September 2, 2025 • 10 mins
In this episode, we dive into the complex topic of Degenerative Disc Disease (DDD) and its role in VA disability claims. Veterans experiencing chronic back pain or spinal issues may be struggling with DDD, a condition that can significantly impact daily life and work. Whether you’re a veteran filing a claim or an advocate assisting others, this episode offers clarity on diagnosis, compensation, and common challenges in the VA claims process.
🩺 Topics Covered:
- What is Degenerative Disc Disease (DDD)?
- How military service can contribute to or aggravate DDD
- Key symptoms veterans experience
- How the VA evaluates and rates DDD
- Understanding secondary conditions linked to DDD (e.g., radiculopathy, depression)
- Tips for strengthening your VA disability claim
- The importance of medical evidence and C&P exams
- Appeals and common pitfalls
Enjoying the podcast? Don’t forget to subscribe, rate, and leave a review! If you or someone you know is struggling with DDD and needs help navigating the VA system, share this episode!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Leah Bucholz (00:05):
Hey guys, it's Leah Bee from Prestige Veteran
Medical Consulting. I'm a USArmy veteran, physician
assistant and formercompensation and pension
examiner. So welcome back to ourchannel where for those of you
that don't know we like to breakdown VA disability benefits one
condition at a time. I am yourhost Leah and today we're gonna
talk about one of the mostcommon orthopedic conditions
claimed by veterans and that isdegenerative disc disease. So
(00:30):
tons of veterans suffer fromback pain, right?
Whether that started on activeduty, it's secondary to another
condition, or perhaps it wasrelated to your jumping on
active duty, being a pilot, anyof your occupational stresses
and develop later, all of thesedifferent ways can be related to
service. And maybe it's acombination of those ways,
(00:50):
right? So if you've been dealingwith chronic back pain,
stiffness, numbness, or shootingpain down your legs, you are not
alone. Degenerative disc diseaseaffects thousands of veterans
and it definitely can be serviceconnected. So today we're gonna
break down what DDD is, how VArates it, how you can prove that
it's related to your service andwhat to do if it's part of a
(01:10):
secondary condition or worseningover time.
So what is degenerative discdisease or DVD? Let's start with
a simple definition.Degenerative disc disease is
it's not technically a diseaseit's more it's a condition that
happens when the intervertebraldiscs in your spine start to
wear down over time. These discsact like shock absorbers between
(01:34):
your vertebrae and when theylose flexibility or cushioning
it can lead to chronic back orneck pain, herniated or bulging
discs, nerve impingement, painradiating down the arms or legs.
You can have stiffness andmobility issues.
For veterans, years of roughmarching, jumping, carrying
(01:55):
gear, physical strain canabsolutely cause or accelerate
this condition. So can DDD beservice connected? So for sure
degenerative disc disease can beservice connected and the VA
recognizes it under severaldifferent diagnostic codes
depending on the location andseverity. So there are two
primary paths, direct orsecondary service connection.
(02:17):
And we talk about this a lot inour videos.
So let's look at each one ofthose. So direct service
connection for degenerative discdisease. So a direct service
connection means that thecondition started while you were
on active duty or you can show aclear medical link between your
time in uniform and your currentspinal condition. So a real
(02:38):
world example of this would bethat you served in the infantry,
you were an 11 Bravo for tenyears, you regularly carried 80
pound ruck sacks for ruckmarching and you had multiple
trips to sick call for back painafter field exercises. Your
medical records demonstrate thatyou have consistent complaints
and after discharge an MRIconfirmed that you had disc
(02:59):
degeneration.
That is pretty strong supportingevidence to show a direct
service connection. So oftenyou'll definitely need a current
diagnosis. So that can be basedon an x-ray, an MRI, or some
type of orthopedic report.Service treatment records may be
helpful or personal reportsshowing your injury or strain. A
(03:21):
nexus statement tying your DDDto your service.
So that statement can come atthe compensation and pension
exam. Your treating doctor canprovide a nexus statement
saying, Hey, think this isrelated to their service. Any of
those, some medical provider hasto agree that your current
condition is related to yourservice. So let's talk about
secondary service connection fordegenerative disc disease. So
(03:45):
let's say that you had back thatyour back pain didn't start
until after service butdeveloped as a result of another
service connected condition.
That's where secondary serviceconnection can come into being
relevant to your case. So commonsecondary causes of DDD are
things like service connectedknee or hip conditions, uneven
(04:07):
gait and poor biomechanics canlead to lumbar strain or disc
issues. So if you've got serviceconnected flat feet or pes
planus, they can alter yourposture and your spinal
alignment. Obesity, we talkabout obesity all the time as an
intermediate step. If you areobese because of another service
connected disability it can leadto a myriad of things.
(04:28):
And so I urge you if you haven'tseen it already to check out our
obesity as an intermediate stepvideo because it can apply to a
number of things to includeorthopedic conditions. Obesity
secondary to things like PTSD ormedication side effects.
Increased body weight definitelyputs added strain on the spine
and other joints so spinalinjuries or surgeries for other
(04:51):
service connected issues, TBIrelated balance disorders can
cause it, abnormal movementpatterns over time can
definitely contribute todegeneration. So another real
world example would be if you'rerated for service connected knee
instability, over time youraltered walking pattern has led
to chronic back pain, imagingreveals degenerative disc
(05:15):
disease. In this case, your DDDcould be secondarily related to
your knee condition.
So again, things that will beimportant will be evidence of a
primary condition that you mayalready be service connected
for, a diagnosis of DDD, amedical link or opinion or a
nexus linking those things. Sowhat does the medical literature
(05:35):
say about DDD and veterans? Sobacking up your case with
medical research gives you anedge especially if you're
appealing a denial or making asecondary service connection. I
often write medical opinions forback pain and if I just said,
Hey, I'm Leah B, I'm a PA and Ithink their back pain is related
to service and that's all Isaid, it probably wouldn't carry
(05:55):
a ton of weight because therehas to be scientific rationale
and reasonable records thatsupport that link. So what does
the literature show?
So heavy lifting and impact,multiple studies including those
in spine and the Journal ofOrthopedic Research show that
repetitive axial loading likerucking or airborne operations
(06:17):
increase spinal discdegeneration. Psychological
stress, chronic stress and PTSDcan intensify perception of
pain, delay healing, and lead tomuscle tension that worsens back
problems. Biomechanicalcompensation orthopedic journals
note that knee and hip problemsalter gait and increase wear and
tear on the lumbar spine leadingto DDD as well. So if your
(06:41):
doctor includes this kind ofevidence in your nexus letter or
if you submit these type ofstudies with your claim, it may
help, it may not. It justdepends on the specifics of your
case.
So how does the VA ratedegenerative disc disease? The
VA rates DDD under generalrating formula for disease and
injuries of the spine which is38 CFR 4.71A. They base your
(07:04):
ratings mostly on things likerange of motion and symptoms
like pain, flare ups, andfunctional limitations. It So
doesn't necessarily matter howmany surgeries you've had, it's
what are those functionallimitations. So typical ratings
are things like ten percentwhere you have some limitation
or pain with motion, twentypercent if your forward flexion
is limited to 60 degrees orless, forty percent if you have
(07:27):
severe limitation or spinalfusion, higher ratings if you're
bedridden or if you have spinalcord issues.
You may also get separateratings for things like
radiculopathy in any of yourextremities which is nerve pain
shooting down the legs or armsAnd that's often rated under
peripheral nerve codes. I've gotother videos you guys can check
(07:47):
out about radiculopathy that maybe beneficial. So the CMP exam
and medical evidence. So we havea great back pain CMP exam
video. If you have a C and Pcoming up for back pain that
might be one you wanna check outso you can kind of see what you
might be able to expect.
So when you file your claim theVA is likely gonna schedule you
a C and P exam or a compensationand pension exam with a PA,
(08:11):
nurse practitioner or a doctor.They're gonna evaluate your
range of motion with and withoutpain, muscle spasms, tenderness
or guarding. They're gonna lookfor neurologic symptoms like
numbness or weakness, anyradiculopathy or nerve
involvement that you might behaving. So if you've got flare
ups that limit your motion evenif your pain is better that day
(08:32):
you wanna talk about your worstday as well and let them know.
So before we close out here aresome things to think about to
make sure your claim is wellsupported.
So having x rays or an MRI canbe helpful in some cases,
documented flare ups like ajournal for pain, diaries or a
(08:54):
symptom tracker. If it'ssomething that's going to be
secondarily related, make surethat you're able to articulate
that. If your doctor's willingto give you a nexus letter,
fantastic. If not, that it'snever required. So if you have
any work impact, like missedtime, physical restrictions,
etcetera, that can be important.
So always remember if you needhelp with filing your claim or
(09:17):
appealing, follow-up with anaccredited claims agent, BSO or
an attorney, accredited VAattorney, they are the best
advocates for you to help youkind of navigate the system. And
those are never at any cost tothe veteran up front. So if you
use a BSO, those guys don'tcharge at all. And the fees
(09:37):
associated with accreditedattorneys and claims agents are
very reasonable and are veryregulated and are only upon your
award outcome for these types ofcases. So I hope this was
helpful to you guys.
Please let me know if you haveany feedback. I always like to
hear your stories. Also, pleaselike and subscribe and I'll see
you guys next time. Okay,thanks.
Hey guys, it's Leah Bee from Prestige Veteran
Medical Consulting. I'm a USArmy veteran, physician
assistant and formercompensation and pension
examiner. So welcome back to ourchannel where for those of you
that don't know we like to breakdown VA disability benefits one
condition at a time. I am yourhost Leah and today we're gonna
talk about one of the mostcommon orthopedic conditions
claimed by veterans and that isdegenerative disc disease. So
(00:30):
tons of veterans suffer fromback pain, right?
Whether that started on activeduty, it's secondary to another
condition, or perhaps it wasrelated to your jumping on
active duty, being a pilot, anyof your occupational stresses
and develop later, all of thesedifferent ways can be related to
service. And maybe it's acombination of those ways,
(00:50):
right? So if you've been dealingwith chronic back pain,
stiffness, numbness, or shootingpain down your legs, you are not
alone. Degenerative disc diseaseaffects thousands of veterans
and it definitely can be serviceconnected. So today we're gonna
break down what DDD is, how VArates it, how you can prove that
it's related to your service andwhat to do if it's part of a
(01:10):
secondary condition or worseningover time.
So what is degenerative discdisease or DVD? Let's start with
a simple definition.Degenerative disc disease is
it's not technically a diseaseit's more it's a condition that
happens when the intervertebraldiscs in your spine start to
wear down over time. These discsact like shock absorbers between
(01:34):
your vertebrae and when theylose flexibility or cushioning
it can lead to chronic back orneck pain, herniated or bulging
discs, nerve impingement, painradiating down the arms or legs.
You can have stiffness andmobility issues.
For veterans, years of roughmarching, jumping, carrying
(01:55):
gear, physical strain canabsolutely cause or accelerate
this condition. So can DDD beservice connected? So for sure
degenerative disc disease can beservice connected and the VA
recognizes it under severaldifferent diagnostic codes
depending on the location andseverity. So there are two
primary paths, direct orsecondary service connection.
(02:17):
And we talk about this a lot inour videos.
So let's look at each one ofthose. So direct service
connection for degenerative discdisease. So a direct service
connection means that thecondition started while you were
on active duty or you can show aclear medical link between your
time in uniform and your currentspinal condition. So a real
(02:38):
world example of this would bethat you served in the infantry,
you were an 11 Bravo for tenyears, you regularly carried 80
pound ruck sacks for ruckmarching and you had multiple
trips to sick call for back painafter field exercises. Your
medical records demonstrate thatyou have consistent complaints
and after discharge an MRIconfirmed that you had disc
(02:59):
degeneration.
That is pretty strong supportingevidence to show a direct
service connection. So oftenyou'll definitely need a current
diagnosis. So that can be basedon an x-ray, an MRI, or some
type of orthopedic report.Service treatment records may be
helpful or personal reportsshowing your injury or strain. A
(03:21):
nexus statement tying your DDDto your service.
So that statement can come atthe compensation and pension
exam. Your treating doctor canprovide a nexus statement
saying, Hey, think this isrelated to their service. Any of
those, some medical provider hasto agree that your current
condition is related to yourservice. So let's talk about
secondary service connection fordegenerative disc disease. So
(03:45):
let's say that you had back thatyour back pain didn't start
until after service butdeveloped as a result of another
service connected condition.
That's where secondary serviceconnection can come into being
relevant to your case. So commonsecondary causes of DDD are
things like service connectedknee or hip conditions, uneven
(04:07):
gait and poor biomechanics canlead to lumbar strain or disc
issues. So if you've got serviceconnected flat feet or pes
planus, they can alter yourposture and your spinal
alignment. Obesity, we talkabout obesity all the time as an
intermediate step. If you areobese because of another service
connected disability it can leadto a myriad of things.
(04:28):
And so I urge you if you haven'tseen it already to check out our
obesity as an intermediate stepvideo because it can apply to a
number of things to includeorthopedic conditions. Obesity
secondary to things like PTSD ormedication side effects.
Increased body weight definitelyputs added strain on the spine
and other joints so spinalinjuries or surgeries for other
(04:51):
service connected issues, TBIrelated balance disorders can
cause it, abnormal movementpatterns over time can
definitely contribute todegeneration. So another real
world example would be if you'rerated for service connected knee
instability, over time youraltered walking pattern has led
to chronic back pain, imagingreveals degenerative disc
(05:15):
disease. In this case, your DDDcould be secondarily related to
your knee condition.
So again, things that will beimportant will be evidence of a
primary condition that you mayalready be service connected
for, a diagnosis of DDD, amedical link or opinion or a
nexus linking those things. Sowhat does the medical literature
(05:35):
say about DDD and veterans? Sobacking up your case with
medical research gives you anedge especially if you're
appealing a denial or making asecondary service connection. I
often write medical opinions forback pain and if I just said,
Hey, I'm Leah B, I'm a PA and Ithink their back pain is related
to service and that's all Isaid, it probably wouldn't carry
(05:55):
a ton of weight because therehas to be scientific rationale
and reasonable records thatsupport that link. So what does
the literature show?
So heavy lifting and impact,multiple studies including those
in spine and the Journal ofOrthopedic Research show that
repetitive axial loading likerucking or airborne operations
(06:17):
increase spinal discdegeneration. Psychological
stress, chronic stress and PTSDcan intensify perception of
pain, delay healing, and lead tomuscle tension that worsens back
problems. Biomechanicalcompensation orthopedic journals
note that knee and hip problemsalter gait and increase wear and
tear on the lumbar spine leadingto DDD as well. So if your
(06:41):
doctor includes this kind ofevidence in your nexus letter or
if you submit these type ofstudies with your claim, it may
help, it may not. It justdepends on the specifics of your
case.
So how does the VA ratedegenerative disc disease? The
VA rates DDD under generalrating formula for disease and
injuries of the spine which is38 CFR 4.71A. They base your
(07:04):
ratings mostly on things likerange of motion and symptoms
like pain, flare ups, andfunctional limitations. It So
doesn't necessarily matter howmany surgeries you've had, it's
what are those functionallimitations. So typical ratings
are things like ten percentwhere you have some limitation
or pain with motion, twentypercent if your forward flexion
is limited to 60 degrees orless, forty percent if you have
(07:27):
severe limitation or spinalfusion, higher ratings if you're
bedridden or if you have spinalcord issues.
You may also get separateratings for things like
radiculopathy in any of yourextremities which is nerve pain
shooting down the legs or armsAnd that's often rated under
peripheral nerve codes. I've gotother videos you guys can check
(07:47):
out about radiculopathy that maybe beneficial. So the CMP exam
and medical evidence. So we havea great back pain CMP exam
video. If you have a C and Pcoming up for back pain that
might be one you wanna check outso you can kind of see what you
might be able to expect.
So when you file your claim theVA is likely gonna schedule you
a C and P exam or a compensationand pension exam with a PA,
(08:11):
nurse practitioner or a doctor.They're gonna evaluate your
range of motion with and withoutpain, muscle spasms, tenderness
or guarding. They're gonna lookfor neurologic symptoms like
numbness or weakness, anyradiculopathy or nerve
involvement that you might behaving. So if you've got flare
ups that limit your motion evenif your pain is better that day
(08:32):
you wanna talk about your worstday as well and let them know.
So before we close out here aresome things to think about to
make sure your claim is wellsupported.
So having x rays or an MRI canbe helpful in some cases,
documented flare ups like ajournal for pain, diaries or a
(08:54):
symptom tracker. If it'ssomething that's going to be
secondarily related, make surethat you're able to articulate
that. If your doctor's willingto give you a nexus letter,
fantastic. If not, that it'snever required. So if you have
any work impact, like missedtime, physical restrictions,
etcetera, that can be important.
So always remember if you needhelp with filing your claim or
(09:17):
appealing, follow-up with anaccredited claims agent, BSO or
an attorney, accredited VAattorney, they are the best
advocates for you to help youkind of navigate the system. And
those are never at any cost tothe veteran up front. So if you
use a BSO, those guys don'tcharge at all. And the fees
(09:37):
associated with accreditedattorneys and claims agents are
very reasonable and are veryregulated and are only upon your
award outcome for these types ofcases. So I hope this was
helpful to you guys.
Please let me know if you haveany feedback. I always like to
hear your stories. Also, pleaselike and subscribe and I'll see
you guys next time. Okay,thanks.
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