perception. We’ve got numbness, tingling in the area, a feeling of pins and needles, a hot and cold difference that you can perceive but doesn’t necessarily impact your ability to get around or walk all the time.
“The 8620 diagnostic code is for neuritis. Essentially, this just means a referred sharp pain, a shooting pain that travels down the leg. A good example of this would be if you bend or twist in the wrong direction and you feel that shooting lightning feeling down your leg, that would be a good example of a neuritis type of pain.
“The 8720 diagnostic code is for neuralgia. Essentially, this is an inflamed nerve. Sometimes even after surgical intervention, it doesn’t resolve.”
Sciatica C&P exam
“Usually, these C&P exams will be called a peripheral nerve exam. If you’re already service connected, you need to keep track of your sciatica and how it is impacting you. The reason the onus is going to be on you to keep track of this and to bring this story out is because the C&P examinations don’t do a very good job of capturing what it’s like to live with sciatica or especially to try to work through sciatica.
“I’d encourage you to journal any of these changes if it’s getting any worse. If it flares in the morning or if it’s bad at night or if the pain becomes more persistent, write that down. If it’s worse after being on your feet, write it down. If you have episodes where your leg becomes increasingly unstable, write it down.
“As we discussed when I was going over ratings, your subjective symptoms will drive the severity findings. The reason for that is the types of severity and their levels, whether mild, moderate, moderately severe, or severe, they’re not well defined in the Code of Federal Regulations.
“C&P examinations for sciatica will involve assessing levels of pain with range of motion. They might perform a straight leg raise test where you lie on your back and then the examiner will ask you to raise your legs straight, trying to get you to a 90-degree angle, and then they’ll record the onset of your pain at what angle that starts.
“There will be some sensation testing to test some of the pin and needle feelings, to test and see if you have good sensation in your feet or in your legs. They’ll ask you questions about what you’re feeling during these tests. But again, because the diagnostic code is so subjective in this area of assessing severity, you want to be as detailed as possible.
“Don’t be a tough guy in these exams. Tell the truth. If it hurts, say that. If you have journaled your symptoms, I’d recommend making photocopies of your journal entries and providing them to your examiners.”
How Woods and Woods can help
“If you have a C&P exam coming up for your sciatica or for any other condition, I would encourage you to check out our YouTube page. We do have other videos out there that discuss C&P exams and can give you some helpful information that might set you at ease, just so you have a plan of attack when you go in.
“You can learn more about VA benefits for sciatica by following the links in the description box of this video. If you have more questions about VA benefits in general, watch some of the other videos on our YouTube channel.
“If you’re wondering if you qualify for a 100% rating or TDIU, contact Woods and Woods for free consultation.”
Zack Evans
VA disability attorney
Woods & Woods
Zack is a former prosecuting attorney. He received his law degree from Southern Illinois University. He joined Woods & Woods in 2017.
