For most spinal conditions, the VA applies specific rating criteria based largely on limitations in movement and function rather than pain severity alone. Certain conditions, such as intervertebral disc syndrome (IVDS), may also be evaluated under alternative criteria.
Associated neurological complications, such as radiculopathy or bowel or bladder impairment, may also be evaluated separately when appropriate.
The General Rating Formula Used by the VA
The VA evaluates most spinal conditions under the General Rating Formula for Diseases and Injuries of the Spine. The rating criteria consider factors such as range of motion, muscle spasm or guarding, abnormal gait or spinal contour, and ankylosis. These findings may be documented during a Compensation and Pension (C&P) exam.
An examiner uses a goniometer to measure movements such as forward flexion, extension, lateral flexion, and rotation. Normal forward flexion of the thoracolumbar spine is 90 degrees.
VA Rating Percentages for the Thoracolumbar Spine
For the thoracolumbar spine, the VA may award the following ratings based on range of motion and other findings, including ankylosis, which means the spine is fixed in one position:
- 10% Rating: Forward bending is limited to between 61 and 85 degrees, or the combined range of motion is between 121 and 235 degrees. This rating may also apply for muscle spasms, guarding, or localized tenderness that does not cause an abnormal gait or spinal contour.
- 20% Rating: Forward bending is limited to between 31 and 60 degrees, or the combined range of motion is 120 degrees or less. This rating may also apply when muscle spasms or guarding cause an abnormal gait or spinal curvature, such as scoliosis.
- 40% Rating: Forward bending is limited to 30 degrees or less, or the entire thoracolumbar spine is fixed in a favorable position.
- 50% Rating: The entire thoracolumbar spine is fixed in an unfavorable position.
- 100% Rating: The entire spine, including the neck and back, is fixed in an unfavorable position.
How Pain and Functional Loss Affect the Exam
How Can Intervertebral Disc Syndrome (IVDS) Affect Your Claim?
Intervertebral disc syndrome (IVDS) is a spinal condition involving damage to the discs between the bones of your spine that can compress or irritate nearby nerves. Qualifying IVDS can affect your claim by giving the VA two ways to evaluate your condition, which may result in a higher overall disability rating than evaluating your range of motion alone.
Under Diagnostic Code 5243 the VA can evaluate IVDS using:
General Rating Formula: The VA evaluates limitations such as reduced range of motion and ankylosis using the spinal rating criteria discussed above.
Incapacitating Episodes: The VA considers how much time you spent on physician-prescribed bed rest and receiving treatment for IVDS during the previous 12 months.
VA Ratings for IVDS Incapacitating Episodes
Under the VA criteria for incapacitating episodes, the ratings are:
- 10%: At least 1 week but less than 2 weeks.
- 20%: At least 2 weeks but less than 4 weeks.
- 40%: At least 4 weeks but less than 6 weeks.
- 60%: At least 6 weeks.
For VA rating purposes, staying in bed because your back hurts does not by itself qualify as an incapacitating episode. The bed rest must be prescribed by a physician, and the episode must involve treatment by a physician.
Why It’s Important to Consider Secondary Conditions
A service-connected back condition can sometimes cause or aggravate other health problems. These secondary conditions may qualify for separate VA disability ratings when evidence links them to your service-connected condition.
One example is radiculopathy, which can cause pain, burning, numbness, tingling, or weakness in the legs or feet. The VA may rate these neurological problems separately from the spinal condition.
Other common secondary conditions may affect the hips, knees, or other joints if back problems change how you move or walk. Bowel or bladder impairment may also qualify for separate evaluation when supported by medical evidence.
Chronic pain and physical limitations may also affect mental health. If you develop a diagnosed condition caused or aggravated by your back disability, medical evidence, including a nexus letter in some cases, can help support the connection.
What Steps Should You Take Next, If The Goal is Benefits and Relief?
If you are pursuing VA disability benefits for a back condition, make sure your medical records reflect how the condition affects your movement and daily function. Keep track of flare-ups, including how long they last and whether they limit work or other activities, and report significant changes or symptoms to your healthcare provider.
You should also document related symptoms, such as numbness, tingling, or radiating pain, that may indicate a secondary neurological condition.
If you previously received a 0% rating or believe your current rating does not reflect the severity of your condition, review your options for seeking a higher rating or appealing the decision. Contact us to learn more about the next steps.
