7 VA Secondary Conditions to Lower Back Pain

Living with lower back pain doesn’t just affect your spine; it can also trigger or exacerbate other health issues throughout your body. 

The VA recognizes these as secondary service-connected conditions, which means you may be entitled to additional disability compensation. 

In this post, we’ll examine how the VA rates lower back pain, highlight 7 VA secondary conditions linked to back pain, and walk through how to prove service connection—including why a strong nexus letter is so important.

Key Takeaways

• The VA rates lower back pain under the General Rating Formula for Diseases and Injuries of the Spine, with possible ratings from 10% to 100%, depending on range of motion, ankylosis, painful motion, and functional loss. 

• Secondary conditions like radiculopathy, hip pain, arthritis, plantar fasciitis, erectile dysfunction, mental health conditions, and shoulder pain may qualify you for additional VA disability benefits. 

• Proving secondary service connection requires a current diagnosis and medical evidence, often in the form of a nexus letter, showing that your secondary condition was caused or aggravated by your service-connected lower back pain. 

How the VA Rates Lower Back Pain

Heavy lifting, repetitive physical strain, injuries, and prolonged periods of awkward posture or sedentary activity during service often cause lower back pain in veterans. 

A 2024 systematic review of over 360,000 service members found that low back pain affects up to 82% of Army, 48% of Air Force, and 5% of Marines each year, showing it’s a common problem across military branches. 

The VA rates lower back pain under the General Rating Formula for Diseases and Injuries of the Spine, with potential ratings ranging from 10% to 100%. 

A low back pain VA rating is based on factors such as painful motion, limitation of range of motion (ROM), ankylosis and functional loss or impairment. For intervertebral disc syndrome (IVDS), ratings may also be based on incapacitating episodes.

7 VA Secondary Conditions to Lower Back Pain

Radiculopathy

Lower back pain can compress or irritate the spinal nerves, leading to radiculopathy. This often causes shooting pain, numbness, tingling, or weakness that radiates from the lower back into the legs. 

The VA frequently rates radiculopathy secondary to lower back pain under the Schedule of ratings for Neurological Conditions and Convulsive Disorders, using diagnostic codes (DC) 8520, 8620, or 8720. 

A VA disability rating for radiculopathy can range from 0% to 80%, depending upon the severity of symptoms and level of paralysis. 

Shoulder Pain

Chronic back pain can change posture or the way veterans move, leading to stress on the shoulders. Over time, this may cause arthritis, tendonitis, or reduced mobility. 

The VA rates shoulder pain secondary to lower back pain under the Schedule of Ratings for the Musculoskeletal System, such as for arthritis or limitation of motion.  

If the medical evidence shows an actual shoulder muscle injury, ratings may instead be assigned under the Schedule of Ratings for Muscle Injuries. 

Most shoulder conditions are rated between 0% and 40%, but severe impairments such as flail shoulder may be rated as high as 80%. 

Hip Pain

When back pain alters gait or weight distribution, it can put strain on the hips. This often leads to chronic pain, arthritis, or even joint degeneration. 

The VA evaluates hip disabilities under the Schedule of Ratings for the Musculoskeletal System, focusing on factors such as range of motion, pain with movement, joint inflammation, instability, and symptoms of degenerative joint disease.  

Ratings are based on how well the hip can move in different directions, including flexion (thigh toward the abdomen), extension (thigh backward), adduction (leg inward), and abduction (leg outward). 

>>View Our Main Guide on Hip Pain Secondary to Back Pain 

Plantar Fasciitis

Changes in walking caused by back pain can stress the feet, sometimes leading to plantar fasciitis.  

You may experience heel pain and difficulty standing or walking for long periods. 

The VA rates plantar fasciitis secondary to lower back pain under DC 5269, with potential ratings of 10%, 20%, or 30%. If there is actual loss of use of the foot, you may be eligible for a 40% VA rating. 

VA ratings for plantar fasciitis depend on if one or both feet are affected, whether it responds to treatment, and if arch supports or other shoe modifications are needed. 

Erectile Dysfunction

Nerve damage, chronic pain, and medications used to treat back conditions can contribute to erectile dysfunction (ED). 

Generally, ED is assigned a 0% VA rating under DC 7522, but it can still qualify for Special Monthly Compensation (SMC-K) for “loss of use of a creative organ.”  

However, several VA schedular codes address conditions of the penis and testicles with varying ratings.  

These include DC 7520–7521 for partial or total removal or deformity of the penis (20–30%) and DC 7523–7524 for testicular atrophy or removal (0–30%), depending on severity and whether one or both testicles are affected.  

Each condition can sometimes be rated under the urinary system if it results in a higher evaluation than the schedular percentage. 

Mental Health Conditions

Living with chronic back pain can lead to depression, anxiety, or other mental health challenges.  

Pain impacts sleep, mood, and quality of life, which can intensify these conditions. 

The VA rates mental health conditions secondary to lower back pain under the General Rating Formula for Mental Disorders, with potential ratings of 0%, 10%, 30%, 50%, 70%, or 100%.  

VA ratings of mental health conditions depend on your level of social and occupational impairment. 

Proposed Mental Health Rating Changes 

To improve accuracy and reflect modern clinical practices, the VA is updating how it evaluates all mental health conditions, including anxiety, PTSD, depression, and eating disorders.  

Learn more about upcoming mental health rating changes HERE. 

Arthritis

Lower back pain can place extra stress on your joints and spine, which may lead to the development or worsening of arthritis. 

When your back is injured or misaligned, it can change the way you move, putting more strain on your hips, knees, or other joints. 

The VA rates arthritis secondary to lower back pain under the Schedule of Ratings for the Musculoskeletal System, using DC 5002, 5003, or 5010, as well as several Limitation of Motion diagnostic codes. 

Proving Secondary Service Connection

To establish secondary service connection, you’ll need two key elements: 

1. A current diagnosis – Medical documentation of your secondary condition from a qualified provider. 

2. A medical nexus – Evidence showing that your secondary condition was caused or aggravated by your service-connected lower back pain. A detailed nexus letter from an independent medical provider is often the most effective way to demonstrate this link.

The Value of a Nexus Letter for Secondary Conditions

A nexus letter for secondary conditions is highly recommended. To prove secondary service connection, you must prove your secondary disability is “proximately due to’ or “aggravated by” another service-connected disability.

A nexus letter provides the VA a detailed medical opinion from a qualified provider that connects your secondary condition to your service-connected back pain. While the VA doesn’t require one, it may be the difference between an approval and a denial.

A nexus letter for a secondary condition: 

• Establishes causation: Explains how your lower back pain caused or aggravated your secondary condition. 

• Adds credibility: Carries weight with VA decision-makers when written by a medical expert. 

• Strengthens weak claims: If the connection isn’t apparent, a nexus letter may provide the missing link.

Filing a VA Claim for Secondary Conditions

To be eligible for a VA rating for secondary conditions to lower back pain, you must file a VA claim.  

Filing online is generally the fastest option, but you can also download and complete VA Form 21-526EZ and submit it in one of the following ways:  

• By mail   

• Via fax 

• In person at a VA regional office 

Medical Evidence Wins VA Claims

Did you know that a lack of medical evidence is the #1 reason VA disability claims are denied?  

Medical evidence is a crucial piece of the puzzle that VA raters consider when reviewing a disability claim. Telemedica provides solutions for veterans looking to bolster their claims through high-quality medical evidence that wins claims!  

Schedule your 20-minute consultation call and learn how to get the supporting medical evidence you need to strengthen your claim.

FAQs | Frequently Asked Questions

Can you get VA disability secondary to lower back pain?

Yes, you can receive VA disability for conditions that develop secondary to lower back pain if you have a current diagnosis of a secondary condition and can prove a medical link between the two conditions. 

What is the VA rating for lower back pain?

The VA rating for lower back pain ranges from 10% to 100%, with breaks at 20%, 30%, 40%, and 50%. 

What are the VA secondary conditions to back pain?

Chronic back pain can lead to other conditions over time, which may qualify as secondary service-connected disabilities.  

Common secondary conditions include radiculopathy, hip pain, knee pain, shoulder problems, plantar fasciitis, erectile dysfunction, and certain mental health conditions.

What are the VA secondary conditions to degenerative disc disease?

Secondary conditions to degenerative disc disease include radiculopathy, sciatica, mental health conditions, sleep disturbances, chronic pain, and orthopedic secondary conditions. >>Explore VA Secondary Conditions to Degenerative Disc Disease 

How do I prove my secondary condition is linked to my lower back pain?

You’ll also need a current diagnosis of the condition you’re linking to your lower back pain. You’ll also need medical evidence, such as a nexus letter, showing that your secondary condition was caused or aggravated by your service-connected lower back pain.  

A nexus letter acts as a professional medical opinion explaining the link between a service-connected disability and a secondary condition, which the VA recognize the validity of your claim.