Understanding VA Disability Benefits for Chronic Pain: A Guide for Veterans

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Remands can be a confusing and frustrating part of the VA claims process but understanding them is key to navigating your appeal successfully. In this video, our team breaks down what remands mean for your case, how the process works under AMA changes, and what steps you can take to avoid delays and keep your claim moving forward. Click below to watch and empower yourself with the knowledge to fight for the benefits you deserve! 

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Understanding VA Disability Benefits for Chronic Pain: A Guide for Veterans

Chronic pain can significantly impact a person’s quality of life, interfering with daily activities, work, and relationships. For veterans, this condition often stems from service-related injuries or illnesses. If you’re a veteran experiencing chronic pain as a result of your military service, you may be eligible for VA disability benefits. However, navigating the VA’s rating system for chronic pain can be complex. This guide breaks down the essentials of chronic pain, its recognition as a disability, and how to build a strong claim. 

What Is Chronic Pain? 

Chronic pain is defined as persistent pain lasting six months or longer. It often begins with an injury or illness and can develop into chronic pain syndrome, a condition that combines physical pain with secondary complications like depression, anxiety, or cognitive impairments. Veterans with chronic pain may experience: 

• Physical Symptoms: Reduced activity, sleep issues, and fatigue. 

• Mental and Emotional Symptoms: Depression, anxiety, suicidal ideation, and social withdrawal. 

• Cognitive Impairments: Difficulty concentrating, memory problems, and irritability. 

These symptoms go beyond physical discomfort, significantly diminishing a person’s overall well-being. 

Is Chronic Pain Recognized as a Disability by the VA? 

Yes, chronic pain is now recognized as a compensable disability by the VA, thanks to the landmark 2018 Saunders v. Wilkie court decision. Before this ruling, veterans could not claim disability benefits for pain alone without a diagnosable underlying condition. 

Saunders v. Wilkie: A Turning Point 

In this case, the Federal Circuit determined that pain qualifies as a disability if it impairs normal functioning and reduces earning capacity. This ruling clarified that veterans could seek benefits for service-connected pain, even without a formal diagnosis of the underlying cause. 

How Does the VA Rate Chronic Pain? 

The VA does not have a specific diagnostic code for chronic pain. Instead, veterans may receive ratings based on the conditions or symptoms caused by their chronic pain. For example: 

• Mental Health Conditions: Chronic pain often leads to depression or anxiety, which can be rated under the VA’s schedule for mental disorders (38 CFR § 4.130). 

• Secondary Conditions: Symptoms or complications stemming from chronic pain, such as muscle injuries or sleep disorders, may also be rated if they are service connected. 

Example 

A veteran with a service-connected back injury suffers from chronic pain that causes severe depression. While there is no standalone rating for chronic pain, the VA could assign a disability rating for depression as a secondary condition. 

Building a Strong Chronic Pain VA Claim 

To strengthen your claim, it’s crucial to provide detailed and compelling evidence. Here’s how: 

1. Obtain a Private Medical Opinion 

A medical opinion from a private healthcare provider can provide critical support for your claim. Your doctor should: 

• Discuss the effects of chronic pain on your brain and overall health. 

• Relate your symptoms to a service-connected condition. 

• Clarify how chronic pain impairs your ability to function. 

2. Highlight Service Connection 

Your claim must establish a clear link between your chronic pain and military service. For instance, if chronic pain stems from a service-connected knee injury, ensure that all documentation explicitly connects the two. 

3. Address Overlapping Conditions 

In cases where pain stems from multiple sources (e.g., a service-connected back condition and a non-service-connected shoulder injury), your medical evidence should explain how these conditions intertwine. The VA can still provide compensation if the symptoms are “inextricably intertwined” with the service-connected condition. 

Chronic Pain and TDIU (Total Disability Individual Unemployability) 

Chronic pain can also serve as a basis for Total Disability Individual Unemployability (TDIU), a benefit that compensates veterans at the 100% disability rate if they cannot maintain gainful employment due to their conditions. Chronic pain often causes both physical and mental impairments that impact work capabilities. 

Key Considerations for TDIU Claims: 

• Physical Limitations: Chronic pain may prevent prolonged sitting, standing, walking, or lifting. 

• Mental Limitations: Depression or anxiety related to chronic pain can lead to difficulty concentrating, irritability, and trouble working with others. 

Strong medical evidence demonstrating how chronic pain affects your employability is essential for a successful TDIU claim. 

Seeking Help with Your VA Claim 

Obtaining an accurate VA disability rating for chronic pain can be challenging, but you don’t have to navigate this process alone. At Hill & Ponton, we specialize in helping veterans secure the benefits they deserve. Whether you’re filing an initial claim, seeking an increased rating, or appealing a denied claim, our experienced team is here to support you. 

Contact us today for a free case evaluation and let us guide you through the complexities of VA disability benefits for chronic pain. 

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Were You Exposed to “Forever Chemicals” in Your Water Supply?

PFAS, also known as “forever chemicals,” are synthetic substances widely used in firefighting foams, water-resistant products, and industrial applications. These chemicals have been found in dangerously high concentrations in some water supplies, including on or near military bases. Learn if your military base was impacted using our Toxic Exposure Map.

Exposure to PFAS has been linked to severe health conditions, such as:

• Testicular Cancer

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If you or a loved one lived or worked in areas with PFAS contamination and have been diagnosed with any of these conditions, you may qualify for compensation.

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Veteran’s Success in Securing Service Connection for Sleep Apnea Secondary to PTSD

Note: All identifying details have been changed to protect privacy. This case is based on examples from the BVA database.

A Navy veteran who served from October 2000 to October 2008 sought service connection for sleep apnea, claiming it was caused or aggravated by his service-connected posttraumatic stress disorder (PTSD). The veteran experienced significant sleep difficulties, including insomnia, hypersomnia, fatigue, and interrupted sleep patterns, which he argued were intertwined with his PTSD symptoms. Despite an initial denial, the veteran presented additional medical evidence supporting the connection between his PTSD and sleep apnea. 

This case underscores the importance of private medical evaluations and evidence-based medical literature in establishing secondary service connections. 

The Outcome 

In this case, the Board of Veterans' Appeals (BVA) granted service connection for sleep apnea as secondary to PTSD. 

Granted: Service connection for sleep apnea due to, or aggravated by, service-connected PTSD. 

Why Was This Decision Made? 

The Board’s decision was based on several critical factors: 

Strong Private Medical Evidence 

The veteran provided a comprehensive medical opinion from a private physician who reviewed the veteran’s records and medical history in detail. This opinion highlighted: 

• Comorbidity of PTSD and Sleep Apnea: Medical literature cited in the opinion explained the bidirectional relationship between PTSD and sleep apnea, with overlapping symptoms like sleep disturbances and hyperarousal. 

• Scientific Basis for Connection: The private physician referenced peer-reviewed studies that demonstrated a strong statistical association between PTSD and sleep apnea, particularly among veterans. 

• Veteran’s Symptomology: The physician described how the veteran’s PTSD exacerbated his sleep apnea symptoms, including disrupted sleep patterns, daytime fatigue, and cognitive impairment. 

VA Concession of PTSD’s Role in Sleep Disturbance 

The VA medical records documented the veteran’s chronic insomnia and sleep disruption related to his PTSD, further supporting the connection between the two conditions. 

Rebuttal to VA’s Negative Opinion 

While the VA examiner argued that sleep apnea was unrelated to PTSD and attributed it to physical factors like age and body structure, the private physician’s opinion was deemed more persuasive. This was because: 

• The private physician provided detailed explanations supported by medical literature. 

• The VA examiner failed to address the potential aggravation of sleep apnea by PTSD, a critical element of the claim. 

Reasonable Doubt in Favor of the Veteran 

The Board found the evidence at least evenly balanced between the VA’s negative opinion and the private physician’s positive opinion. In accordance with VA regulations, the benefit of the doubt was resolved in favor of the veteran. 

Lessons for Veterans

This case highlights key strategies for veterans seeking secondary service connection for conditions like sleep apnea: 

• Secure Strong Private Medical Opinions: A detailed opinion from a qualified physician can strengthen your case, especially if it cites medical literature and thoroughly explains the connection between conditions. 

• Document Overlapping Symptoms: Ensure your medical records reflect how symptoms of both conditions (e.g., PTSD and sleep apnea) are interconnected. 

• Challenge Negative VA Opinions: Present evidence that directly addresses and refutes the VA’s conclusions. 

• Highlight Aggravation: Even if a condition isn’t caused by a service-connected disability, showing that it is worsened by the disability can still qualify you for benefits. 

If you’re struggling to secure service connection for a condition related to your military service, contact us at (855) 494-1298 for a free case evaluation. Our experienced team can guide you through the VA claims process and fight for the benefits you deserve. 

Use our VA Disability Calculator to see if your current rating aligns with your level of disability and explore potential increases based on any secondary conditions you may have. Calculate Your Combined VA Disability Rating Now!