Spine Conditions (Back & Neck) (DC 5235–5243)

Nearly all back and neck conditions, strains, degenerative disc disease, stenosis, fusion, fracture, are rated under this same General Rating Formula for Diseases and Injuries of the Spine, based primarily on range of motion and ankylosis (fusion).

Common Filing Mistake

The cervical spine (neck) and thoracolumbar spine (mid and lower back) are rated SEPARATELY, as two independent ratings, not combined into one. A very common mistake is claiming only "back pain" generally, or claiming only one region, when both are affected and each deserves its own rating. Another common miss: associated nerve symptoms (radiating pain, numbness, bowel/bladder impairment) are rated separately under peripheral nerve diagnostic codes, and combined with the spine rating, they are not folded into the spine percentage itself.

Diagnostic Codes

DC 5235Vertebral fracture or dislocation
DC 5236Sacroiliac injury and weakness
DC 5237Lumbosacral or cervical strain
DC 5238Spinal stenosis
DC 5239Spondylolisthesis or segmental instability
DC 5240Ankylosing spondylitis
DC 5241Spinal fusion
DC 5242Degenerative arthritis of the spine
DC 5243Intervertebral disc syndrome (IVDS)
DC 5244Facet syndrome

Rating Criteria

Rating	Criteria
100%	Unfavorable ankylosis of the entire spine
50%	Unfavorable ankylosis of the entire thoracolumbar spine
40%	Unfavorable ankylosis of the entire cervical spine; or forward flexion of the thoracolumbar spine 30° or less; or favorable ankylosis of the entire thoracolumbar spine
30%	Forward flexion of the cervical spine 15° or less; or favorable ankylosis of the entire cervical spine
20%	Forward flexion of the thoracolumbar spine greater than 30° but not greater than 60°; or combined range of motion of the thoracolumbar spine not greater than 120°; or combined range of motion of the cervical spine not greater than 170°; or muscle spasm, guarding, or localized tenderness resulting in abnormal gait or abnormal spinal contour (scoliosis, reversed lordosis, or abnormal kyphosis)
10%	Forward flexion of the thoracolumbar spine greater than 60° but not greater than 85°; or combined range of motion of the thoracolumbar spine greater than 120° but not greater than 235°; or combined range of motion of the cervical spine greater than 170° but not greater than 335°; or muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or vertebral body fracture with loss of 50% or more of height

Special Rules

The cervical and thoracolumbar spine are evaluated separately, except when there is unfavorable ankylosis of both, which is rated as a single disability.
Associated objective neurological abnormalities (including but not limited to radiculopathy, bowel or bladder impairment) are rated separately under the appropriate nerve diagnostic code and combined with the spine rating.
Intervertebral Disc Syndrome (DC 5243) can alternatively be rated based on incapacitating episodes requiring physician-prescribed bed rest, whichever method (this formula or the incapacitating-episodes formula) produces the higher combined rating: 60% for at least 6 weeks total in the past 12 months, 40% for at least 4 but less than 6 weeks, 20% for at least 2 but less than 4 weeks, 10% for at least 1 but less than 2 weeks.
Under the painful motion rule (38 CFR § 4.59), if pain is documented during motion, even with technically normal range of motion, at least the minimum compensable rating (10%) generally applies.

Sourced from 38 CFR §§ 4.71a / 4.130. This is a reference aid, not a rating decision, your actual rating depends on the medical evidence in your specific case and your C&P exam findings. Rules can be amended, verify current text at eCFR.gov or with an accredited VSO before relying on this for a specific claim.