Spondylolisthesis or segmental instability
Spondylolisthesis or segmental instability is rated under 38 CFR 38 CFR § 4.71a, Diagnostic Code 5239, from 10% 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 10% or 20% rating before reaching the top tier.
What are the VA rating criteria for Spondylolisthesis or segmental instability?
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: 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 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
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
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: 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 thoracolumbar 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 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”
Common Questions About Spondylolisthesis or segmental instability VA Ratings
What is the VA rating range for Spondylolisthesis or segmental instability?
The VA rates Spondylolisthesis or segmental instability under Diagnostic Code 5239 at 10%, 20%, 30%, 40%, 50%, 100%. The minimum 10% rating requires: 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. The maximum 100% rating requires: Unfavorable ankylosis of the entire spine.
Which 38 CFR diagnostic code does the VA use for Spondylolisthesis or segmental instability?
The VA rates Spondylolisthesis or segmental instability under Diagnostic Code (DC) 5239, governed by 38 CFR 38 CFR § 4.71a. The diagnostic code establishes the specific rating tiers and severity criteria the VA examiner applies.
What is the difference between a 10% and a 100% rating for Spondylolisthesis or segmental instability?
A 10% rating requires: 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. 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 Spondylolisthesis or segmental instability qualify for TDIU (Total Disability Individual Unemployability)?
Veterans rated for Spondylolisthesis or segmental instability 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 Spondylolisthesis or segmental instability?
Service connection for Spondylolisthesis or segmental instability 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.
What is the C&P exam like for Spondylolisthesis or segmental instability?
A Compensation & Pension (C&P) exam for Spondylolisthesis or segmental instability 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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