“Hi, I am Lori Underwood, a VA-accredited attorney working for Woods and Woods, a law firm that has represented thousands of veterans nationwide in their VA disability compensation claims.
“Today, we are going to be discussing VA claims for chronic pain. Chronic pain is pain that lasts longer than three months. It can be anywhere in the body, it can be throbbing, shooting pain, burning, or stabbing. All of those symptoms apply to chronic pain.”
What causes chronic pain in veterans?
“Some more medically-known causes of chronic pain can include injuries which can result in further degeneration or arthritis, like cancer and autoimmune diseases such as diabetes or lupus, which can also result in peripheral neuropathy or other associated diagnoses as well. But at times there is no diagnosis associated with the chronic pain and it is unexplainable.
“More research is needed on medically-unexplained chronic pain or chronic pain that is not associated with a known diagnosis, although research does show that it affects veterans at a higher rate than their non-veteran counterparts. An article published by the National Institute of Health shows that veterans are 40% more likely to experience chronic pain than their non-veteran counterparts, and that it affects veterans of all ages — the young and the older veterans.”
How to prove direct service connection for chronic pain
“You may prove your chronic pain is directly related to your service, and this would be if you sustained that injury in service. There are clear records that you attended sick bay to treat the injury, and there is clear documentation of when that pain and injury was onset in service that may result in a direct service connection.”
Was your chronic pain aggravated by service?
“Service connection by aggravation persists when you had a preexisting injury when you entered into service which was noted and documented, but because of either overuse, exertion, or just the general duties of your service, your condition worsened more rapidly than it would have by natural progression.
“Your service treatment records would indicate that you were receiving treatment for this, or that you were struggling with pain that had been exacerbated by some aspect of your service. That would be strong evidence of aggravation of a medical condition that you had entering into service.
“Service connection by aggravation can be a little tricky to prove, so it does help to have a medical doctor who is trained to look at your medical records and is able to explain how the condition worsened over time outside of it just being a natural progression.”
Most veterans are diagnosed with chronic pain after service
“It seems most often chronic pain is not diagnosed until after service. Some of the injuries you sustained during service that are service connected may further progress over time and eventually lead to chronic pain that you did not experience at the outset of your service.
“Over time, if that pain becomes debilitating, you may attribute it to just your aging body, but it may also be developing at a pace more rapidly than you feel like it should be. So it may be related to some of the diagnoses that you’re receiving service connection for.
“You may also be service connected for conditions we mentioned before, such as diabetes, which are autoimmune, but lead to conditions such as peripheral neuropathy, which bring about a new onset of pain.”
Unexplained chronic pain may be a presumptive for Gulf War veterans
“Chronic pain has been commonly linked with Gulf War service, and these are undiagnosed chronic illnesses. The term that the VA likes to use is “medically unexplained multi-symptom chronic illness.” This is where there is no known associated diagnosis to explain the chronic pain.
“A medically unexplained multisymptom chronic illness is a presumptive condition to Southwest Asia service.”
How does the VA rate chronic pain?
“The VA does not have a specific diagnostic code for chronic pain. If your chronic pain is unexplained and unassociated with a diagnosed condition, the VA will rate on what is the analogous condition, meaning they will rate it based on the body part affected and rate it as closely as they can to establish the functional loss you’re experiencing due to the chronic pain.
“For example, if you have back pain and no diagnosis to explain the back pain, but you’re experiencing functional loss, they will rate you as closely as they can from the diagnostic code that best represents the functional loss you’re experiencing in your back.”
“From the day we contacted [Woods and Woods], they made us feel so comfortable. They treated us like we mattered and we were not just clients but family.”
L.B., a Navy veteran and wife in Florida
Chronic pain may affect your ability to work
“Chronic pain can prevent a veteran from being able to work, and that may be reason for the veteran to pursue the total disability individual unemployability benefit (TDIU) through the VA, which is allowed for veterans who can’t work due to their service-connected conditions.
“The combined effects of chronic pain may make even sedentary work impossible, and you often have associated symptoms like difficulty sleeping – insomnia — and trouble concentrating. Chronic pain may make finding a comfortable position to work in impossible, and it can cause difficulty lifting, bending, and carrying things.
“It can result in mental health symptoms as well, either an onset of mental health issues or the worsening of existing mental health conditions. The pain is an awful lot for someone to deal with, so it can bring about mental health concerns which bring their own limitations into the workplace.
“There are also a whole lot of symptoms that come along with medications that are prescribed for chronic pain, like brain fog, inability to concentrate, or sleepiness, which make work impossible as well. The side effects of those medications for your service-connected conditions should be taken into consideration when deciding your ability to work.
“A high-quality nexus letter may be crucial in proving your service connection for chronic pain or how it impacts your ability to work.
“We work with highly-trained medical professionals who are accustomed to working with veterans and their medical records and understand their issues and are able to provide this evidence for our clients.
“We also work with vocational experts who are trained in explaining how your limitations impact your ability to obtain and maintain work in the national workplace, which is evidence that is needed to obtain TDIU benefit.”
How hiring an attorney can help
“At Woods and Woods, we have worked on thousands of cases for our veterans over the years and we work hard to get veterans the benefits that they deserve. You can visit our YouTube channel for more information about VA benefits. In general, if you would like help with your claim, you can contact us by giving us a call for a free consultation regarding your claims.”
Talk to Us About Your Claim:
(812) 426-7200
Lori Underwood
VA disability attorney
Woods & Woods
Lori Underwood received her law degree from Northern Kentucky University. She has experience in Social Security disability and personal injury law and was a juvenile court attorney. She has been an attorney at Woods and Woods since 2014.
