CLAIM RECON | CONDITIONS
Back (Thoracolumbar Spine) VA Disability Rating
DC 5235-5243 | 38 C.F.R. § 4.71a | General Rating Formula for Diseases and Injuries of the Spine
NOT AFFILIATED WITH THE VA|Educational tools only - not legal advice▼
Back conditions (thoracolumbar spine, DC 5235-5243) are rated by the U.S. Department of Veterans Affairs under 38 C.F.R. § 4.71a via the General Rating Formula for Diseases and Injuries of the Spine across five tiers (10%, 20%, 40%, 50%, 100%). Forward flexion of the thoracolumbar spine is the primary measurement; DeLuca functional-loss factors (DeLuca v. Brown, 1995), Sharp flare-up ROM estimation (Sharp v. Shulkin, 2017), and Correia active/passive/weight-bearing testing (Correia v. McDonald, 2017) apply.
Understanding Back Ratings
Back conditions (lumbar/thoracolumbar spine) are rated under the General Rating Formula for Diseases and Injuries of the Spine at 38 C.F.R. § 4.71a, Diagnostic Codes 5235-5243. This covers degenerative disc disease (DDD), strain, fractures, spondylolisthesis, stenosis, and intervertebral disc syndrome (IVDS).
Ratings are primarily based on range of motion (ROM), specifically forward flexion. Per M21-1, Part IV.ii.2.A, the RVSR must also consider functional loss due to pain, weakness, fatigability, and incoordination under the DeLuca factors (DeLuca v. Brown, 8 Vet. App. 202, 1995). Per Sharp v. Shulkin (2017), the examiner MUST estimate ROM during flare-ups. Per Correia v. McDonald (2017), the exam must include active, passive, and weight-bearing ROM testing.
Rating Criteria (DC 5235-5243)
10%$175.03/mo
Forward flexion greater than 60 degrees but not greater than 85 degrees; OR combined ROM greater than 120 degrees but not greater than 235 degrees; OR muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour.
20%$345.78/mo
Forward flexion greater than 30 degrees but not greater than 60 degrees; OR combined ROM not greater than 120 degrees; OR muscle spasm or guarding severe enough to result in abnormal gait or abnormal spinal contour.
40%$795.38/mo
Forward flexion of the thoracolumbar spine 30 degrees or less; OR favorable ankylosis of the entire thoracolumbar spine.
50%$1,131.68/mo
Unfavorable ankylosis of the entire thoracolumbar spine.
100%$3,938.58/mo
Unfavorable ankylosis of the entire spine.
38 C.F.R. § 4.71a | General Rating Formula for Diseases and Injuries of the Spine | 2026 rates
Secondary Conditions Linked to Back
Under 38 C.F.R. § 3.310 | Per M21-1, Part IV.ii.1.C
Lower Extremity Radiculopathy (L/R)DC 8520STRONG
Typical ratings: 10%, 20%, 40%
Nerve root compression from disc pathology. VA C&P DBQ includes radiculopathy screening for every spine exam. Rated separately per extremity.
Somatic Symptom DisorderDC 9422STRONG
Typical ratings: 30%, 50%, 70%
Chronic pain causes clinically documented psychological symptoms. DSM-5 F45.1.
Depression / AnxietyDC 9434/9413STRONG
Typical ratings: 30%, 50%, 70%
Chronic pain is a well-established cause of depressive and anxiety disorders.
Erectile Dysfunction + SMC-KDC 7522MODERATE
Typical ratings: 0% + $139.87/mo
Pain medications (opioids, gabapentin) cause ED. 0% rating but qualifies for SMC-K.
GERD / Acid RefluxDC 7346MODERATE
Typical ratings: 10%, 30%
Long-term NSAID use for spinal pain causes gastrointestinal damage.
Hip Condition (Secondary)DC 5252-5255MODERATE
Typical ratings: 10%, 20%
Altered gait mechanics cause asymmetric hip loading. Biomechanical nexus.
Knee Condition (Secondary)DC 5256-5263MODERATE
Typical ratings: 10%, 20%
Altered gait and weight distribution accelerate knee degeneration.
Cervical Spine (Secondary)DC 5237-5243WEAK-MOD
Typical ratings: 10%, 20%
Compensatory posture changes can accelerate cervical degeneration.
Urinary FrequencyDC 7517-7542MODERATE
Typical ratings: 10%, 20%, 40%
Spinal nerve compression can cause neurogenic bladder dysfunction.
Insomnia / Sleep DisturbanceDC 9422/8099MODERATE
Typical ratings: 0%, 10%, 30%
Chronic pain disrupts sleep architecture.
Key Regulatory Authority
38 C.F.R. § 4.71a, DC 5235-5243 — General Rating Formula for Spine
38 C.F.R. § 4.40, 4.45, 4.59 — Functional loss, joints, painful motion
DeLuca v. Brown (1995) — Functional loss factors (pain, weakness, fatigue)
Sharp v. Shulkin (2017) — Flare-up ROM estimation required
Correia v. McDonald (2017) — Active/passive/weight-bearing ROM testing
M21-1, Part IV.ii.2 — The Musculoskeletal System
M21-1, Part IV.ii.2.A — General Rating Policies for Musculoskeletal