Lumbosacral or Cervical Strain Secondary to Ankylosis of the Scapulohumeral Articulation (Shoulder Joint)

How does secondary service connection work?

When the service-connected condition caused it

38 CFR § 3.310(a): “Except as provided in § 3.300(c), disability which is proximately due to or the result of a service-connected disease or injury shall be service connected. When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition.”

When it made an existing condition worse

38 CFR § 3.310(b): “Any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, will be service connected.” VA will not concede aggravation unless medical evidence establishes the baseline severity; it then deducts that baseline, and any natural progress, from the current level.

How strong the evidence for the link has to be

38 U.S.C. § 5107(b): “When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant.” When the positive and negative evidence on the link is in approximate balance, VA gives the benefit of the doubt to the veteran.

What VA means by reasonable doubt

38 CFR § 3.102: “By reasonable doubt is meant one which exists because of an approximate balance of positive and negative evidence which does not satisfactorily prove or disprove the claim.”

A statute that asks for an “at least as likely as not” medical opinion

38 U.S.C. § 1168(a)(1)(B): “obtain a medical opinion (to be requested by the Secretary in connection with the medical examination under subparagraph (A)) as to whether it is at least as likely as not that there is a nexus between the disability and the toxic exposure risk activity.” § 1168 covers exams and opinions in toxic-exposure claims. For any claim for VA benefits, § 5107(b) above gives the veteran the benefit of the doubt when the evidence is in approximate balance.

How is Back or Neck Strain rated as a secondary condition?

If Lumbosacral or Cervical Strain was caused by the service-connected condition, VA rates it on its own severity under its own diagnostic code, as part of the original condition (38 CFR 3.310(a)). If Lumbosacral or Cervical Strain existed first and the service-connected condition made it worse, VA compensates only the worsening: it rates the baseline and current severity and deducts the baseline, and any natural progression, from the current level (38 CFR 3.310(b)). Read 38 CFR § 3.310.

Common questions about Back or Neck Strain secondary to Ankylosis of the Scapulohumeral Articulation (Shoulder Joint)

Can Back or Neck Strain be service-connected as secondary to Ankylosis of the Scapulohumeral Articulation (Shoulder Joint)?

Yes. Under 38 CFR § 3.310, a condition that is caused or aggravated by an already service-connected disability can be granted secondary service connection. Compensating for shoulder immobility. You'll need a current Lumbosacral or Cervical Strain diagnosis and a medical nexus opinion linking it to your service-connected Ankylosis of the Scapulohumeral Articulation (Shoulder Joint), the same standard the VA uses for any secondary claim.

What VA rating can I get for Back or Neck Strain as a secondary condition?

Lumbosacral or Cervical Strain is rated under VASRD diagnostic code 5237. Possible VA ratings for Lumbosacral or Cervical Strain are 100%, 50%, 40%, 30%, 20%, 10%, 0%. The 0% level comes from 38 CFR 4.31, which assigns it wherever no compensable level is met. If Lumbosacral or Cervical Strain was caused by the service-connected condition, VA rates it on its own severity under its own diagnostic code, as part of the original condition (38 CFR 3.310(a)). If Lumbosacral or Cervical Strain existed first and the service-connected condition made it worse, VA compensates only the worsening: it rates the baseline and current severity and deducts the baseline, and any natural progression, from the current level (38 CFR 3.310(b)).

How does a secondary Back or Neck Strain claim affect my combined VA rating?

The VA doesn't add ratings together. With example figures of 30% for Ankylosis of the Scapulohumeral Articulation (Shoulder Joint) and 10% for Lumbosacral or Cervical Strain: 30% and 10% combine to a Table I value of 37%, which VA converts to a 40% combined rating under 38 CFR 4.25, not 40%. Approving Lumbosacral or Cervical Strain as secondary still typically raises your overall combined rating and monthly compensation.

What evidence do I need to service-connect Back or Neck Strain as secondary to Ankylosis of the Scapulohumeral Articulation (Shoulder Joint)?

Strong evidence for the underlying Lumbosacral or Cervical Strain diagnosis includes: C&P or orthopedic exam showing measured loss of range of motion, muscle spasm, or guarding; Service treatment records documenting the in-service injury, incident, or repetitive strain; Buddy statements or personnel records corroborating the in-service event (e.g., heavy lifting, vehicle accident, parachute jumps). For the secondary link itself, a nexus letter from a treating provider explaining how Ankylosis of the Scapulohumeral Articulation (Shoulder Joint) caused or aggravated Lumbosacral or Cervical Strain is typically the deciding piece of evidence. If the claim is that a pre-existing Lumbosacral or Cervical Strain got worse, include records showing how severe it was before it worsened: VA will not concede aggravation unless the baseline is established by medical evidence created before the worsening began, or by the earliest medical evidence after it (38 CFR 3.310(b)).