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Thoracic Spine VA Disability Rating
DC 5237-5243 | 38 C.F.R. § 4.71a | M21-1, Part IV.ii.2
OVERVIEW
The thoracic spine is rated together with the lumbar spine as the 'thoracolumbar spine' under the General Rating Formula at 38 C.F.R. 4.71a. There is no separate rating for the thoracic spine alone -- it is combined with the lumbar spine as a single rating. The rating criteria use combined thoracolumbar ROM measurements. If you have both thoracic and lumbar spine conditions, they are rated as one disability.
RATING CRITERIA (4 LEVELS)
50% -- Unfavorable ankylosis of entire thoracolumbar spine
Unfavorable ankylosis of the entire thoracolumbar spine under DC 5237. Thoracic spine is evaluated with lumbar spine as the thoracolumbar segment.
40% -- Forward flexion 30 degrees or less, or favorable ankylosis
Forward flexion of the thoracolumbar spine 30 degrees or less; OR favorable ankylosis of the entire thoracolumbar spine.
20% -- Forward flexion 30-60 degrees or combined ROM 120 degrees or less
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.
10% -- Forward flexion 60-85 degrees or combined ROM 120-235 degrees
Forward flexion greater than 60 degrees but not greater than 85 degrees; OR combined ROM greater than 120 but not greater than 235 degrees; OR muscle spasm or localized tenderness not resulting in abnormal gait.
KEY EVIDENCE TO GATHER
-MRI or X-ray showing thoracic disc disease, compression fractures, or degenerative changes
-ROM measurements of the thoracolumbar spine as a unit
-Service records documenting thoracic spine injury, heavy rucking, parachute landings, or vehicle-borne IED exposure
-Documentation of intercostal neuralgia or radiculopathy from thoracic nerve roots
SECONDARY CONDITIONS (2 MAPPED)
DC 8719
Thoracic disc or joint pathology can compress intercostal nerves, causing chest wall pain.
DC 5237-5243
Thoracic spine dysfunction alters cervical spine mechanics.
C&P EXAM TIPS (4)
1.The thoracic and lumbar spine are rated TOGETHER as one disability. You cannot get separate ratings for each.
2.If you have thoracic nerve root involvement causing intercostal neuralgia, that CAN be rated separately as a neurological condition.
3.ROM testing measures the entire thoracolumbar spine as a unit. Report limitations from both thoracic and lumbar sources.
4.Paratrooper and airborne veterans commonly have thoracic compression fractures from hard landings.
RELEVANT CASE LAW
38 C.F.R. 4.71a, DC 5237; Sharp v. Shulkin, 29 Vet. App. 26 (2017); DeLuca v. Brown, 8 Vet. App. 202 (1995)
Thoracic rated with lumbar as thoracolumbar segment. Sharp requires estimating ROM during flare-ups. DeLuca requires consideration of functional loss due to pain, weakness, fatigability, and incoordination.
DOLLAR IMPACT
Thoracolumbar spine at 40% pays $795.38/mo. Adding bilateral radiculopathy and intercostal neuralgia can push the combined rating significantly higher.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026