Rating Schedule for the Spine (Back and Neck)
For the purposes of VA disability. The diagnosis of your actual back condition is generally not all too important in how it is rated. The vast majority of spine conditions will be based upon the Veteran's limitation of Range of Motion (ROM). This is done based upon the Veteran's neck (cervical spine) or rest of the back (thoracolumbar spine).
IMPORTANT NOTE:
For the purposes of Range of Motion (ROM), the examiner/rater are REQUIRED to consider flair ups in your conditions. Meaning, if you do not happen to have an Examination on your worst day, the examiner is required to reasonably estimate your impairment on your worst day! The rater is required to use this estimate, unless your ROM is somehow noted as being worse during ROM testing during the exam. In any event, the rater is to use the most impaired ROM measurements noted by the examiner!
5235 through 5242 Ratings Based Off Limitations of Range of Motion (ROM)
PYRAMIDING NOTES:
Veterans who have disabilities that affect their neck and back CAN receive 2 ratings (one for their neck and one for their back)!
If a Veteran has multiple conditions (DDD, Strain, etc) that affect the same section of spine (neck or middle/lower back). Then they can only get ONE rating per section of their spine (neck or middle/lower back)!
Example: lower back has a diagnosis of strain and DDD, middle back has a diagnosis of DDD, and neck has a diagnosis of DDD. Only two separate ratings can be awarded. One for the neck and another for the middle/lower back.
NOTE:
In exceptional cases, an examiner may state that because of age, body habitus, neurologic disease, or other factors not the result of disease or injury of the spine, the range of motion of the spine in a particular individual should be considered normal for that individual, even though it does not conform to normal range of motion.
| Rating | Back (Thoracolumbar) | Neck (Cervical) |
|---|---|---|
| 0% | Forward flexion measures 90° or more, OR combined ROM measures 240° or more. | Forward flexion measure 45° or more, OR combined ROM measures 340° or more. |
| 10% | Forward flexion measures more than 60° but not more than 85°, OR combined ROM is between 125° and 240°. | Forward flexion measures more than 30° but less than 45°, OR combined ROM is between 175° and 340°. |
| 20% | Forward flexion measures more than 30° but not more than 60°, OR combined ROM is 120° or less. | Forward flexion measures more than 15° but not more than 30°, OR combined ROM is 170° or less. |
| 30% | N/A | Forward flexion measures 15° or less, OR entire cervical spine is frozen in a favorable position. |
| 40% | Forward flexion measures 30° or less, OR entire thoracolumbar spine frozen in a favorable position. | Entire cervical spine frozen in an unfavorable position. |
| 50% | Entire thoracolumbar spine frozen in an unfavorable position. | N/A |
| 100% | Entire spine frozen in an unfavorable position. | <--- |
5243 Rating Based off Incapacitating Episodes
If the Veteran is rated for Intervertebral Disc Syndrome (IVDS) and has a number of incapacitating episodes within the span of 12 months that require PRESCRIBED bed rest, they can be rated based on incapacitating episodes INSTEAD of ROM.
Additional names for IVDS include:
Bulging disc;
Degenerative Disc Disease (DDD);
Discogenic pain syndrome;
Herniated disc;
Herniated nucleus pulposus;
Pinched nerve;
Prolapsed disc;
Protruded disc;
Ruptured disc; and
Slipped disc.
PYRAMIDING NOTES:
The Veteran's ROM rating can be replaced (not rated in addition to) with one of these ratings. Whichever rating is highest!
If rated under this schedule, separate ratings for related spine-Nerve conditions are NOT allowed!
| Rating |
Weeks of Rest |
|---|---|
| 10% |
At least 1 but less than 2. |
| 20% | At least 2 but less than 4. |
| 40% | At least 4 but less than 6. |
| 60% | More than 6. |
Other Spine Ratings
Miscellaneous
PYRAMIDING NOTE:
The Veteran will NOT receive an additional rating if they fit the criteria of ANY of these miscellaneous cases. The Veteran will get a single rating for the ROM, Incapacitating Episodes, or Miscellaneous rating; Whichever rating is higher!
| Rating |
Description |
|---|---|
| 10% |
Pain with motion. |
| 10% | Vertebral body fracture with loss of 50% or more of the height. |
| 10% | Muscle spasm, guarding, or localized tenderness NOT resulting in abnormal gait. |
| 20% | Muscle spasm or guarding severe enough to result in an abnormal gait. |
| 20% | Abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. |
Arthritis of the Spine
When a Veteran's arthritis does not warrant a rating based upon ROM or other miscellaneous situations. The Veteran's condition will be rated under degenerative arthritis.
For an explanation of arthritis ratings click HERE.
RATER NOTE:
Degenerative Disc Disease (DDD) is NOT arthritis, and as such is NOT subject to Presumptive service connection.
5928 The Tailbone (Coccyx)
Veteran has had their coccyx bone removed (whole or partial).
PYRAMIDING NOTE:
A separate evaluation IS allowed for residuals of removal (whole or partial) of the tailbone and other spine conditions.
| Rating |
Description |
|---|---|
| 0% |
No pain. |
| 10% | Residual pain. |
Common Secondary Conditions
Having spinal issues can bring with it a host of secondary conditions.
SPECIAL NOTE:
Effective dates for secondary conditions of spinal conditions that have a nerve component CAN receive an earlier effective date up to a year BEFORE you initiated the claim, if there is appropriate medical evidence of record showing the existence of the condition.
Bowel or Bladder Impairment
The Veteran may find they have trouble controlling their pipes:
To see how Bladder control issues are rated click HERE.
To see how Bowel control issues are rated click HERE.
Radiculopathy
Nerve pain, numbness, tingling, and/or weakness.
To learn how nerve issues are rated click HERE.
PYRAMIDING NOTE:
The Veteran CAN receive a separate individual ratings for the radiculopathy for each limb that is affected.
5244 Traumatic Paralysis
Loss of use of limbs.
NOTE:
If paralysis is in-complete then the Veteran will be rated based upon the severity of the Paralysis.
Entitled to Special Monthly Compensation.
| Rating |
Description |
|---|---|
| 100% |
Paraplegia. |
| 100% | Quadriplegia. |
Disability Benefits Questionnaire (DBQs)
To get an idea of how a C&P exam will be conducted it is recommended that the Veteran look at the applicable DBQ.
Veteran's may ask a physician to complete a DBQ on their behalf to submit with their claim. For more information on DBQs click HERE.
Having Trouble Finding Your Condition?
Click HERE to view the Master Condition List.