Start here
Stop saying it short. Say it specific.
Too vague: "My back hurts all the time."
A rater cannot turn that into a percentage. There is no frequency, no severity, no lost function.
Every sentence you write should carry at least one of these four things:
- How often — times per week, per month
- How long it lasts when it happens
- What sets it off — standing, walking, bending, lifting, stairs, sitting too long
- What you cannot do during it — not just how much it hurts
That last one matters more than veterans think. A court decision called Mitchell v. Shinseki
holds that pain by itself is not compensable unless it actually limits normal working movement. So do
not stop at "it's an 8 out of 10." Write what the 8 stopped you from doing.
★ Numbers and lost function. Not adjectives.
Write it this way
A model paragraph — and the math trap in it
"My lower back pain began during service after years of ruck marches, carrying heavy gear and lifting
equipment, and it has continued without a break from then to today. On a normal day the pain is about a
4 out of 10 with stiffness. About twice a month I have a flare-up lasting 2 to 3 days where the
pain is severe and I cannot bend, lift, or stand more than a few minutes. It is worse with standing,
walking, bending and lifting. I have trouble getting out of bed, putting on my shoes, and doing chores
around the house, and the pain wakes me up at night."
Watch your arithmetic. A common version of this statement says "twice a week, lasting 2 to 3
days." That is 4 to 6 bad days out of 7 — which contradicts the same paragraph's claim of a
normal day at 4 out of 10. A rater can use that contradiction to find your whole account not credible.
Give your real frequency and duration, and make sure the two numbers leave room for the baseline you
describe.
★ Consistent beats dramatic.
Straight talk
What a "flare-up" actually is
Here is a piece of honesty you will not get anywhere else.
No VA regulation defines the word "flare-up." Not 38 CFR 4.1, not 4.40, not 4.45, not 4.59. The
word does not appear in any of them. Anybody who tells you a regulation defines it is citing something
that does not say what they claim.
What is real is this:
- The Disability Benefits Questionnaires — the forms VA examiners fill out — ask
about flare-ups directly. The back form asks, "Does the Veteran report flare-ups of the thoracolumbar
spine?" and tells the examiner to record frequency, duration, characteristics, precipitating and
alleviating factors, severity, and extent of functional impairment.
- 38 CFR 4.40 requires VA to consider functional loss, and says a part "which becomes painful
on use must be regarded as seriously disabled."
In plain words, and these are my words and not VA's: a flare-up is a temporary stretch where a
condition gets significantly worse than its usual level. The limit you need to know: 38 CFR 4.1
says the rating you are given is already considered adequate to cover "considerable loss of working
time from exacerbations." So a flare-up only raises a rating when the extra lost function it
causes actually reaches the next higher step for your diagnostic code — not just because it hurt
more.
★ Describe the extra loss, not just the worse pain.
Costliest miss
If the pain travels, say so — and say which limb
This is the detail that costs veterans the most, and almost nobody tells you.
- Pain that radiates — into the buttock, down the back of the leg, into the foot, or
from the neck into the arm and hand
- Numbness, tingling, burning, or weakness in the arm, hand, leg or foot
- Dropping things, the foot catching, the leg giving out
Name the symptom, and name which arm or which leg. Left and right are rated separately.
Why it matters: 38 CFR 4.71a, General Rating Formula, Note (1) directs VA to "evaluate any associated
objective neurologic abnormalities… separately under an appropriate diagnostic code" and combine
them with the spine rating. Sciatic nerve involvement is rated under 38 CFR 4.124a, diagnostic code
8520 — 20 percent for moderate, 40 percent for moderately severe, 60 percent
for severe with marked muscular atrophy. Describe only the joint, and that separate rating never gets
considered.
★ Nerve symptoms are a second rating. Do not leave them out.
The exam
What the examiner owes you if you are not flaring that day
The exam report — not your written statement — usually drives the percentage.
Show up and describe the bad days, not just how you feel sitting in that chair.
The DBQ instructs the examiner to estimate range of motion in degrees during flare-ups "based on
information procured from relevant sources including the lay statements of the Veteran." Your words are
the input the form asks for.
A court decision called Sharp v. Shulkin holds that an exam that skips that estimate is
inadequate. If the report says the examiner "cannot estimate without resort to mere speculation," that
is a known defect you can point to when you ask for a review — not a dead end.
Timing. Get your written statements into the claims file before the exam. The examiner is
told to estimate from the statements already in the record. Evidence filed after the exam cannot inform
an estimate that has already been written.
★ Never say "I'm fine today" and leave it there.
Two rules people miss
A painful joint, and doctor-ordered bed rest
Minimum compensable rating. Under 38 CFR 4.59, a joint that is actually painful, unstable or
malaligned from a healed injury is entitled to at least the minimum compensable rating for that joint
— even if your range of motion measures close to normal. Veterans accept 0 percent every
day without knowing this rule exists. If you were rated 0 percent on a joint that hurts, that is worth
a second look.
Prescribed bed rest. If a doctor has ever ordered you to bed rest for your back, write down each
episode, the dates, and how long it lasted — and make sure it is in your treatment records.
Intervertebral disc syndrome can be rated on an alternative scale based on incapacitating episodes,
which VA defines by physician-prescribed bed rest and treatment by a physician (38 CFR 4.71a,
diagnostic code 5243). Your own description of a bad day does not substitute for the order being
documented.
★ Two rules. Both leave money on the table.
Not just joints
Migraines and other conditions that come and go
Migraines are not rated on range of motion. They are rated on how often you have
characteristic prostrating attacks.
VA's headache form defines a prostrating attack as one "causing extreme exhaustion, powerlessness,
debilitation or incapacitation with substantial inability to engage in ordinary activities." Under
38 CFR 4.124a, diagnostic code 8100: 0 percent for less frequent attacks; 10 percent for
an average of one every 2 months over the last several months; 30 percent for an average of one
a month over the last several months; 50 percent for very frequent completely prostrating and
prolonged attacks productive of severe economic inadaptability.
50 percent is the ceiling for migraines under DC 8100. There is no higher schedular step. Above
that the routes are extraschedular consideration under 38 CFR 3.321(b) or total disability based on
individual unemployability under 38 CFR 4.16 — and both have to be raised, not assumed.
Keep a dated log: each attack, how long it lasted, whether you had to lie down, work missed.
The same "how often, how long, what I could not do" method applies to any condition that comes and goes
— mental health conditions, irritable bowel syndrome, asthma, and others. Flare-ups are not an
orthopedic-only idea.
★ Log it the day it happens.
Where it goes
Getting the statement into the file
A strong statement nobody filed is worth nothing. Name the vehicle.
- VA Form 21-4138, Statement in Support of Claim — your own account
- VA Form 21-10210, Lay/Witness Statement — the buddy statement, for someone else's
account of what they have seen
- VA also accepts a statement written on a blank sheet of paper — but put your name, file
number or Social Security number, and a signature and date on it
Use the buddy statement. A spouse, a squad member, a supervisor, a Family member who watches you
on the bad days — any of them can write one, and none of them needs medical training. Somebody
else describing what they have seen is often what makes your own account credible. It is free evidence.
★ Written, signed, filed. All three.
The bigger picture
What your statement does and does not do
Your statement carries frequency, severity and daily-life impact. It is not the whole
claim.
- A current diagnosed condition
- An in-service event, injury, illness — or aggravation of something you already had
- A connection between the two
That connection does not always require a separate medical opinion. If the condition was
diagnosed in service, or your symptoms have continued without a break since service, or you have
arthritis that reached a compensable level within one year of separation, VA can connect it without a
nexus opinion (38 CFR 3.303(a), (b) and (d); 3.307(a)(3); 3.309(a)). It also counts if you had the
problem before service and service made it worse. Do not let anyone talk you out of filing because you
do not have a doctor's letter.
So in your statement: date your onset as closely as you can, and say plainly that the symptoms
have continued from service to today. That sentence is what bridges a gap in your service treatment
records.
★ No nexus letter is not a closed door.
Keep it true
Honest beats big
VA weighs your account for credibility against everything else in the record.
- Describe a bad day and a typical day, both honestly
- Do not overstate. An account that does not match your treatment records can be discounted in
full — including the parts you reported accurately
- Do not push through the exam movements past what you can really do. Tell the examiner where it
starts to hurt and stop there
- Do not understate either. "I don't want to complain" is how strong claims get rated low
★ Your word is the evidence. Protect it.
If it goes wrong
Deadlines, and free help
If the decision ignores what you described, you have options — and the clocks are
not the same.
- Higher-Level Review — within one year of the decision notice
- Board Appeal — within one year of the decision notice
- Supplemental Claim — no filing deadline, but file within one year anyway. Filed
inside that year, your effective date goes back to your original claim. Filed after it, your effective
date is no earlier than the date VA receives the Supplemental Claim (38 CFR 3.2500). Waiting can
silently cost you years of back pay
- Contested claim — 60 days, and Board Appeal only. Higher-Level Review is not
available for a contested claim
An accredited VSO representative is free. Always. They help you prepare and file these
statements at no cost. An accredited attorney or claims agent may charge a fee, but only after VA
issues its
initial decision, and a fee up to 20 percent of past-due benefits is presumed
reasonable (38 CFR 14.636). Recognized organizations are not permitted to charge fees at all. Find
accredited help at
va.gov/get-help-from-accredited-representative.
★ Never pay for help you can get free.