Workers’ Comp When the MRI Shows Degenerative Disc Disease

Corey R. PollardWorkers’ compensation attorney · Former insurance defense · $100M+ recovered

Degenerative disc disease on your MRI is not a diagnosis that explains what happened to you at work. It describes the condition of the intervertebral discs in your spine. These discs dry out, break down, and shrink over time, and by 40, many people’s spines show it on imaging, whether they’ve ever had back pain or not.

Years ago, an orthopedic surgeon told me everyone has it by middle age, and nothing I’ve seen since has changed my mind. So when the adjuster reads “degenerative disc disease,” “DDD,” or “spondylosis” in your report, the adjuster isn’t learning how the work affected you. The adjuster is looking for a reason to call your current disability and need for medical care pre-existing and deny the case.

That’s usually the main fight in a workers’ compensation case with degenerative disc disease, and you can win it. Virginia workers’ compensation law holds employers and insurers liable for DDD aggravated, exacerbated, or flared by a compensable work accident the same way it does an injury to an otherwise healthy disc. And the key to winning lies in the medical evidence and your testimony comparing your pre- and post-injury abilities and symptoms.

This page is part of my back injury hub. The pages on herniated discs, sciatica, and back injuries from lifting cover the injuries that usually come with it, and the general rule on pre-existing conditions is on its own page. Here I’m only talking about what DDD does to your case.

What the words “degenerative disc disease” on your MRI mean

You have 23 spinal discs between the spine’s vertebrae. When healthy and hydrated, these discs cushion and provide flexibility, absorbing shocks throughout your body.

However, over time, these discs lose water (desiccation) and height, weaken, and tear. When they do, your MRI shows degenerative disc disease.

In my practice, I see injured employees with DDD diagnosed at all levels of the spine. But the most common sites for degenerative disc disease are L3-L4, L4-L5, and L5-S1. These discs are located in the low back, where your spine moves the most.

Look for these terms: The radiologist reviewing your MRI may use different terms to describe forms of degenerative disc disease: disc desiccation; facet arthropathy; osteophytes; bulging; or spondylosis.

Much of this condition could have been there before you were hurt at work. That’s fine. What the Commission cares about is whether something changed with the injury. Maybe a disc that bulged slightly has now herniated. Or maybe you went from asymptomatic to symptomatic. Or maybe you have a flare of sciatica, with pain running down your leg at an intensity you’ve never felt before. All of this is evidence in a DDD case, and the rest of this page explains how to present your case as best you can to recover benefits.

The easiest way to win a DDD claim under workers’ compensation

The overwhelming majority of DDD cases I win for employees do not require a showing that the work accident caused all of the degenerative disc disease. Rather, I focus on proving the specific injury made a spine with DDD worse.

In Virginia, the employer takes you as you are, bad back and all. If a specific work incident aggravates, flares, or accelerates degenerative disc disease – to a “minute degree” or “one iota” – the employer and insurer are on the hook for your treatment and the disability that follow, even though the disc was already wearing out. See Henrico County School Board v. Etter, 552 S.E.2d 372, 36 Va. App. 437 (2001).

This rule applies to surgery, too, even a lumbar fusion. I’ve represented clients who were told years ago they would likely need a fusion in the future. That prediction becomes urgent with the work injury. Under workers’ comp law, the insurer is responsible for that surgery if the Commission finds the injury accelerated – i.e., sped up – the need for that surgery.

What to expect when the insurance company sees DDD on your MRI

When I defended these claims, a mention of degenerative disc disease on the MRI and in the office visit note was one of the first things I looked for. I knew I had a potential defense to the workers’ comp case if I found it, and if I could get the treating physician to agree that the work accident was no more than a temporary exacerbation of the underlying DDD that had resolved.

Sometimes the treating doctor wouldn’t talk to the insurer, or disagreed with that defense. When that happened, the adjuster would schedule an independent medical examination (IME) with a hand-picked doctor. The insurer picks the examiner, and it picks one whose opinions have helped it before. Depending on who an injured employee sees, I can predict with near certainty that the IME will find the employee had a strain or sprain that would have resolved after three to six months, and that ongoing problems are entirely related to pre-existing DDD.

So if your MRI shows degenerative disc disease, you should expect a denial, at least as to the nature and severity of your work-related injury, and the scheduling of an IME. That IME will likely hurt your case. But you can overcome it by developing evidence from your treating doctor and testifying as to how this work accident worsened your back and leg problems. If the insurer has also denied the MRI, an injection, or surgery along the way, my page on medical treatment denials covers how to get the treatment authorized.

The five facts that beat the degenerative disc disease defense

In every DDD hearing I try, I build the case around the same five questions, because the Commission decides these cases on them.

1. Were you doing your job before the accident? Full duty, no time off for your back, for months or years. That’s the baseline the accident changed. Say it on the stand, and back it up with a co-worker’s or supervisor’s attendance record, or a family member’s pre-injury observations.
2. Were you asymptomatic? Plenty of people learn they have DDD from the MRI after the accident. If you never had back pain before, say so plainly, and let the insurer try to find a record that says otherwise.
3. If you had symptoms before, what’s different now? A flare every few months before; constant pain and a leg that goes numb now. New symptoms and a new frequency are an aggravation. Be specific about both.
4. How long since you last treated? The number of years since your last back visit is strong evidence. Months is still useful. Weeks is tougher. Make sure the record shows the gap if it exists.
5. Is there a before-and-after image? A pre-accident MRI showing degeneration and a post-accident MRI showing a herniation that wasn’t there is as close to proof as these cases get. If you’ve ever had spine imaging, tell me, and we’ll get it.

Notice that none of these questions asks whether your spine was healthy. It wasn’t, and the Commission knows it wasn’t. They ask whether you were working, and whether you still can. That’s the case.

Get it from the doctor in writing – the questionnaire about DDD worsening

Office visit notes tell you what hurt and what the doctor did about it. They rarely explain why – doctors focus on diagnosis and treatment, not litigation, and that explanation is the whole case.

The sentence that wins a DDD claim is a causation opinion from the treating physician: that the work accident aggravated your pre-existing degenerative condition and caused your current symptoms, your restrictions, and your need for treatment, stated to a reasonable degree of medical probability. Most treating doctors will write that if someone asks them and explains what it needs to say. Remember, a slight aggravation is enough under Virginia law; the doctor doesn’t have to say the accident caused the degeneration, or even that it’s a major cause. It’s rare for someone on the insurer’s side to ask in writing, unless they’ve already confirmed by phone that the doctor will support their defense.

I send the treating physician a short letter and a questionnaire that walks through the five questions above and details the evidence supporting my client’s position. In more of my DDD cases than I can count, the Deputy Commissioner cited the completed questionnaire as evidence. Choose your panel doctor with that in mind, and if you’ve already got one who won’t engage with causation, call me before you change doctors, because the rules on switching are specific.

Does Virginia workers’ comp cover degenerative disc disease that develops gradually?

No. Virginia does not cover a disc that wore out from years of lifting, bending, or driving. If you can’t point to a specific incident, you don’t have a claim, no matter how obvious it is that the job did this to you. That’s the repetitive-motion rule, and it’s the trap insurers set in DDD files. The adjuster asks whether your back had been bothering you for a while, you say yes because it had, and the file now reads “onset gradual.” So answer the question you were actually asked. Your back may have ached on and off for years, and you can say so. The injury happened when you lifted the tote, and that’s what you’re claiming. Keep those two things separate every time you tell the story. My lifting page covers what counts as an accident in these situations.

What your case is worth with DDD in the file

The math for DDD cases is the same as any back claim. What changes is whether it gets paid at all. Take a Harrisonburg poultry-plant worker earning $850 a week who herniates a degenerated L5-S1 disc lifting a tote and is out eight weeks. The numbers are made up; the formula is the Commission’s.

With an aggravation opinion in the file, every line on that table is the insurer’s. Without one, the insurer’s position is that it owes a few weeks for a strain and nothing after. That difference, not the size of the wage, is what a DDD file is about.

Questions about DDD from Work

Does degenerative disc disease qualify for workers’ comp in Virginia?

By itself, no. A work accident that causes or worsens it does. The claim is the accident and what it changed, and the DDD is the background.

Can the insurer deny my claim because my MRI shows degenerative disc disease?

It can deny for any reason it likes; that’s a letter, not a ruling. A denial based on degeneration is answered with a treating physician’s opinion that the accident aggravated it and your testimony, and the Commission decides.

I never had back pain before. Why does the MRI say degenerative disc disease?

Because almost every adult MRI does. Degeneration shows on imaging long before it causes symptoms, if it ever does. Going from no symptoms to symptoms after an accident is evidence for you, not against you.

Is degenerative disc disease a pre-existing condition?

Yes, and that doesn’t end the claim. Virginia pays for the aggravation of a pre-existing condition. The rule is on my pre-existing conditions page.

Will workers’ comp pay for a fusion if I already had degenerative disc disease?

If the accident made the fusion necessary now, yes, even if a surgeon had mentioned it before. That has to come from your treating doctor in writing. The Commission may even find the insurer must pay for a revision fusion or extension if the work injury contributed to the need; a past fusion doesn’t automatically mean denial.

Before you accept that it’s “just degeneration”

A denial letter that says pre-existing is the insurer’s opening position. I used to write that letter, and I knew then the best response was a treating doctor who could say what the accident changed, plus a work history showing you were on the job until the day you weren’t. Both of those usually exist. Somebody on your side has to get them, and in some DDD cases nobody does.

Tell me what’s happening. I’ll tell you what it means. Free, confidential, and we respond fast. Richmond (804) 251-1620. Hampton Roads (757) 810-5614.

Some Results from Workers’ Comp DDD Cases I Handled

Here are sample results from workers’ comp cases I won where degenerative disc disease was front and center.

• I represented a construction laborer who suffered a work-related back injury. The insurance carrier denied the claim, alleging that my client’s disability and need for medical care were related to his pre-existing degenerative disc disease. He had undergone three prior back surgeries before the accident. By focusing on his ability to return to construction work after the third surgery, until he re-injured his back while moving two buckets of drywall mud, I helped him win the case. Then we negotiated a six-figure workers’ compensation settlement.
• I represented a truck driver after the insurer filed an employer’s application for a hearing to stop wage loss benefits based on a treating physician’s light-duty release and allegations of an intervening incident. To support its defense, the insurer introduced evidence about my client’s prior injuries and diagnosis of degenerative disc disease, including a past discussion of the need for future surgery. I was able to defeat the application to suspend benefits, which allowed my client to continue receiving weekly temporary total disability (TTD) payments, by working with his physicians and focusing on the new symptoms and limitations caused by the recent work injury.

Past results don’t guarantee future outcomes. Every case depends on its own facts.

About the authorCorey Pollard is a Virginia workers’ compensation and Social Security Disability attorney in Richmond. Best Lawyers in America® (2020–2026), $100M+ recovered, and a former insurance defense lawyer — which is the part that matters.