VA disability claims
How to describe your symptoms so the rating reflects them
"My back hurts all the time" tells VA almost nothing. Here is what to write, what to say at the exam, and the details veterans leave out that cost them money.
Veterans Crisis Line — dial 988, then press 1. Text 838255. Chat at
veteranscrisisline.net. TTY 711 then 988, or
1-800-799-4889. 24 hours a day, 7 days a week. You do not have to be enrolled in VA benefits or
health care to connect.
Why this page exists. Your own written account of your symptoms is evidence. VA's rule on
lay evidence says "competent lay evidence means any evidence not requiring that the proponent have
specialized education, training, or experience" (38 CFR 3.159(a)(2)), and VA's own evidence page says
"anyone can provide lay evidence. This person doesn't need to have any specific training or education."
Federal law requires VA to give due consideration to "all pertinent medical and lay evidence"
(38 USC 1154(a)). You do not need a lawyer's words. You need specific ones. I am one retired
Sergeant First Class putting this in plain English — I am not VA.
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.
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.
Give VA the name of the condition, not just the ache
A doctor's diagnosis gives VA something to rate. Symptoms tell VA how bad it is.
VA's own rule for a first claim is that you have a current physical or mental disability
(VA evidence page,
VA eligibility page).
A named diagnosis helps VA pick the right rating rules, and a diagnosed condition can also open the door to
secondary claims (see below).
Do this: get seen by a medical provider, ask what the diagnosis is, collect your medical records, add
your own statement (VA Form 21-4138), add a buddy statement (VA Form 21-10210) if someone has watched you struggle,
and think about which conditions may be linked to each other. File with a plan, not a list of complaints.
The flyers going around say "VA rates diagnoses, not symptoms." That is too simple.
The Federal Circuit ruled in Saunders v. Wilkie (2018) that pain by itself can be a disability when it
reaches the level of a functional impairment of earning capacity, even with no diagnosis. It also does not let
you claim just by saying you hurt. So name the diagnosis if you have one, and if you do not, describe exactly
what the pain stops you from doing
(VA's summary of the decision).
| You say | Ask your provider whether it is |
|---|---|
| My back hurts | Degenerative arthritis of the spine, degenerative disc disease, bulging discs |
| Pain, numbness or weakness down the leg | Radiculopathy, sciatica, femoral nerve involvement |
| My knee hurts | Degenerative joint disease, torn meniscus, chronic instability, knee replacement |
| My hip hurts | Osteoarthritis of the hip, chronic hip strain |
| My foot hurts | Plantar fasciitis, bone spurs, tarsal tunnel syndrome |
| I cannot sleep | Insomnia, sleep apnea, or a sleep problem caused by pain or by PTSD |
| I feel anxious or sad | Depression, anxiety disorder, adjustment disorder, PTSD |
These are examples of names a provider may use. Only a provider can diagnose you. Do not file a
diagnosis nobody has given you.
★ A diagnosis names it. Your words show what it does to you.
One condition can cause another, but VA will not pay twice for the same symptom
Name every condition you think is linked, and do not list the same symptom under two names. The secondary rule (38 CFR 3.310), the no-double-counting rule and the sleep and nerve examples are on Secondary Conditions.
★ Link the conditions. Do not list the same symptom twice.
When there is no diagnosis, there is still a lane
For service in Southwest Asia (Iraq, Kuwait, Saudi Arabia, Bahrain, Qatar, UAE, Oman and nearby waters, and
Afghanistan after Sept. 19, 2001), VA compensates chronic multisymptom illness and undiagnosed illness with signs
or symptoms such as fatigue, headaches, muscle and joint pain, sleep disturbances and stomach problems
(VA: Gulf War illnesses;
38 CFR 3.317).
Symptoms must have lasted at least 6 months. The regulation sets a time limit for symptoms that first show up
after service, so ask an accredited VSO to check it before you wait.
★ Iraq service? Ask about this lane.
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.
twice a week, lasting 2 to 3 days4 to 6 bad days out of 7
On a normal day4 out of 10
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.
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: nerve symptoms are rated separately from the joint and combined with it. Describe only the joint, and that separate rating never gets considered. The rating rules are on Secondary Conditions. For the neck and arm, see Cervical Spine C&P Exam.
★ Nerve symptoms are a second rating. Do not leave them out.
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.
What the examiner must ask about flare-ups and what to tell them on exam day are on C&P Exam Cheat Sheet.
A court decision called Sharp v. Shulkin holds that an exam that skips the estimate of range of motion during flare-ups 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.
You can request a copy of your exam report and read it for accuracy. VA's exam page:
va.gov/disability/va-claim-exam.
★ Never say "I'm fine today" and leave it there.
A painful joint, and doctor-ordered bed rest
A joint that is actually painful may be entitled to at least the minimum compensable rating even when range of motion measures near normal (38 CFR 4.59). If you were rated 0 percent on a joint that hurts, see C&P Exam Cheat Sheet.
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.
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.
diagnostic code 8100
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.
Find both forms at va.gov/find-forms. The examiner forms
themselves are public too, so you can read the exact questions before your exam:
benefits.va.gov/compensation/dbq_publicdbqs.asp.
★ Written, signed, filed. All three.
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.
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.
Deadlines, and free help
If the decision ignores what you described, you have options, and the clocks are not the same.
The three review lanes, their forms and their deadlines are on Appeal a VA Decision. Accredited VSO help is free; fee rules for attorneys and claims agents are on Help Your Own Claim. Find accredited help at va.gov/get-help-from-accredited-representative.
★ Never pay for help you can get free.
Where to call and where to go
- VA benefits (claims, status): 800-827-1000, Mon-Fri 8am-9pm ET
- VA health care (get seen, enrollment): 877-222-8387, Mon-Fri 8am-8pm ET
- Veterans Crisis Line: dial 988, then press 1
- VA contact numbers
- How to file a VA disability claim
- VA Form 21-4138, Statement in Support of Claim
- VA Form 21-10210, Lay/Witness Statement
- VA claim exam: what to expect