Conditions · 38 CFR 4.71a
Lower back (lumbosacral strain): VA rating criteria (5237)
Back conditions are rated under the General Rating Formula for the Spine, by range of motion, muscle spasm or guarding, and ankylosis, from 10 to 100 percent.
Written by Mia AI · Veterans Support · September 16, 2026 · Who writes these
How VA rates it
Lumbosacral strain and the other spine diagnoses from 5235 to 5243 share one formula. It rates on measured forward flexion and combined range of motion of the thoracolumbar spine, on muscle spasm or guarding that changes gait or spinal contour, and at the top on ankylosis. Pain by itself is expected ("with or without symptoms such as pain") and does not change the level; what the pain does to motion does.
Radiating nerve symptoms are rated separately under the nerve codes (see radiculopathy), and the schedule's note says so.
The rating criteria, as published
Diagnostic code 5237, 38 CFR 4.71a. Transcribed on September 16, 2026.
| Rating | Criteria |
|---|---|
| 100% | Unfavorable ankylosis of the entire spine. |
| 50% | Unfavorable ankylosis of the entire thoracolumbar spine. |
| 40% | Forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. |
| 20% | Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 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. |
| 10% | Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 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. |
- Evaluate any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, separately, under an appropriate diagnostic code.
- For VA compensation purposes, normal forward flexion of the thoracolumbar spine is zero to 90 degrees, extension zero to 30, left and right lateral flexion zero to 30, and left and right lateral rotation zero to 30; the combined range of motion is the sum of those six.
What a rater looks for in the record
- Goniometer measurements of forward flexion and the other five movements, from the claim exam, including after repetition and during a flare if it can be measured.
- Documented muscle spasm, guarding, tenderness, and whether gait or spinal contour is abnormal.
- Imaging and the treatment history in service and since; a nexus opinion when the in-service record is thin.
Claimed alongside it
- Radiculopathy of the sciatic nerve (8520) is rated separately when the back condition radiates into a leg.
- Hip, knee and the opposite side of the body are commonly claimed as secondary to an altered gait; the link needs a medical opinion.
What the records reader finds
The records reader finds every mention of the condition in the records you add, the Blue Button report, claims file, private notes and exam reports, and cites each fact to its file and page: the diagnosis, the dates, the treatment, the findings a rater would look for. It does not decide the rating, and it never invents a fact that is not on a page.
Questions veterans ask
Does pain count toward the rating?
The formula applies "with or without symptoms such as pain." Pain that limits motion on examination, or during flare-ups, is measured through the motion it limits; VA's rules also require the examiner to consider functional loss from pain, weakness and fatigue.
What is combined range of motion?
The sum of forward flexion, extension, left and right lateral flexion, and left and right rotation. Normal for the thoracolumbar spine adds to 240 degrees.
Is sciatica part of the back rating?
No. Objective neurologic abnormalities are rated separately under the nerve codes, and the two ratings combine.
Read next
Sources
- 38 CFR 4.71a, General Rating Formula for Diseases and Injuries of the Spine
- 38 CFR 4.40 and 4.45, functional loss
- VA claim exam (C&P exam), VA
The criteria above are the rating schedule as published, read on September 16, 2026; the rating is VA's decision.
YourVABenefits is software you run on your own records. It is not part of the U.S. Department of Veterans Affairs and does not file claims. You file on VA.gov, or an accredited representative files for you at no charge.