EDUCATIONAL TOOL ONLY. Not legal or medical advice. Not affiliated with the VA.
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Lumbosacral Strain
DC 5237 | 38 CFR § 4.71a, DC 5237 |
Lumbosacral Strain is rated by the U.S. Department of Veterans Affairs under DC 5237 of 38 CFR § 4.71a, DC 5237 across 5 severity tiers (10% / 20% / 40% / 50% / 100%). Service connection requires (1) a current diagnosis, (2) an in-service event, injury, or exposure, and (3) a medical nexus opinion linking the two under 38 C.F.R. § 3.303. This condition is frequently rated as secondary to Lumbar Radiculopathy or Sciatica under 38 C.F.R. § 3.310.
OVERVIEW
Strain or sprain of the lower back (lumbosacral) muscles and ligaments causing chronic pain and limited range of motion
RATING CRITERIA (5 LEVELS)
10%
Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, combined range of motion of the thoracolumbar spine 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; or, vertebral body fracture with loss of 50 percent or more of the height.
20%
Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, combined range of motion not greater than 120 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis.
40%
Forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine.
50%
Unfavorable ankylosis of the entire thoracolumbar spine.
100%
Unfavorable ankylosis of the entire spine (cervical + thoracolumbar).
KEY EVIDENCE TO GATHER
-Service treatment records showing injury or complaints
-Imaging (X-ray, MRI, CT)
-Range of motion measurements
-Flare-up documentation per Sharp v. Shulkin
-Buddy statements describing limitations
-Prescription history
-Physical therapy records
-Employment impact documentation
SECONDARY CONDITIONS (16 MAPPED)
DC
Chronic strain causes inflammation compressing lumbar nerve roots
DC
Persistent muscle spasm and inflammation impinge sciatic nerve
DC
Chronic strain accelerates degenerative narrowing of spinal canal
DC
Altered gait and compensatory mechanics stress hip joints
DC
Years of abnormal gait damages both hip joints
DC
Compensatory movement patterns stress knee joints
DC
Altered gait affects both knees
DC
Gait changes stress ankle and foot joints
DC
Lumbar strain transfers stress to SI joints
DC
Compensatory changes in adjacent spine segments
DC
Chronic pain frequently causes clinical depression
DC
Fear of pain, movement anxiety, and disability concerns
DC
Pain interferes with sleep quality and positioning
DC
Nerve damage and pain medications affect sexual function
DC
Chronic inflammation and nerve root irritation cause permanent nerve damage
DC
Reduced mobility leads to weight gain, worsening back condition
C&P EXAM TIPS (6)
1.Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation.
2.Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.
3.Tell the examiner about flare-ups: frequency, duration, estimated ROM loss. Sharp v. Shulkin (2017) requires estimates.
4.Request active, passive, weight-bearing, and non-weight-bearing ROM testing per Correia v. McDonald (2016).
5.If you use assistive devices (brace, cane), bring them.
6.Describe daily activity impact: work, sleep, household tasks.
SOURCES & EDITORIAL
Rating criteria reference 38 C.F.R. Part 4 (Schedule for Rating Disabilities). This entry has not yet undergone editorial review against the live regulation text — consult the authoritative source directly before relying on the criteria shown.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026