Back Pain (Lumbosacral/Cervical Strain) VA Rating Guide

Overview

Chronic pain in the lower back or neck region commonly resulting from military service activities such as carrying heavy gear, parachute jumps, vehicle accidents, or repetitive physical strain. Rated using the General Rating Formula for Diseases and Injuries of the Spine.

• VA Disability Code: 5237
• ICD Code: M54.5
• Category: Musculoskeletal

Rating Percentages & Criteria

100% Rating

Criteria: Unfavorable ankylosis of the entire spine

Examples:

• Complete spinal fusion in unfavorable position
• Severely restricted breathing
• Unable to walk normally due to vision limitation

50% Rating

Criteria: Unfavorable ankylosis of the entire thoracolumbar spine

Examples:

• Complete fusion of lower back in poor position
• Significant functional impairment

40% Rating

Criteria: 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

Examples:

• Neck completely fused
• Cannot bend forward more than 30 degrees
• Severe limitation of trunk movement

30% Rating

Criteria: Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine

Examples:

• Severe neck stiffness
• Cannot look down more than 15 degrees

20% Rating

Criteria: 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

Examples:

• Moderate limitation of back/neck movement
• Abnormal gait due to spasm
• Visible spinal curvature from guarding

10% Rating

Criteria: 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

Examples:

• Mild to moderate stiffness
• Tenderness on palpation
• Some limitation but no gait change

Symptoms & Functional Impact

Common symptoms associated with this condition:

• Persistent lower back or neck pain
• Muscle spasms
• Limited range of motion
• Pain radiating down legs or arms
• Difficulty standing or sitting
• Stiffness in the morning
• Numbness or tingling
• Weakness in extremities

Evidence Requirements for Your Claim

To support your claim, gather the following evidence:

• Range of motion measurements from C&P exam
• X-rays or MRI showing spinal problems
• Medical records documenting back/neck pain
• Service treatment records
• Physical therapy records
• Pain management treatment records

Secondary Conditions Commonly Connected

This condition often leads to secondary disabilities:

Depression (Strong Connection)

Chronic pain significantly increases risk of depression

Radiculopathy (Strong Connection)

Spinal problems commonly cause nerve compression and radiating pain

Knee Pain (Strong Connection)

Altered gait from back pain puts additional stress on knees

Sleep Apnea (Moderate Connection)

Pain-related sleep disturbances and positional restrictions can contribute to sleep apnea

Compensation & Pension (C&P) Exam Tips

Prepare for your C&P exam with these strategic tips:

• Avoid pain medication before exam if safe to do so
• Demonstrate your actual range of motion - don't push beyond pain
• Describe flare-ups and worst symptoms
• Mention all functional limitations in daily life
• Bring records of ongoing treatment

Frequently Asked Questions

Can I get separate ratings for lower back and neck problems?

Yes. The thoracolumbar spine (lower back) and cervical spine (neck) are rated separately unless both are completely fused.

What if I have radiculopathy from my back condition?

Radiculopathy (nerve damage causing radiating pain) is rated separately from the spinal condition.

Key Points for Your Claim

When filing for Back Pain (Lumbosacral/Cervical Strain):

1. Document everything - Every medical visit, treatment, and symptom counts
2. Get a nexus letter - A medical opinion linking your condition to service is crucial
3. Be thorough - Don't downplay your symptoms in your claim
4. Track progression - Show how the condition has worsened over time
5. Claim secondary conditions - Back Pain (Lumbosacral/Cervical Strain) often causes other disabilities

Ready to File Your Claim?

The VA disability system is complex, but you don't have to navigate it alone. We help veterans understand their benefits, gather strong evidence, and maximize their ratings.

Related Rating Guides:

• Depression VA Rating Guide
• Radiculopathy VA Rating Guide
• Knee Pain VA Rating Guide