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Back pain is one of the most frequently claimed service-connected conditions among veterans. The unfortunate reality is that the extent of these claims is commonly underrated. For many veterans, back pain isn’t a constant, unchanging experience. Instead, it comes in painful and unpredictable episodes—commonly known as flare-ups—that can leave you unable to walk, work, or function in day-to-day life.
The VA disability system, however, struggles to account for these fluctuations. In fact, if your condition appears relatively stable on the day of your Compensation & Pension (C&P) exam, you could find your disability claim denied. Our team of attorneys is here to help you get the back pain VA rating you deserve.
How the VA Assigns Ratings for Back Pain
The VA evaluates most back-related disabilities using a formula that looks primarily at how much your back pain limits your range of motion, whether you have muscle spasms that alter your posture or gait, and whether your condition involves neurological issues like sciatica or nerve compression.
The range of motion is typically measured in degrees during a C&P exam, and the result helps determine your disability percentage. In some cases, the VA may use the number of incapacitating episodes per year to assign a rating.
But here’s the problem: this approach offers only a brief glimpse of your condition. Many veterans have relatively “normal” function on good days but suffer extreme limitations during flare-ups. A snapshot of your condition on the day you are evaluated might not do the severity of your back pain justice. The result is a system that can undervalue your back pain VA rating unless you take steps to ensure those flare-ups are documented and understood.
What Counts as a Flare-Up?
Flare-ups are sudden, temporary increases in the severity of your pain. They may occur weekly, monthly, or even more sporadically, but they typically result in increased pain, limited movement, and reduced function. You may find yourself needing to lie down, cancel plans, miss work, or use a cane or brace during these periods.
Importantly, the VA recognizes flare-ups as a real component of a veteran’s disability only if the functional impact is clearly demonstrated. Simply telling your examiner that you experience flare-ups may not be enough. You need to show how those episodes restrict your daily life.
Flare-ups are often triggered by physical activity, weather changes, or prolonged periods of standing or sitting. In some cases, they can arise without warning, which makes them difficult to plan around and even harder to explain during a brief medical appointment.
Why Flare-Ups Are Overlooked by the VA
The VA claims process tends to favor observable, measurable symptoms. That means your range of motion on the day of your C&P exam can carry more weight than the pain you report between those visits. If your symptoms aren’t visibly limiting at the moment of your exam, the VA may conclude that your disability is mild, even if that’s not the case most of the time. Additionally, many examiners don’t ask detailed questions about flare-ups. Some even write “unable to assess” or “requires speculation” if the veteran isn’t actively experiencing a flare-up during the exam.
How to Record Flare-Ups for Your VA Claim
If you’re seeking a higher disability rating, your best tool is a consistent and thorough record of how your flare-ups affect your daily life. This doesn’t require any special medical training, just honest observations over time.
Start by keeping a daily or weekly journal. Record each flare-up, including the date, duration, symptoms, and how it interfered with your routine. Include details such as whether you had to lie down, missed work, avoided social activities, or relied on medications or assistive devices. These records not only help you remember the pattern of your symptoms, but they also demonstrate to the VA that your condition has functional consequences beyond what appears in a five-minute medical exam.
In addition to your personal notes, lay statements from family members, friends, or coworkers can strengthen your claim. These individuals can explain how they’ve seen you struggle during flare-ups.
Finally, whenever possible, seek medical attention during a flare-up. Even if you’ve already been diagnosed with a back condition, updated medical records showing your pain level, mobility restrictions, or prescribed treatments during flare-ups offer powerful evidence that your condition is worse than initially rated.
The Value of Visual and Circumstantial Evidence
Beyond traditional documentation, other types of evidence can illustrate the real-world impact of your flare-ups. For example, if you use a back brace, heating pad, TENS unit, or mobility aids, and a brief explanation of how and when you use them can be included in your claim.
Similarly, if flare-ups cause you to miss work, consider submitting workplace records or a supervisor’s statement. If you regularly text friends or family to say you can’t attend events due to pain, screenshots of those can offer real-life proof of your limitations. All of this helps create a complete picture of how your flare-ups interfere with your ability to function.
Mistakes That Can Hurt Your Claim
Even well-documented claims can fall short if there are inconsistencies or gaps in the evidence. One common mistake is being too vague when describing your symptoms. Generic phrases about how much your back hurts don’t convey the severity or frequency needed to justify a rating increase.
The more specific you are, the better. Explain how many times per month your flare-ups occur, how long they last, what you can’t do during those times, and how long it takes to recover. Consistency is also key. If your personal journal says your pain lasts for three days but your C&P exam notes only one day of pain, the VA may question your credibility. Make sure your records match across all sources.
Another mistake is failing to follow up medically. Even if you manage your symptoms at home, periodic visits to a primary care provider, physical therapist, or pain specialist help establish that your condition is ongoing and requires treatment.
The Role of Secondary Conditions
Over time, back pain can lead to other health problems. These secondary conditions may also be eligible for compensation if properly documented and linked to your primary disability.
For example, many veterans with chronic back pain develop radiculopathy, a nerve condition that causes tingling, numbness, or shooting pain in the arms or legs. Others may experience mental health conditions such as depression or anxiety, stemming from the frustration and isolation of dealing with constant pain. Long-term use of NSAIDs or muscle relaxants may lead to gastrointestinal issues or liver problems.
Each of these can be filed as a secondary claim, and if approved, may contribute to a higher overall combined disability rating. Don’t overlook these related conditions—they represent the full scope of how your service-connected disability affects your health.
Filing for an Increased Rating
If your current rating doesn’t reflect the severity of your flare-ups, you have the right to request an increased rating. To do so, you’ll need to submit a new claim along with supporting evidence that your condition has worsened since your last decision. This can include updated medical records, lay statements, personal journals, and proof of flare-up impact.
You can also request a new C&P exam, especially if your original one failed to consider flare-ups or resulted in an inadequate evaluation. In some cases, veterans have to appeal a denial or low rating through a supplemental claim, higher-level review, or even the Board of Veterans’ Appeals.
If you go this route, you may want to seek help from an accredited representative, veterans service organization, or VA disability attorney. These professionals can help ensure your evidence is properly framed and that the VA considers all aspects of your condition—including those unpredictable but debilitating flare-ups.
Let Gang & Associates Help
Back pain is rarely consistent, and for many veterans, the worst parts come in waves. Flare-ups can leave you temporarily disabled, unable to work, and forced to miss out on important parts of life. Unfortunately, unless those episodes are clearly documented and presented as part of your VA claim, they may never factor into your disability rating.
A higher back pain VA rating is possible, but only if the VA understands the full picture. Keep detailed records, pursue medical follow-up when possible, and be specific in describing how flare-ups impact your functional capacity. The more clearly you show how your condition affects your life beyond a standard exam room, the more likely you are to receive the compensation you’ve earned.
At Gang & Associates, we understand the challenges that can come with a back pain claim. We look forward to putting our experience to work getting you the benefits you deserve. Contact us today to learn more.