38 CFR: Lumbosacral strain
- Criteria: One or more disc herniations accompanied by nerve irritation or compression
- Diagnostic Code: 5237
- Typical Rating Range: 10%, 20%, 40%, 50%, or 100%
- Factors Considered: frequency, intensity, and duration of your symptoms
A lumbosacral strain is a lower back injury that occurs when the muscles or tendons in the lumbosacral area tear. This strain can cause pain, stiffness, and muscle spasms.
If you are a veteran living with lumbosacral strain, you likely have limited mobility and daily pain. If there is a connection between your military service and your current condition, you are likely entitled to VA disability compensation.
So, what do you do if the VA declines your claim?
In this article, we will examine why the VA may have turned down your lumbosacral strain VA rating and discuss your next steps.
You are not alone with this condition; there are over a million US veterans who live with the struggles associated with lumbosacral strain and currently receive VA disability. It is one of the most common disabilities that the VA deals with.
So why wasn’t your claim for a VA back pain rating approved? Let’s start with the three must-haves for a VA rating:
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1. Diagnosis
You must have a diagnosis in your medical records confirming lumbosacral strain.
Your diagnosis could have happened while you were in service or after. If you do not yet have an official diagnosis, you can seek one out from a civilian or VA doctor.
Without an official medical diagnosis of lumbosacral strain, the VA will turn down your claim.
2. Service Connection
Lumbosacral strain is caused by repeated over-stretching or tearing of the muscles in your lower back.
Veterans’ lumbosacral strain is often triggered by carrying heavy loads, making sudden movements during combat exercises, engaging in repetitive bending and twisting while loading and unloading vehicles, and standing or sitting in awkward positions for prolonged periods of time.
The VA needs to know that your condition developed in relation to your military service, so you must clearly establish that connection.
3. Description of Symptoms
The VA rating you might get for living with lumbosacral strain ranges from 10% to 100%, depending on the severity, duration, and frequency of your symptoms.
Now is not the time to try to tough it out and downplay your discomfort; the VA needs to understand the real-term impact the lumbosacral strain has on your day-to-day life.
You must link your service and subsequent medical condition to your current symptoms to get the VA rating you are entitled to.
Other Ways to Support Your Application
If you’re filing a supplemental claim or an appeal, you want to make sure you have all of the supporting information for an approval-worthy claim. In addition to the must-haves described above (diagnosis, service connection, and description of symptoms)
● A Nexus Letter
A nexus letter is a powerful supporting document from a licensed medical professional. It shows the medical link between your service event or injury and your condition. Not sure your doctor knows how to write a compelling nexus letter? Contact VA Claims Academy for a nexus letter template.
● A Personal Statement
A well-written personal statement can help your claim get approved. It should detail:
- When you first started experiencing symptoms of your lumbosacral strain
- The in-service event, series of events, injury, or illness that triggered your strain
- Information about the treatment you have received/are receiving for your strain
- How your condition limits your personal and professional life
● Buddy Letters
Buddy letters are from people you know who can vouch for how your lumbosacral strain affects your life. These letters could be from friends who you used to be able to play sports with, fellow veterans who are suffering from the same condition, your employer or former employer (if your back pain has had an impact at work), or any non-medical professionals you see to help with your back pain (like an acupuncturist or a chiropractor).
● Complete Records
You either need to give permission for the VA to gather your military and medical records or submit copies yourself. (Hint: It will go quicker if you do the gathering.)
These records can show when you first had to seek medical advice, how often you needed to see a doctor about your lumbosacral strain, and any treatment plan you have been following. All of this information helps paint a picture for the VA and gives them more information to rate you accurately.
Do an Accuracy Check
Poor admin might result in your claim being declined, preventing you from receiving the VA disability benefits you are entitled to.
Make sure that you fill in all forms accurately and entirely; something as simple as missing a date or signature could sabotage your claim.
Also, make sure you submit the correct type of claim. A fully developed claim, where you send in the evidence when you submit it, will get you a faster response. However, if you submit this type of claim and don’t have all your ducks in a row, the VA might decline your claim or send it to the back of the standard disability claims queue.
A standard disability claim is where you don’t yet have all of your evidence gathered, and you need assistance from the VA to complete your claim. These move slower than fully developed claims.
Your Options After Being Denied
If you were denied for your lumbosacral strain VA rating, you can do the following:
Request a Higher-Level Review
As the name implies, this process1 brings in a reviewer who is at a higher level of seniority than the one who previously reviewed your case. Think of this process as asking to speak to someone’s manager. If the initial reviewer made a mistake when reviewing your case, a higher-level VA adjudicator can correct those mistakes and, hopefully, grant your VA rating.
File a Supplemental Claim
If your claim was denied, you can resubmit2 with new evidence to bolster your claim or to show that your condition has gotten worse. This “new evidence” can include the “must haves” and other supporting documentation described above.
File an Appeal
Many veterans want to know how to appeal a VA claim once theirs is denied, but an appeal is often the least desirable option because it restarts the claims process and leads to major delays (sometimes seven years or more).
Get the Lumbosacral Strain VA Rating You Deserve
Follow our recommended steps to ensure that you submit a strong claim to the VA for your lumbosacral strain rating.
We can help you customize your personal statement and nexus letters and gather the right documents to support your claim. In many cases, you don’t need to file an appeal, which can land you in VA rating limbo for years. We can often show you a more direct path to getting (or increasing) your VA rating.
1https://www.va.gov/decision-reviews/higher-level-review/request-higher-level-review-form-20-0996/start
2https://www.va.gov/decision-reviews/supplemental-claim/