Category: Veterans Disability Law
VA Disability Rating for Sciatica and Sciatic Nerve Paralysis Claim
Veterans who experience a disability or disabling condition as a result of their time in the military may qualify for financial compensation from the U.S. Department of Veterans Affairs (VA). Eligible conditions include everything from hearing issues to complete paralysis. One relatively common disability is sciatica or damage to the sciatic nerve. As of 2015, almost half a million veterans receive VA disability for sciatic nerve damage.
What is Sciatica?
The sciatic nerve is the largest nerve in the human body, stretching from the lower back, through the hips, and down each leg. Sciatica refers to any pain that is caused by or causes a problem with the sciatic nerve.
Sciatica is often caused by an injury, a ruptured intervertebral disk, or a narrowing of the spinal canal. This narrowing, called spinal stenosis, applies pressure on the sciatic nerve. Compression of the sciatic nerve caused by bone overgrowth can result in inflammation, numbness, and pain in whichever leg is affected.
It is also important to note that sciatica is not a direct diagnosis. This term is a way of describing the location and severity of pain caused by a different condition or issue. When an individual’s sciatic nerve is irritated, the individual will experience a variety of symptoms associated with sciatica.
Some of the symptoms associated with sciatica include the following:
- Numbness in the legs or lower back
- Muscle weakness
- Burning sensation
- Pain along the sciatic nerve
- Inability to move feet and legs
These symptoms typically only affect one side of the body, but veterans can experience bilateral sciatica. Some other indicators that an individual may be suffering from sciatica include:
- Abnormally high levels of pain when sitting or standing
- Difficulty standing or walking for extended periods of time
- Heightened pain after harsh movement, like coughing or sneezing
Sciatica can also cause partial or complete paralysis of the legs, feet, and toes.
Determining Your Sciatica VA Rating
Sciatica is a VA disability that’s rated as a nerve issue. Nerve issues are rated by VA under three separate categories that are based on symptom severity. Each of these severities has their own diagnostic code and separate assigned percent ratings under 38 CFR § 4.124a, Schedule of ratings – neurological conditions and convulsive disorders. These codes can help you determine your VA rating for nerve damage.
Neuralgia of the Sciatic Nerve
The term “sciatica” technically refers to neuralgia, the least severe category. Neuralgia is characterized by sharp pain from a nerve being damaged or irritated. This is the most common category that veterans file a claim under. Under 38 CFR sciatica Diagnostic Code 8720, sciatic nerve neuralgia is rated by the following criteria:
- 10 percent VA rating: The veteran experiences mild neuralgia that causes tingling or mild pain that results in minor interference with limb functionality
- 20 percent VA rating: The veteran experiences moderate neuralgia that involves tingling, numbness, and pain that is moderate to severe, along with a form of interference with the affected limb’s functionality.
There is no VA disability rating for severe neuralgia.
Neuritis of the Sciatic Nerve
Although less common, a veteran’s sciatica may cause symptoms that indicate a higher level of severity. The next level of severity beyond neuralgia is neuritis, which is caused by the inflammation of peripheral nerves and those beyond the spine and brain. Diagnostic Code 8620 contains the following rating criteria for neuritis:
- 10 percent VA rating: Mild neuritis
- 20 percent VA rating: Moderate neuritis
- 30 percent VA rating: Moderately severe neuritis
- 60 percent VA rating: Severe neuritis — this is identified by the loss of reflexes and sensations, muscular atrophy, and extremely limited function of the affected body part
Paralysis of the Sciatic Nerve
The third and most severe nerve rating criteria under 38 CFR, paralysis, is documented in Diagnostic Code 8520. Paralysis is the loss of strength or control in one or more muscles within the body. Often cause by extreme nerve damage or irritation, the ratings for paralysis of the sciatic nerve are as follows:
- 10 percent VA rating: The veteran experiences incomplete or partial paralysis of leg muscles, mild paralysis
- 20 percent VA rating: The veteran experiences moderate incomplete paralysis of leg muscles, causing moderate pain or difficulties
- 40 percent VA rating: The veteran experiences incomplete but moderately severe paralysis which begins to make knee movement difficult
- 60 percent VA rating: The veteran experiences incomplete but severe paralysis marked by limited functionality, poor blood circulation, and muscular atrophy
- 80 percent VA rating: The sciatic nerve paralysis VA rating is the most severe, occurs when all muscles of the leg below the knee fail, making it extremely difficult to bend the knee
Complete paralysis and incomplete but severe paralysis can heavily contribute to a veteran receiving Total Disability based on Individual Employability, or TDIU.
TDIU is rewarded when a veteran’s disability or combined disabilities prevent them from maintaining substantially gainful employment. If the veteran is unable to get or keep a job that pays above a certain amount as a direct result of their service-connected disability, VA will grant them TDIU. TDIU benefits are equal to those of a 100 VA disability percentage for nerve damage.
The severity of your sciatica will determine how quickly you can receive an accurate diagnosis. At first, a medical examination will be conducted based on your complete history of the issue. All pain, all symptoms, the location of symptoms, actions that heighten pain, and the circumstances that give you relief are all taken into account. Providing the doctor with as much information as possible increases the chances of an accurate diagnosis.
After all the history has been discussed, the next step of the examination is physical. A state-certified technician will perform physical tests on you to try and discover the underlying cause of your nerve pain. The physical exam tests metrics like posture, balance, and spinal range of motion. The doctor will check your nerve reflexes, and how well your knees and legs respond to external stimuli. Depending on how extreme your sciatica is, you may not require more than a physical exam to determine the cause and severity of your nerve pain. However, if the sciatica is severe you will likely need an orthopedic exam as well.
The orthopedic exam will allow doctors to take a closer look at what may be causing the problem so they can properly identify solutions. The information discovered from these exams will help VA determine your VA disability rating for sciatica.
Establishing VA Service Connection for Your Sciatica
After getting an accurate diagnosis, the next step towards receiving your VA compensation rating for sciatica is to establish a service connection. Service connection is proof that the disability in question is from your time in the military, and not something else.
Sciatica is usually caused by other back issues like spinal stenosis or disc herniations. If you already have a service-connected back condition, there’s a relatively high chance that your sciatica is connected to that. If you don’t have a service-connected back condition, that does not disqualify you from being eligible for compensation.
If you think your injury occurred during service try to keep a comprehensive record of any relevant information. This could include details about the inciting incident, other instances that might’ve aggravated your injury, and how daily activities you performed could’ve hurt your legs or back. Buddy statements from fellow service members can also be helpful pieces of evidence. Letters from another person who has seen the way your injury affected you show VA it’s a visible restriction on your lifestyle.
Use records of medical history to show that you didn’t have back pain until your time in the military. If you had back pain before your time in the military, it might become more difficult to prove service connection. It is still possible to earn compensation for service connection by aggravation if the military service causes a condition to worsen at a disproportionate rate. Before and after comparisons help the VA see that military service was the primary cause of your back or nerve pain. Lay statements from friends or family are one way to communicate the change in your behavior or health. Many veterans also request an opinion from their physician stating the sciatic nerve issues are most likely a result of their time in the military.
There are three main pieces of evidence involved in establishing service connection:
- A current diagnosis of sciatica or sciatic nerve-related condition from a medical professional
- Documentation of an in-service event that may have aggravated or caused the condition in question
- A medical nexus letter that links the sciatica diagnosis to the in-service event
Establishing service connection is a necessary part of filing a VA disability claim for sciatica or another sciatic nerve condition.
Bilateral Sciatica VA Rating
Although sciatica typically affects one side, the sciatic nerve runs through both sides of the body. If a veteran does experience nerve pain or mobility issues on both sides they should be rated for bilateral sciatica. VA acknowledges that bilateral disabilities can make life activities increasingly difficult for veterans. This realization means that veterans who experience the bilateral factor are entitled to more compensation.
Bilateral ratings are calculated by combining the rating of each individual condition then adding an extra value to compensate for both sides being affected. First, use VA’s combined disability calculator to figure out your flat combined rating. For example, if you have sciatic neuralgia in your left leg that is rated at 10 percent, and in your right leg, your combined score is 28 percent. Additionally, for the bilateral factor, you add 10 percent of the combined rating score. 10 percent of 28 is 2.8, add that to 28, and you have a final bilateral rating of 30.8 percent, which rounds to a 30 percent VA disability rating.
In this example, the bilateral factor does not change the rating because 28 percent also would’ve rounded up to 30. However, as the disability percentages get higher this factor can easily affect your VA rating.
Pyramiding and Sciatica
While it is possible to get multiple ratings for different conditions and get a higher combined rating, it’s important to note that pyramiding is not allowed. Pyramiding is when the same condition is rated more than once. Be careful when adding additional claims that they focus on conditions that are distinct enough from the first.
If a situation arises in which two possible ratings are presented and each has legitimate reasons behind it, whichever rating benefits the veteran more will be used to determine compensation. If the two ratings can be viewed as separate, the veteran will receive a combined rating.
If the same diagnosis is recorded differently by two separate exams, the rating will be based on the more thorough one. Whichever test was performed by a more qualified professional and involved more comprehensive data will take precedence. Some doctors don’t understand how VA disability works, and some are simply less experienced than others. If the dispute cannot be settled, VA has approved professionals that know what to look for and how to look for it.
Ratings for Additional Medical Attention
If a sciatica condition requires hospitalization or constant medical care, it will be rated at 100 percent during that treatment. After treatment ends, the 100 percent rating will last for three months unless a longer amount of time is specified. At the end of that time, the condition will be reassessed and a new nerve damage disability rating will be assigned.
Other Sciatica-Related Conditions
Along with sciatica, the condition which is causing sciatic nerve pain might also be viable to claim as a disability. Lumbar radiculopathy is a condition when a spinal nerve root gets pinched and becomes inflamed. The lower back nerve pinch can directly contribute to sciatic nerve pain. If the veteran is dealing with both conditions, they may be able to combine the sciatica rating with the lumbar radiculopathy VA rating to ultimately receive more benefits.
Some conditions that result from or contribute to sciatica are less severe, and cannot be claimed as a VA disability. Some, such as pain in the hip due to compression of the piriformis muscle, are less severe but still provide small benefits. The maximum piriformis syndrome VA compensation rating is 10 percent because veterans typically still maintain full range of motion.
Secondary conditions can be claimed separately and will result in a higher combined VA rating.
Contact Tuley Law Office
When filing a VA disability claim, many veterans employ the help of a VA disability lawyer. An experienced VA disability attorney can guide you through the process of gathering information and organizing it in a presentable way to receive the compensation you deserve.
At Tuley Law Office, our VA disability lawyers have the knowledge necessary to go above and beyond for your disability case. We will ensure you don’t overlook any of the additional policies that might apply to your situation, help you locate medical or service records, and even work with you to dispute or appeal an unfavorable VA decision. When you work with us, you become the top priority.
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