Rating criteria · 38 CFR §4.71a
Back & Spine: VA Rating Criteria
The exact rating criteria below are quoted from the Code of Federal Regulations as currently in force — not paraphrased. Compensation amounts come from the current VA rate tables.
By Mario Bailey — U.S. Air Force veteran · current Air National Guard member. Data updated 2026-06-08.
Plain-language guide
What this rating actually turns on
Almost every back condition — strain, stenosis, spondylolisthesis, fusion, degenerative disc disease (DCs 5235–5243) — is rated under one formula: the General Rating Formula for Diseases and Injuries of the Spine. The formula applies “with or without symptoms such as pain (whether or not it radiates), stiffness, or aching.” That phrase matters: the rating tiers are set by measured motion and ankylosis, not pain level.
For the thoracolumbar spine: forward flexion greater than 60 but not greater than 85 degrees rates 10 percent; greater than 30 but not greater than 60 degrees rates 20 percent; 30 degrees or less rates 40 percent. Above 40 percent, only ankylosis (a spine fixed in position) qualifies — 50 percent for unfavorable ankylosis of the entire thoracolumbar spine, 100 for the entire spine. Combined range of motion (all six movements summed; normal is 240 degrees thoracolumbar, 340 cervical) and muscle spasm or guarding severe enough to cause abnormal gait or spinal contour are alternate routes to 10–20 percent. Measurements are rounded to the nearest 5 degrees (Note 4).
Two add-ons are easy to miss. Note (1) requires VA to rate objective neurologic abnormalities — radiculopathy, bowel or bladder impairment — separately under their own diagnostic codes. Note (6) requires separate ratings for the cervical and thoracolumbar segments.
Intervertebral disc syndrome (DC 5243) — which since the 2021 schedule revision applies only to disc herniation compressing or irritating a nerve root — can alternatively be rated on incapacitating episodes: 10 percent at one to two weeks of episodes in the past 12 months, up to 60 percent at six weeks or more, whichever method rates higher when combined under 38 CFR 4.25.
What the C&P exam measures
The examiner completes the Back (Thoracolumbar Spine) DBQ: degree endpoints for all six movements, active and passive, where pain begins, and repeat testing after at least three repetitions. The examiner must estimate range of motion in degrees during flare-ups and after repeated use over time, drawing on your lay statements if no flare-up is observable — that estimate implements the functional-loss rules in 38 CFR 4.40 and 4.45. The DBQ also covers guarding and spasm (and whether they cause abnormal gait or contour), muscle strength, reflexes, sensory testing, straight-leg raising, radiculopathy severity by side, and physician-prescribed bed rest episodes.
What to have in your file
Per VA’s evidence page: service treatment records, ongoing treatment notes with measured range of motion, imaging (the DBQ notes imaging isn’t required to diagnose IVDS, but an MRI documents the herniation and nerve-root contact DC 5243 requires), written physician orders for bed rest, and lay statements describing flare-ups, radiating pain, and changes in gait.
Common mistakes
- Expecting a higher rating for severe pain alone. Unless flexion drops to the threshold numbers or the spine is ankylosed, pain by itself doesn’t reach the higher tiers — though 38 CFR 4.59 supports at least the minimum compensable rating for painful motion.
- Self-prescribed bed rest. The IVDS formula’s own note defines an incapacitating episode as one requiring “bed rest prescribed by a physician and treatment by a physician.” Days you stayed down on your own don’t count.
- Not claiming radiculopathy. Sciatica-type symptoms are rated separately by regulation; leaving them out leaves compensation unclaimed. See the radiculopathy guide.
Worth knowing
Radiculopathy ratings in both legs are paired-extremity disabilities, so the bilateral factor applies — the combined-rating calculator handles it. The DBQ lets an examiner certify that a restricted range is “normal for that individual” for reasons unrelated to the back (Note 3), so unrelated conditions shouldn’t drag the measurement down. A VA-accredited representative or VSO can help with the claim at no charge.
Rating criteria from the CFR
General Rating Formula for Diseases and Injuries of the Spine
(For diagnostic codes 5235 to 5243 unless 5243 is evaluated under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes):
| Rating criteria | Rating |
|---|---|
| With or without symptoms such as pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease | |
| Unfavorable ankylosis of the entire spine | |
| Unfavorable ankylosis of the entire thoracolumbar spine | |
| Unfavorable ankylosis of the entire cervical spine; or, forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine | |
| Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine | |
| Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, the combined range of motion of the cervical spine not greater than 170 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 | |
| Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, forward flexion of the cervical spine greater than 30 degrees but not greater than 40 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, combined range of motion of the cervical spine greater than 170 degrees but not greater than 335 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 |
Note (1): Evaluate any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, separately, under an appropriate diagnostic code.
Note (2): (See also Plate V.) For VA compensation purposes, normal forward flexion of the cervical spine is zero to 45 degrees, extension is zero to 45 degrees, left and right lateral flexion are zero to 45 degrees, and left and right lateral rotation are zero to 80 degrees. Normal forward flexion of the thoracolumbar spine is zero to 90 degrees, extension is zero to 30 degrees, left and right lateral flexion are zero to 30 degrees, and left and right lateral rotation are zero to 30 degrees. The combined range of motion refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. The normal combined range of motion of the cervical spine is 340 degrees and of the thoracolumbar spine is 240 degrees. The normal ranges of motion for each component of spinal motion provided in this note are the maximum that can be used for calculation of the combined range of motion.
Note (3): 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 the normal range of motion stated in Note (2). Provided that the examiner supplies an explanation, the examiner's assessment that the range of motion is normal for that individual will be accepted.
Note (4): Round each range of motion measurement to the nearest five degrees.
Note (5): For VA compensation purposes, unfavorable ankylosis is a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching. Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis.
Note (6): Separately evaluate disability of the thoracolumbar and cervical spine segments, except when there is unfavorable ankylosis of both segments, which will be rated as a single disability.
Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes
| Rating criteria | Rating |
|---|---|
| With incapacitating episodes having a total duration of at least 6 weeks during the past 12 months | |
| With incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months | |
| With incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months | |
| With incapacitating episodes having a total duration of at least one week but less than 2 weeks during the past 12 months |
Note (1): For purposes of evaluations under diagnostic code 5243, an incapacitating episode is a period of acute signs and symptoms due to intervertebral disc syndrome that requires bed rest prescribed by a physician and treatment by a physician.
Note (2): If intervertebral disc syndrome is present in more than one spinal segment, provided that the effects in each spinal segment are clearly distinct, evaluate each segment on the basis of incapacitating episodes or under the General Rating Formula for Diseases and Injuries of the Spine, whichever method results in a higher evaluation for that segment.
Diagnostic Code 5235 — Vertebral fracture or dislocation. See the regulation text for how this code is evaluated.
Diagnostic Code 5236 — Sacroiliac injury and weakness. See the regulation text for how this code is evaluated.
Diagnostic Code 5237 — Lumbosacral or cervical strain. See the regulation text for how this code is evaluated.
Diagnostic Code 5238 — Spinal stenosis. See the regulation text for how this code is evaluated.
Diagnostic Code 5239 — Spondylolisthesis or segmental instability. See the regulation text for how this code is evaluated.
Diagnostic Code 5240 — Ankylosing spondylitis. See the regulation text for how this code is evaluated.
Diagnostic Code 5241 — Spinal fusion. See the regulation text for how this code is evaluated.
Diagnostic Code 5242 — Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (also, see either DC 5003 or 5010). See the regulation text for how this code is evaluated.
| Rating criteria | Rating |
|---|---|
| Evaluate intervertebral disc syndrome (preoperatively or postoperatively) either under the General Rating Formula for Diseases and Injuries of the Spine or under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes, whichever method results in the higher evaluation when all disabilities are combined under § 4.25. |
SOURCE: eCFR, 38 CFR Part 4 (issue date 2026-02-27, current through 2026-06-08) · retrieved 2026-06-10
Monthly compensation at each rating level
Veteran-alone amounts, effective 2025-12-01. Dependents increase these amounts at 30% and above — use the combined rating calculator for your exact situation, especially if this isn't your only rated condition.
| Rating | Monthly (veteran alone) |
|---|---|
| $3,938.58 | |
| $1,435.02 | |
| $1,132.90 | |
| $795.84 | |
| $552.47 | |
| $356.66 | |
| $180.42 |
SOURCE: VA compensation rate tables, va.gov · retrieved 2026-06-10 · effective 2025-12-01
Frequently asked questions
What is the highest schedular VA rating for back & spine?
Under the criteria in 38 CFR §4.71a, the highest schedular rating in this group is 100%. At the 100% level, the 2026-02-27 rate tables pay $3,938.58 per month for a veteran with no dependents (rates effective 2025-12-01).
What ratings are possible for back & spine?
The rating schedule provides these levels for this condition group: 10%, 20%, 30%, 40%, 50%, 60%, 100%. The exact criteria for each level are quoted on this page directly from the CFR.
Next steps
- Combine this rating with your others — VA math doesn't add ratings.
- How long are claims taking right now? Weekly VBA data.
- Browse other condition rating criteria.