Spinal stenosis — VA Rating Criteria (38 CFR DC 5238)
The VA rates Spinal stenosis under 38 CFR 38 CFR § 4.71a, Diagnostic Code 5238, from 10% to 100% based on the frequency and functional severity of symptoms. The maximum 100% rating requires Unfavorable ankylosis of the entire spine. Related conditions in the Musculoskeletal body system share this rating framework.
What are the VA rating criteria for Spinal stenosis?
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
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
Unfavorable ankylosis of the entire thoracolumbar spine
Unfavorable ankylosis of the entire spine
“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”
How does the VA rate Musculoskeletal conditions?
Common Questions About Spinal stenosis VA Ratings
What is the VA disability rating for Spinal stenosis?
The VA rates Spinal stenosis under Diagnostic Code 5238 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.
What is Diagnostic Code 5238?
Diagnostic Code 5238 is the VA rating identifier for Spinal stenosis 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.
What is the highest rating for Spinal stenosis?
The highest schedular rating for Spinal stenosis under DC 5238 is 100%. This tier requires: Unfavorable ankylosis of the entire spine. Veterans who cannot secure substantially gainful employment due to Spinal stenosis alone or in combination with other service-connected conditions may also qualify for TDIU at the 100% compensation rate under 38 CFR § 4.16.
What 38 CFR section governs Spinal stenosis ratings?
Spinal stenosis is rated under 38 CFR 38 CFR § 4.71a, Diagnostic Code 5238. This section is part of the Schedule for Rating Disabilities (38 CFR Part 4) and can be read in full at the eCFR website.
Which conditions are commonly secondary to Spinal stenosis?
Secondary conditions caused or aggravated by Spinal stenosis may be ratable under 38 CFR § 3.310. Veterans should work with a VSO or accredited claims agent to document the medical relationship.
What evidence do I need to establish service connection for Spinal stenosis?
Service connection for Spinal stenosis 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.
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