Lumbosacral Strain
Lumbosacral Strain is rated under 38 CFR 38 CFR § 4.71a, DC 5237, Diagnostic Code 5237, from 0% to 100% based on the frequency and functional severity of symptoms. The maximum 100% rating requires: Unfavorable ankylosis of the entire spine. Most claims establish the 0% or 10% rating before reaching the top tier.
What are the VA rating criteria for Lumbosacral Strain?
Forward flexion of the thoracolumbar spine greater than 60 degrees; and no ankylosis, no muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour, and no localized tenderness of the muscles or vertebral spinous processes.
Note: Rated under the General Rating Formula for Diseases and Injuries of the Spine. All spinal conditions DC 5235–5243 use the same rating formula. The 0% rating requires a diagnosis but no functional impairment meeting higher 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
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 cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine
Note: Via (For diagnostic codes 5235 to 5243 unless 5243 is evaluated under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes):
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
Note: Forward flexion of 30 degrees or less is significant functional impairment. Ankylosis at this stage requires the spine to be in a favorable (near normal) position.
Unfavorable ankylosis of the entire thoracolumbar spine
Note: Unfavorable ankylosis means the spine is fused in a position that is not functionally useful (e.g., flexed, laterally deviated, or rotated). This is the maximum rating for lumbosacral strain under the general formula.
Unfavorable ankylosis of the entire spine
Note: Via (For diagnostic codes 5235 to 5243 unless 5243 is evaluated under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes):
“Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine”
Which conditions are commonly secondary to Lumbosacral Strain?
View 6 secondary conditions linked to Lumbosacral Strain
Medical rationale, evidence strength, and filing tips — rated under 38 CFR § 3.310
Common Questions About Lumbosacral Strain VA Ratings
What is the VA rating range for Lumbosacral Strain?
The VA rates Lumbosacral Strain under Diagnostic Code 5237 at 0%, 10%, 20%, 30%, 40%, 50%, 100%. The minimum 0% rating requires: Forward flexion of the thoracolumbar spine greater than 60 degrees; and no ankylosis, no muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour, and no localized tenderness of the muscles or vertebral spinous processes.. The maximum 100% rating requires: Unfavorable ankylosis of the entire spine.
Which 38 CFR diagnostic code does the VA use for Lumbosacral Strain?
The VA rates Lumbosacral Strain under Diagnostic Code (DC) 5237, governed by 38 CFR 38 CFR § 4.71a, DC 5237. The diagnostic code establishes the specific rating tiers and severity criteria the VA examiner applies.
What is the difference between a 0% and a 100% rating for Lumbosacral Strain?
A 0% rating requires: Forward flexion of the thoracolumbar spine greater than 60 degrees; and no ankylosis, no muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour, and no localized tenderness of the muscles or vertebral spinous processes.. A 100% rating requires: Unfavorable ankylosis of the entire spine. The difference typically reflects the frequency, severity, or functional impact of the condition as documented in medical records and C&P examination findings.
Can Lumbosacral Strain qualify for TDIU (Total Disability Individual Unemployability)?
Veterans rated for Lumbosacral Strain may qualify for TDIU if the condition — alone or in combination with other service-connected disabilities — prevents substantially gainful employment. A single disability rated at 60% or higher (or multiple disabilities combining to 70%, with one at 40%) can support a TDIU claim under 38 CFR § 4.16.
What evidence do I need to establish service connection for Lumbosacral Strain?
Service connection for Lumbosacral Strain requires three elements: (1) a current diagnosis of the condition, (2) an in-service event, injury, or disease, and (3) a medical nexus linking the current diagnosis to that in-service occurrence. A nexus letter from a treating or independent medical examiner is the most reliable nexus evidence.
Which conditions are commonly secondary to Lumbosacral Strain?
Lumbosacral Strain is associated with 6 documented secondary conditions. Secondary conditions caused or aggravated by a service-connected disability are ratable under 38 CFR § 3.310. See the secondary conditions page for the full list with medical rationale and evidence strength ratings.
What is the C&P exam like for Lumbosacral Strain?
A Compensation & Pension (C&P) exam for Lumbosacral Strain uses a Disability Benefits Questionnaire (DBQ) specific to the body system involved. The examiner documents the frequency, severity, and functional impact of your symptoms. Bring all relevant treatment records and be prepared to describe your worst-day symptoms — the examiner rates your condition based on the full clinical picture, not a single visit.
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