Can You Get an Impairment Rating for a Back Injury in Virginia Workers’ Comp?

A doctor can give you a whole-person impairment rating for a back injury. But Virginia workers’ compensation law does not allow you to receive permanent partial disability (PPD) benefits for the thoracic or lumbar spine. That is because the back is not a body part listed in Va. Code § 65.2-503. However, if your back injury causes permanent partial disability of a leg, you can get PPD payments for impairment to the leg, if the rating says so and explains why.

This page discusses how Virginia treats an impairment rating for a back injury, and how to recover permanent partial disability benefits when your low back or lumbar spine injury affects one or both legs. For general information on what PPD is and the full schedule of weeks by body part, see my page on permanent partial disability benefits. For how any rating turns into a payment, see the impairment rating calculator. And for what a back injury claim is worth overall, see back injury settlements.

Why a 30% impairment rating for the back may be worth $0 in PPD benefits

Many states recognize whole-person impairment ratings and pay permanent partial disability benefits for chronic low back pain or permanent damage to the lumbar spine after a compensable work injury. Virginia does not.

The Virginia Workers’ Compensation Act has “no provision for awarding benefits based upon whole person impairment.” Underwood v. Velocity Construction of Virginia Inc., JCN VA00001800907 (March 21, 2025). The only way to obtain benefits for partial disability to an injured body part is to offer a medical rating showing the percentage of incapacity for “an anatomical member specified in Code 65.2-503” that has reached maximum medical improvement (MMI).

That text – “specified in Code Section 65.2-503” – reflects the challenge of receiving partial disability benefits when you have an impairment rating for a back injury. Code Section 65.2-503 does not list the lumbar spine, thoracic spine, back, or the whole person. No bill to change that has advanced in the Virginia General Assembly, and the Workers’ Compensation Commission has not deviated from the statute in its numerous judicial opinions.

So when your orthopedic surgeon gives you a “30% whole person impairment due to stenosis or spondylolisthesis at multiple levels that required a lumbar fusion,” the number is real but useless under the law in Virginia. Even if the Commission believes your back injury causes ongoing pain or other symptoms, you will not win your PPD claim unless you have a rating that explains the permanent functional loss to a body part listed in the statute.

I explain how to prove this in the next section. As you’ll see, the Act’s failure to include the back or spine in the PPD statute does not mean your back injury has little value. Rather, it means you need specific evidence.

Does your back injury affect one or both legs?

Did you answer yes? Then you can receive permanent partial disability benefits for a back injury if it results in permanent loss of use of your leg, and you get an impairment rating for the leg.

In Washington Metro. Area Transit v. Rogers, 17 Va. App. 657 (Va. Ct. App. 1994), the Court of Appeals affirmed the Commission’s award of PPD benefits to a claimant whose compensable lumbar strain resulted in partial disability of his left leg. It pointed out that, “Nowhere does [Code Section 65.2-503] specify that any loss of use must result from an injury directly to the member [body part] itself. Therefore, we read the statute to allow compensation for any work-related injury which manifests itself in a scheduled member.”

The leg is a scheduled body part in Code Section 65.2-503, worth up to 175 weeks of compensation. A back injury that causes leg problems, contributes to or worsens a pre-existing lumbar spine condition, and leads to radiculopathy in one or both legs can qualify for partial disability benefits.

Lumbar radiculopathy is the path to an impairment rating for a back injury.

In Virginia, the medical path to PPD benefits for an impairment rating for a back injury is lumbar radiculopathy.

For example:

• An injury at L3-4 or to the L4 lumbar nerve root can cause a motor deficit in your quadriceps; sensory deficits in the front of the thigh or knee and the medial part of the leg and foot; and a weakened knee reflex.

• An injury at L4-5 or to the L5 lumbar nerve root can cause motor deficits in the muscles in the lower part of your leg; sensory deficits in the lateral thigh and middle of the foot; and an abnormal reflex in the hamstrings.

• A back injury affecting the lowest part of the lumbar spine (L5-S1) or the S1 nerve root can cause motor deficits in the ankle flexors; sensory deficits in the back of the leg and the side of the foot; and weakened ankle reflexes.

When determining whether your back injury causes partial disability of the legs, your doctor will consider the difficulties you report in completing job duties and daily living activities, in-office exam findings, and the results of clinical studies.

You increase the likelihood of receiving benefits for impairment from a back injury if your medical records reflect complaints of:

• Weakness in a muscle group or part of the leg that your spine injury is known to affect
• Foot drop
• Sensory loss – for example, you do not feel a pinprick to your calf or the top of your foot.
• Trouble getting up or down from a seated position
• Difficulty sitting, standing, or walking for long
• Decreased range of motion, although the AMA Guides no longer consider this as a primary basis for defining permanent impairment

So make sure you tell your treating physician about the severity, frequency, and duration of all symptoms affecting your back and legs while receiving treatment for your work injury.

In addition to these symptoms and limitations, the following kinds of findings on exam and during diagnostic testing can support permanent impairment for a back injury due to problems with the legs:

• Abnormal or absent knee or ankle reflexes
• Muscle atrophy, observed visually or through measurement of the circumference of the affected vs. non-affected leg
• A positive straight-leg raising test that matches the imaging or location of the back injury
• EMG or nerve conduction study findings confirming the lumbar radiculopathy

Back injuries and spine conditions that can result in a permanent leg impairment

Remember: the question is never “what is the back injury impairment rating for a herniated disc or stenosis.” It is: Did this compensable back injury leave the leg with a measurable deficit and you with loss of use of the leg?

The AMA Guides recognize these lumbar spine conditions as leading to permanent partial impairment:

• Chronic low back pain with non-verifiable radicular complaints and similar findings at multiple visits. This condition is often diagnosed as chronic sprain/strain, symptomatic degenerative disc disease (DDD), SI joint dysfunction, or facet joint pain.
• Intervertebral disc herniation (annular tear, bulging disc) at one or more levels. This condition can result in permanent impairment to the legs with or without surgery.
• Pseudarthrosis. This condition occurs when bones fail to fuse after a fracture or a surgical fusion.
• Lumbar stenosis. This condition may compress the nerve root, resulting in problems with the part of the leg that nerve controls.
• Sciatica. Your doctor likely diagnosed sciatica, which is nerve pain caused by irritation, inflammation, or compression of the sciatic nerve, because you had pain in one or both legs.
• Spondylolysis or spondylolisthesis. These terms describe defects in the vertebra or one vertebra slipping forward on another. Both conditions narrow the space the nerve roots can travel through, potentially causing impingement.
• Fractures of one or more vertebrae (including compression fractures, burst fractures, and fractures of the pedicle, lamina, transverse process, or articular process).
• Post-operative complications (including wounds or infections of the spine)

Do you need a separate accident to the leg to receive an impairment rating from a back injury?

No, you do not need a separate compensable injury to the leg to recover permanent partial disability for a back injury.

The leg problem results from the compensable back injury, so the insurer must address it under the compensable consequence doctrine.

Educate your doctor on the back injury impairment ratings that Virginia will recognize

How you frame the back injury and its resulting symptoms is often the difference between receiving thousands of dollars in PPD benefits and nothing.

And it’s your job – or your attorney’s – to educate the treating physician on what Virginia will cover.

Here is an example of what to ask for when you have permanent impairment from a back injury:

Now that I’m at MMI, would you rate the permanent partial loss of use of my left leg caused by the work injury on February 5, 2025? Virginia pays only for impairment to the leg, not the spine, so a whole-person rating doesn’t help me.

Please list the findings your rating is based on – weakness, EMG results, reflex changes, sensory losses – and the symptoms I have reported, and whether they result from the compensable back injury.

What not to do: don’t ask the doctor to “convert” an existing whole-person number, and don’t ask for a specific percentage. Ask for the leg to be rated on the findings.

If you already have a back or whole-person impairment rating

The answer depends on which of the following situations applies:

You have a whole-person rating for the back and leg symptoms. Ask the treating physician for an addendum like what I describe above. If the doctor won’t, you may need to undergo a second permanent impairment evaluation and instruct that examiner to rate the leg. Then file the PPD claim for the back injury.

You have a whole-person rating but no leg symptoms. Unfortunately, you are unlikely to receive PPD for your back injury in Virginia. You can still use the report as evidence; for example, your axial back pain may result in work restrictions.

Your back claim is years old, and you’ve just developed leg problems.

This is the case the deadline governs. A claim for PPD after the Commission enters an award order for lifetime medical or wage loss benefits must be filed within 36 months of the last day for which compensation was paid under the award; § 65.2-708 gives PPD claims a longer window than other changes in condition, which get 24 months.

If the last compensation check was more than three years ago, you may be out of luck even if you get a leg rating from the back injury. That is why I always recommend filing a protective claim for PPD benefits when you file the initial claim.

Does a useless whole person impairment rating mean your back claim has little value?

No. In most back claims I handle, PPD is the smallest number in my settlement evaluation, and in many it’s close to zero. The value is in three other places: unpaid and future wage loss; permanent restrictions from the back injury; and projected lifetime medical needs.

Send me the impairment rating for the back injury.

If we accept representation and you have an impairment rating for your back or spine injury, send it to me with the office note declaring that you have reached MMI. I can tell you whether the rating may qualify for PPD benefits under Virginia law, what the doctor needs to add if it doesn’t, and what deadlines you should know.

Call (804) 251-1620 or request a free case review.