Journal of Rehabilitation Research & Development (JRRD)

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Volume 53 Number 6, 2016
   Pages 659 — 668

Abstract — Iraq/Afghanistan-era Veterans with back pain: Characteristics and predictors of compensation and pension award

Carine J. Sakr, MD, MPH;1–2* Anne C. Black, PhD;1–2 Martin D. Slade, MPH;2 Justin Calfo, BA;2 Marc I. Rosen, MD1–2

1Department of Veterans Affairs Connecticut Healthcare System, West Haven, CT; 2Yale University School of Medicine, New Haven, CT

Abstract — Approximately 440,000 U.S. Veterans receive compensation for back and/or neck conditions. Veterans Benefits Administration (VBA) criteria state that back compensation determinations are based on impaired back function and not comorbidity or lifestyle, but whether compensation is based solely on consideration of the lumbosacral region is unknown. In this study, we conducted a cross-sectional analysis of medical chart data from 178 post-9/11 Veterans applying for service connection for back pain in fiscal year 2012 at the Department of Veterans Affairs Connecticut Healthcare System. Altogether, 62% were noted to have impairment of back functioning and 74% were awarded compensation. Rates of comorbidities (obesity, depression, smoking, and illicit drug use) were high. In multivariate models predicting compensation awarded, only having an impaired back was associated with service-connected compensation. Pain was associated with extent of service connection, but this relationship was fully mediated by functional back impairment. No other measure (including work status) significantly predicted compensation. In summary, service connection was largely based on functional impairment, as called for in VBA criteria. Although pain and comorbidities undoubtedly affect day-to-day functioning, these factors were not independently related to service connection. Veterans present with many remediable conditions, and the service-connection evaluation may be an opportunity to engage them in treatment.

Key words: back pain, compensation, disability, employment, functional impairment, OEF, OIF, OND, pension, service connection, VBA, Veterans.


View HTML ¦ View PDF ¦ Contents Vol. 53, No. 6
This article and any supplementary material should be cited as follows:
Sakr CJ, Black AC, Slade MD, Calfo J, Rosen MI. Iraq/Afghanistan-era Veterans with back pain: Characteristics and predictors of compensation and pension award. J Rehabil Res Dev. 2016;53(6):659–68.
http://dx.doi.org/10.1682/JRRD.2015.08.0151
ORCID: Anne C. Black, PhD: 0000-0003-0295-7351; Justin Calfo, BA: 0000-0003-2007-7251
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