When you have scoliosis, it means that your spine has an abnormal curvature. Typically, the spine forms a curvature in the lower back and at the top of the shoulders. The most obvious sign of scoliosis is when the curvature in you back resembles the letter C or S instead. If you developed scoliosis during military service, you may be eligible for full or partial disability benefits. You could also qualify to file disability claims if you already had scoliosis, and it became worse during military service.
According to the American Association of Neurological Surgeons (AANS), approximately 80 percent of scoliosis cases are congenital. That means the degenerative spine condition was present at birth, often without a discernable cause. When adults develop scoliosis, the AANS describes this as the neurological type caused by abnormalities in the nerves that affect the spine. The most common scoliosis symptoms include:
- Back pain
- Difficulty breathing because the chest does not provide enough room for the lungs to expand.
- Limited mobility and range of motion
- One shoulder blade is higher and sticks out further than the other.
- Rotating spine
- Uneven hips
Service Connection for Scoliosis
If you are considering filing disability claims for scoliosis, you need to receive an official diagnosis from a doctor with a diagnosis code confirming the scoliosis. You will also need to provide documentation that proves your military service caused your scoliosis or caused it to become worse. Your injuries of the spine may have developed as the result of a single episode or from repeated painful motions you had to make to complete your military service duties.
Lastly, you will need a nexus letter that connects your military service with your current diagnosis code indicating scoliosis. Without a service-connected disability, the Department of Veterans’ Affairs (VA) will deny your claim. A nexus letter provides documented evidence from your medical provider that supports the information you provide to the VA. Here are some tips to help you and your doctor write a persuasive nexus letter to accompany your disability claim.
- Resist the urge to allow emotion to take over as you write the letter by focusing on proven facts like back pain and limited range of motion.
- Ask your current doctor to add his or her input as to your level of disability to the nexus letter.
- Make sure your doctor has access to all your medical records related to your musculoskeletal system. Having your doctor state that he or she has viewed medical records and has ongoing access to them could help to influence the decision made by the Department of Veterans Affairs.
- Remind your doctor to act as a neutral party when assisting you with the nexus letter and that the main purpose is for him or her to confirm it is at least as likely as it is unlikely that your back pain and limited range of motion has a service-related connection.
Keep in mind that you do not have to experience incapacitating episodes of spine or back pain to qualify for disability benefits. The VA typically looks at the limitation of motion caused by your scoliosis when assigning a disability rating and approving or denying your disability claim.
Secondary Service Connection for Scoliosis
When you have a disease or disability related to a secondary service connection, it means that the condition developed in response to your primary disability of scoliosis. Spinal stenosis and arthritis of the spine are closely related to scoliosis and may develop as a result of this painful spine and back condition.
Spinal stenosis occurs when the spaces within your spine narrow and cause pain by putting pressure on nerves that travel through the spine. Arthritis of the spine, also known as spinal arthritis, develops due to inflamed facet joints located in the spine or the sacroiliac joints that connect the pelvis and spine. Degenerative arthritis of the spine is the 10th most common reason that the VA grants a secondary service connection for scoliosis.
Service Connection by Aggravation | What if you were diagnosed with Scoliosis before service?
Service connection by aggravation means that you had scoliosis before signing on for military service, and it became worse while you were on active duty. However, you will need to submit documentation proving that you had scoliosis when you entered military service before the VA will consider you for service connection by aggravation disability benefits.
Proving service connection by aggravation will be easier to do if your military service entrance exam noted that you already had scoliosis. If your military service record does not mention this, contact your doctor to see if he or she will write a letter outlining your pre-existing condition of scoliosis.
You will also have to prove that your scoliosis worsened during military service. Unlike your primary disability claim, you do not have to document a specific event or duties that caused a worsening of your scoliosis. However, the progression of your impairment cannot have been due to its natural progression or occasional flare-ups. Creating a compelling case of service connection by aggravation requires input from your medical provider.
Compensation and Pension Exam (C&P exam) for Scoliosis
The VA requires some applicants for disability benefits to undergo a C&P exam when it needs more information to approve or deny a disability claim. The main purpose of a C&P exam is to help the VA understand the severity of the injury or illness. This information helps VA disability claims processors
assign an accurate disability rating. A staff member at your local VA Center will contact you to schedule the exam. Here is what you can expect when you arrive at your C&P exam.
- The doctor will review your disability claim and may ask questions about your medical records. Questions regarding your medical records typically come from the VA Disability Questionnaire.
- The doctor will perform a physical exam that may test the range of motion in your neck and spine.
- The doctor may request that you get a follow-up X-ray or other medical tests to support your disability claim.
You can expect your C&P exam to last several minutes to more than an hour depending on the severity of your back curvature, back pain, and other symptoms. Once you have completed the C&P exam, the doctor forwards visit notes to VA disability claims processors. After reviewing the information in your medical records and appointment notes, the VA disability claims processors assign a disability rating and notify you of their decision by mail. This can take three to four months.
You have the right to appeal the decision of the VA disability claims processors if you received a denial or disagree with the disability rating. As of February 19, 2019, you will need to go through the decision review process on the Department of Veterans’ Affairs website to file an appeal.
VA Disability Ratings for Scoliosis
The VA uses a system called the Veterans Affairs Schedule for Rating Disability (VASRD) when assigning a disability rating for conditions related to spine and back conditions, including scoliosis. However, scoliosis does not have a separate disability rating system on its own. The VA uses a general rating formula for all conditions related to spine and back conditions and then bases its disability rating primarily on limited range of motion of the spine. Here are some of the specific conditions included in the general rating formula for spine and back conditions.
- Ankylosing spondylitis
- Arthritis of the spine
- Intervertebral Disc Syndrome
- Favorable ankylosis
- Limited range of motion of the sacroiliac and lumbosacral joints
- Limited range of motion of the coccyx bone
- Unfavorable ankylosis
- Other diseases of the musculoskeletal system
The VA uses a general rating formula that considers the degree of flexion you have in both your cervical spine and thoracolumbar spine. You would receive a 100 percent disability rating if scoliosis caused your entire spine to freeze in an unmovable position. The greater the percentage of flexion you have in your spine after a diagnosis of scoliosis, the lower your disability rating will be.
TDIU for Scoliosis
You may qualify for a Total Disability Rating Based on Individual Unemployability (TDIU) if your service-connected disability of scoliosis prevents you from finding or keeping gainful employment. This is true even if your disability rating from scoliosis is less than 100 percent.
Feel free to reach out to Hill and Ponton, a law firm serving the Veteran community, with additional questions about disability compensation for scoliosis or assistance with appealing your VA disability claim.