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Learn why a veteran received 40% for lumbar spine DJD but was denied a higher rating, and what specific evidence is needed to prove severe spinal conditions to the VA.
The veteran in this case was seeking higher disability ratings for several service-connected conditions, including their lumbar (lower back) spine and a condition called Intervertebral Disc Syndrome (IVDS). For their lumbar spine, specifically for degenerative joint disease (DJD) after a fusion surgery, the Board of Veterans' Appeals (BVA) granted a 40 percent disability rating. This was a positive step, as it acknowledged the severity of their lower back condition and represented an increase from a previous rating, as the veteran had filed a claim for a higher rating for their low back disability and lumbar spine DJD in July 2020. However, the veteran was also seeking an even higher rating for their lumbar spine condition, beyond the 40 percent they received. The BVA reviewed the medical evidence, which showed that the veteran had significant limitation in their lower back's range of motion, specifically, flexion was limited to less than 30 degrees. While this supported the 40 percent rating, the evidence did not show "unfavorable ankylosis of the entire thoracolumbar spine." This specific finding is crucial because a 100 percent rating for spinal conditions under Diagnostic Code 5241 requires this more extensive and severe form of spinal fusion or stiffness affecting both the thoracic (mid-back) and lumbar (lower back) regions. Without this evidence, the BVA could not grant a rating higher than 40 percent for the lumbar spine. Separately, the veteran also sought an increased rating for spinal stenosis with spondylolisthesis and IVDS. It's important to note that in this particular case, the BVA clarified that this IVDS claim was related to the veteran's *cervical spine* (neck), not their lumbar spine. The BVA denied a rating in excess of 30 percent for this cervical spine condition, finding that the evidence did not support a higher rating. This means that while the veteran achieved a 40 percent rating for their lumbar spine DJD, their efforts to secure an even higher rating for their lower back, and an increased rating for their cervical IVDS, were ultimately denied.
To successfully achieve a rating higher than 40 percent for a lumbar spine condition, or an increased rating for IVDS (whether lumbar or cervical), a veteran must provide comprehensive and specific medical evidence that directly addresses the VA's rating criteria. For lumbar spine conditions like DJD with fusion, the 40 percent rating is often granted when there is significant limitation of motion or ankylosis of the lumbar spine itself, as seen in this case with flexion limited to less than 30 degrees. To move beyond this to the 100 percent rating under Diagnostic Code 5241, the evidence must clearly demonstrate "unfavorable ankylosis of the *entire thoracolumbar spine*." This means showing that both the mid-back (thoracic) and lower back (lumbar) are severely stiffened or fused in an unfavorable position, causing extreme functional impairment. This requires more than just a finding for the lumbar region alone. For IVDS, whether in the lumbar or cervical spine, a higher rating depends on the severity and frequency of symptoms, including pain, muscle spasm, guarding, and objective neurological signs like muscle weakness, sensory loss, or reflex changes. The veteran's medical records need to contain detailed findings from orthopedic or neurological examinations. These exams should include precise measurements of range of motion, documented evidence of painful motion, and specific neurological deficits. It's not enough to simply state that the condition is painful; the medical evidence must quantify the functional loss and directly map it to the specific criteria outlined in the VA's Schedule for Rating Disabilities. A key part of a winning strategy involves obtaining a strong medical opinion, often from an independent medical expert or a private physician who understands VA disability rating criteria. This opinion should review all existing medical evidence and provide a clear nexus statement, explaining how the veteran's current symptoms and functional limitations meet the requirements for a higher rating. For spinal conditions, this means addressing specific measurements (like range of motion), the presence and extent of ankylosis, and the impact of pain and functional impairment on daily life and work. Without this precise and detailed medical documentation, the BVA will likely uphold the lower rating, as they did in this case by denying an increase beyond 40 percent for the lumbar spine and denying a higher rating for cervical IVDS.
To get a higher VA disability rating for spinal conditions, you need specific medical evidence that clearly shows your symptoms and functional limitations meet the exact criteria for that higher rating, not just general pain or discomfort.
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