Lumbar Spondylosis Secondary to Obesity: DVA Secondary Claim

Lumbar spondylosis secondary to obesity follows the obesity cascade: an accepted service injury limits your mobility, your weight increases to a BMI of 30 or above sustained over time, and that obesity becomes a causal factor for lumbar spondylosis. The critical element that distinguishes this claim is the 10-year BMI threshold.

The SoP factor

The Thoracolumbar Spondylosis SoP No. 13 of 2023 (Reasonable Hypothesis) contains factor 9(14): being obese (BMI 30 or greater) for a continuous period of at least ten years within the 25 years before the clinical onset of thoracolumbar spondylosis. The Balance of Probabilities version is SoP No. 14 of 2023 with the equivalent factor.

What the 10-year threshold means practically

You need to establish that your BMI was at or above 30 continuously for at least 10 years within the 25 years before lumbar spondylosis developed. BMI history is established through GP records, which routinely document weight and height at consultations. A GP’s records spanning 10+ years will typically contain enough weight measurements to reconstruct a BMI timeline.

Gaps in GP records can be bridged through other medical records, pharmacy records that include body weight, or employment health assessments. DVA does not require unbroken measurement at every appointment — a reasonable reconstruction of the BMI pattern over the period is sufficient.

Building the obesity cascade

If you also have a primary lumbar spondylosis claim

Some veterans have lumbar spondylosis already accepted as a primary service-related condition through load-carriage or physical work factors. The obesity secondary claim is relevant when the obesity has independently contributed to additional levels of lumbar spondylosis or to degeneration beyond what the primary claim covers.

In practice, the more common situation is where a veteran has an accepted injury elsewhere (knee, shoulder, ankle) that reduced their activity, leading to weight gain, and lumbar spondylosis is the secondary claim.

The full obesity cascade

Once the obesity cascade is established from an accepted injury, multiple conditions may be claimable through it:

• Sleep apnoea (SoP No. 68 of 2022): BMI 30+ at onset of OSA
• Lumbar spondylosis (SoP No. 13 of 2023): BMI 30+ for 10 continuous years
• Cervical spondylosis (SoP No. 11 of 2023): BMI 30+ for 10 continuous years
• Hypertension (SoP No. 21 of 2022): through sleep apnoea as a secondary to the secondary
• Plantar fasciitis (SoP No. 82 of 2023): BMI 25+ at onset
• Type 2 diabetes (relevant SoP): BMI 30+ for 5 continuous years

Frequently asked questions

What if my BMI has fluctuated above and below 30 over the 10 years?

The factor requires a continuous period. If GP records show your BMI regularly dipping below 30 during the relevant period, the continuous threshold may not be satisfied. However, minor fluctuations around the boundary warrant careful review with an advocate rather than an automatic rejection. The specific record matters.

Can I claim both lumbar spondylosis and sleep apnoea as secondary to obesity from the same accepted injury?

Yes. Each has its own SoP and its own threshold. Both can be claimed through the same obesity cascade from the same primary accepted injury, and each contributes its own impairment points independently.

My lumbar spondylosis was already accepted as a primary condition. Can I claim additional levels through the obesity pathway?

This is a complex scenario that depends on the specific accepted levels and whether the obesity cascade can be shown to have caused or aggravated additional spinal levels. Discuss this with an advocate who can review the specific acceptance and imaging.