Ankylosing spondylitis — VA Rating Criteria (38 CFR DC 5240)

The VA rates Ankylosing spondylitis under Diagnostic Code 5240 at the following tiers: 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.

Diagnostic Code 5240 is the VA rating identifier for Ankylosing spondylitis within 38 CFR 38 CFR § 4.71a. It defines the specific symptom criteria and percentage thresholds a VA adjudicator uses to assign a disability rating. The diagnostic code is listed on a veteran's rating decision letter.

The highest schedular rating for Ankylosing spondylitis under DC 5240 is 100%. This tier requires: Unfavorable ankylosis of the entire spine. Veterans who cannot secure substantially gainful employment due to Ankylosing spondylitis alone or in combination with other service-connected conditions may also qualify for TDIU at the 100% compensation rate under 38 CFR § 4.16.

Ankylosing spondylitis is rated under 38 CFR 38 CFR § 4.71a, Diagnostic Code 5240. This section is part of the Schedule for Rating Disabilities (38 CFR Part 4) and can be read in full at the eCFR website.

Secondary conditions caused or aggravated by Ankylosing spondylitis may be ratable under 38 CFR § 3.310. Veterans should work with a VSO or accredited claims agent to document the medical relationship.

Service connection for Ankylosing spondylitis requires three elements: (1) a current diagnosis of the condition, (2) an in-service event, injury, or disease that may have caused or aggravated it, and (3) a medical nexus connecting the current diagnosis to that in-service event. A nexus letter from a treating physician or independent medical examiner is the most reliable nexus evidence. C&P exam findings can also establish nexus if adequately documented.