VA rates back conditions — like lumbosacral strain (DC 5237) — on the General Rating Formula for the Spine (38 CFR 4.71a), mostly by your range of motion and ankylosis, from 10% to 100%. The single biggest thing veterans miss: nerve problems like sciatica are rated separately from the back itself.
Straight talk first
The back is one of the most-claimed conditions and one of the most under-rated, for two reasons. First, the rating leans on range of motion, so a rushed exam that doesn't capture your real limits and flare-ups can lowball you. Second — and bigger — the spine formula rates only the back; the radiculopathy (pain, numbness, weakness) shooting down a leg is a separate rating under its own nerve code. Claim the back and the nerves.
This is the back-rating cut of how VA rates conditions.
How the rating works (thoracolumbar spine, DC 5237)
| Rating | Criteria (forward flexion / other) |
|---|---|
| 100% | Unfavorable ankylosis of the entire spine |
| 50% | Unfavorable ankylosis of the entire thoracolumbar spine |
| 40% | Forward flexion 30° or less, or favorable ankylosis of the entire thoracolumbar spine |
| 20% | Forward flexion >30° to 60°, or combined motion ≤120°, or muscle spasm/guarding severe enough to alter gait or spinal contour |
| 10% | Forward flexion >60° to 85°, or combined motion >120° to 235°, or guarding not altering gait |
The formula applies the same way regardless of how you got the diagnosis — it's based on the objective measurements, with pain and flare-ups factored in under VA's functional-loss rules.
The radiculopathy you're leaving on the table
The spine formula has a built-in instruction: evaluate associated objective neurologic abnormalities separately. So if your back condition causes sciatica/radiculopathy down a leg, that nerve involvement gets its own rating (the sciatic nerve is DC 8520) — per leg. This is the most common way back claims are under-rated.
Direct or secondary?
- Direct — an in-service injury, lifting event, or years of rucking/overuse.
- Secondary — altered gait from a service-connected knee or ankle loading the spine, under 38 CFR 3.310.
You'll need a current diagnosis, the service event or primary, and a nexus. See how to file your own claim, then run the back plus any radiculopathy through the VA Combined Rating Calculator.
Key takeaways
- Back conditions (DC 5237) are rated on the Spine Formula by range of motion / ankylosis, 10%–100%.
- Painful motion and flare-ups must be captured at the exam — that's where ratings get lowballed.
- Sciatica/radiculopathy is rated separately (DC 8520, per leg) — claim the nerves, not just the back.
- Claim it directly or as a secondary depending on the cause.
Frequently asked questions
- How does VA rate back pain?
- Back conditions like lumbosacral strain (DC 5237) are rated on the General Rating Formula for the Spine (38 CFR 4.71a), mainly by your range of motion. For the thoracolumbar spine: forward flexion of 60–85 degrees (or combined motion 120–235) is 10%; 30–60 degrees (or muscle spasm/guarding that alters gait) is 20%; 30 degrees or less (or favorable ankylosis) is 40%; unfavorable ankylosis of the thoracolumbar spine is 50%.
- Is sciatica included in my back rating?
- No — and this is where ratings get missed. The spine formula rates the back itself, but objective neurologic abnormalities like sciatica/radiculopathy are rated SEPARATELY under their own codes (the sciatic nerve is DC 8520). So a back claim with nerve involvement should produce more than one rating.
- Does painful motion count for a back rating?
- Yes. Under VA's functional-loss rules, pain on motion and flare-ups that further limit your range should be reflected in the rating, not just your best-day degrees. Make sure the C&P exam measures your range and notes pain and flare-ups.
- Can a back condition be a secondary?
- Yes. A back condition can be claimed directly (an in-service injury or overuse) or as a secondary — for example, an altered gait from a service-connected knee or ankle loading the spine, under 38 CFR 3.310. The cause decides the lane.
Sources
- 38 CFR 4.71a — General Rating Formula for the Spine (DC 5237): https://www.law.cornell.edu/cfr/text/38/4.71a
- 38 CFR 4.124a — neurological conditions (DC 8520, sciatic nerve / radiculopathy): https://www.law.cornell.edu/cfr/text/38/4.124a
- 38 CFR 3.310 — secondary service connection: https://www.ecfr.gov/current/title-38/chapter-I/part-3/subpart-A/section-3.310
- VA — How VA decides service connection: https://www.va.gov/disability/eligibility/
