What rates 40% for Thoracolumbar Strain under 38 CFR § 4.71a, DC 5237?

Under 38 CFR § 4.71a, DC 5237 (DC 5237), a 40% rating for Thoracolumbar Strain requires: Forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine.

What rates 50% for Thoracolumbar Strain under 38 CFR § 4.71a, DC 5237?

Under 38 CFR § 4.71a, DC 5237 (DC 5237), a 50% rating for Thoracolumbar Strain requires: Unfavorable ankylosis of the entire thoracolumbar spine.

What rates 100% for Thoracolumbar Strain under 38 CFR § 4.71a, DC 5237?

Under 38 CFR § 4.71a, DC 5237 (DC 5237), a 100% rating for Thoracolumbar Strain requires: Unfavorable ankylosis of the entire spine.

What secondary conditions are linked to Thoracolumbar Strain?

Common secondary conditions for Thoracolumbar Strain include Intercostal Neuralgia, Costochondritis, Postural Kyphosis, Cervical Spine Condition, Lumbar Spine Condition. Secondary service connection is established under 38 C.F.R. 3.310 when a condition is caused or aggravated by an already service-connected disability.

What happens during a C&P exam for Thoracolumbar Strain?

Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation. Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.

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Thoracolumbar Strain

Q: What are the VA rating percentages for Thoracolumbar Strain?

Thoracolumbar Strain (DC 5237) is rated at 10%, 20%, 40%, 50%, 100% under 38 CFR § 4.71a, DC 5237. Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, combined range of motion 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.

Q: What rates 10% for Thoracolumbar Strain under 38 CFR § 4.71a, DC 5237?

Under 38 CFR § 4.71a, DC 5237 (DC 5237), a 10% rating for Thoracolumbar Strain requires: Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, combined range of motion 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.

Q: What rates 20% for Thoracolumbar Strain under 38 CFR § 4.71a, DC 5237?

Under 38 CFR § 4.71a, DC 5237 (DC 5237), a 20% rating for Thoracolumbar Strain requires: 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 abnormal gait or abnormal spinal contour.

Q: What evidence do I need for a Thoracolumbar Strain VA claim?

Key evidence for a Thoracolumbar Strain claim includes: 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. All evidence should document both the condition and its impact on daily functioning.

DC 5237 | 38 CFR § 4.71a, DC 5237 | 

Thoracolumbar 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 Intercostal Neuralgia or Costochondritis under 38 C.F.R. § 3.310.

OVERVIEW

Strain of the thoracolumbar (mid-to-lower back) muscles and ligaments causing chronic pain and reduced spinal mobility

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 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%

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 abnormal gait or abnormal spinal contour.

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.

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 (8 MAPPED)

Intercostal NeuralgiaMODERATE

DC

Thoracic nerve root irritation causes rib pain

CostochondritisMODERATE

DC

Thoracic dysfunction affects rib-sternum joints

Postural KyphosisMODERATE

DC

Progressive degeneration increases thoracic curve

Cervical Spine ConditionMODERATE

DC

Compensatory changes in adjacent spine segments

Lumbar Spine ConditionMODERATE

DC

Thoracic dysfunction increases lumbar stress

Intercostal NeuralgiaMODERATE

DC

Thoracic nerve irritation causes rib pain

Lumbar Spine ConditionMODERATE

DC

Compensatory stress on lower spine

Postural KyphosisMODERATE

DC

Pain avoidance causes spinal curvature

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.

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SECONDARY CONDITIONS

Intercostal Neuralgia Costochondritis Postural Kyphosis Cervical Spine Condition Lumbar Spine Condition Intercostal Neuralgia Lumbar Spine Condition Postural Kyphosis

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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.

→ View 38 C.F.R. Part 4 on eCFR → Editorial Standards → Suggest a correction

EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
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