VA Disability Ratings for Back Pain Explained (The Definitive Guide)

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Back pain is one of the most common (and most debilitating) conditions veterans face after military service. Years of physical strain, heavy gear, hard landings, or service-related injuries can lead to lasting spine problems that impact your mobility, work, and quality of life.

If your back pain was caused or aggravated by your time in service, you may qualify for VA disability compensation and benefits.

The VA rates back pain under the General Rating Formula for Diseases and Injuries of the Spine, with possible ratings from 10% to 100% depending on your range of motion, functional loss, and symptoms such as painful motion or ankylosis.

In this guide, I’ll break down exactly how the VA rates back pain, what evidence you need to strengthen your claim, and how to increase your rating (whether your back pain is a primary service-connected disability or a secondary condition like radiculopathy).

Okay, let’s jump into some important definitions first because these principles are critical to understand and may affect your final VA disability rating for back pain.

Summary of Key Points

• VA back pain ratings range from 10% to 100% and depend on range of motion, painful motion, and functional loss.

• Even with a full range of motion, the Painful Motion principle can qualify you for the minimum compensable rating (usually 10%).

• Back pain can be rated alongside secondary conditions like radiculopathy if they cause separate functional impairments.

• Strong medical documentation from C&P exams, including accurate goniometer measurements, is essential for the highest rating possible.

What is the VA’s “Painful Motion” Principle?

Under 38 CFR §4.59, if you have pain when moving a joint (even with full range of motion), the VA must award at least the minimum compensable rating for that condition (usually 10% for back pain).

Painful motion can be shown through:

• Facial expressions or wincing during movement
• Muscle spasms in the affected area
• Crepitation (crackling) in soft tissue or joint structures

The VA will check for pain during active and passive motion, in both weight-bearing and non-weight-bearing positions. Even if your ROM is normal, documented pain can secure a rating.

What is “Limitation of Range of Motion” for VA disability for back pain?

The VA bases most back pain ratings on your range of motion (ROM)—how far you can bend or move your spine—measured during your Compensation & Pension (C&P) exam.

A VA examiner must use a goniometer to ensure accurate measurements and document any muscle atrophy. If you experience pain at any point during movement, tell the examiner to stop immediately and note where the pain begins.

You must be open, honest, and truthful at your C&P exam for back pain. If you can’t move at all without pain, make sure to let the examiner know that.

One severe condition the VA looks for is unfavorable ankylosis (when part or all of your spine is stuck in a harmful position). This can cause serious functional problems, like:

• Difficulty walking due to a limited line of vision
• Restricted mouth opening and trouble chewing
• Breathing limited to diaphragmatic respiration
• Gastrointestinal issues from spine pressure on the abdomen
• Nerve-related symptoms from stretching or compression

PRO TIP: Limitation of ROM is one of the most important factors in your VA rating for back pain, so make sure your exam captures the full extent of your symptoms.

What is “Functional Loss” and how can it affect my VA back rating?

Functional loss refers to how much your back condition limits your ability to perform normal movements with strength, speed, coordination, and endurance. It can be due to the following factors:

• #1. Pain

• #2. Fatigue

• #3. Weakness

• #4. Lack of endurance

• #5. Incoordination

The VA considers both your initial range of motion and any additional loss after repeated movements when determining your rating.

VA Disability Ratings for Back Pain (Explained)

• 100% VA Disability for Back Pain: Unfavorable ankylosis of the entire spine

• 50% VA Disability Rating for Back Pain: Unfavorable ankylosis of the entire thoracolumbar spine

• 40% VA Rating for Back Pain: 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

• 30% VA Rating for Back Pain: Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine

• 20% VA Disability Rating for Back: 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

• 10% VA Rating for Back Pain: 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

*If no limitation of range of motion is observed, but the claimant has painful motion, the minimum rating or 10% should be applied.

>> Read the complete VA Spine Examination guide here <<

Back Pain VA Ratings (Table)

General Rating Formula for Diseases and Injuries of the Spine	VA Rating
Unfavorable ankylosis of the entire spine	100%
Unfavorable ankylosis of the entire thoracolumbar spine	50%
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	40%
Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine	30%
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	20%
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	10%
Evaluate intervertebral disc syndrome (preoperatively or postoperatively) either under the General Rating Formula for Diseases and Injuries of the Spine or under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes, whichever method results in the higher evaluation when all disabilities are combined under §4.25.
Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes	VA Rating for Intervertebral Disc Syndrome
With incapacitating episodes having a total duration of at least 6 weeks during the past 12 months	60%
With incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months	40%
With incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months	20%
With incapacitating episodes having a total duration of at least one week but less than 2 weeks during the past 12 months	10%
Note (1): For purposes of evaluations under diagnostic code 5243, an incapacitating episode is a period of acute signs and symptoms due to intervertebral disc syndrome that requires bed rest prescribed by a physician and treatment by a physician.
Note (2): If intervertebral disc syndrome is present in more than one spinal segment, provided that the effects in each spinal segment are clearly distinct, evaluate each segment on the basis of incapacitating episodes or under the General Rating Formula for Diseases and Injuries of the Spine, whichever method results in a higher evaluation for that segment.

Veterans can download an image of the VA rating for back pain infographic below, which describes the VA disability ratings for back pain from 0% to 100%, with breaks at 10%, 20%, 40%, and 50%.

C&P Exam for Back Pain Expert Tips! (VIDEO)

Can I Be Rated for More Than One VA Disability for the Back?

The legal concept of “Avoidance of Pyramiding” applies to the back just like any other VA disability.

However, you can be rated for more than one disability condition for your back that causes different levels of impairment and are clearly separately rated conditions.

For example, you may have a 50% VA rating for your back due to unfavorable ankylosis of the entire thoracolumbar spine.

Perhaps this condition has also led to radiculopathy, which occurs when nerve roots become pinched or damaged; the resulting symptoms lead to this painful condition.

List of VA Secondary Conditions to Back Pain

Many veterans suffer from various service-connected back conditions, which can affect their backs.

For example, the following codes from 38 CFR, Part 4, Schedule for Rating Disabilities apply:

• Code 5237: Lumbosacral or cervical strain—a generic label for back pain

• Code 5238: Spinal stenosis—the spinal column narrows and presses on the spinal cord or nerves

• Code 5239: Spondylolisthesis or segmental instability—when a vertebra slips out of position

• Code 5240: Ankylosing spondylitis—an arthritic disease that causes the spinal joints to freeze in place

• Code 5241: Spinal fusion—the vertebrae are surgically fused together

• Code 5235: Vertebral fracture or dislocation—the bones of the spine break or slip out of alignment due to a traumatic event like a car accident. Any generic spinal bone injury would be coded here.

These six back conditions can often lead to pinched or damaged nerve roots, which can cause significant pain known as radiculopathy.

Radiculopathy is commonly rated as a secondary VA disability claim for secondary service connection due to one or more service-connected back conditions.

Note that a veteran is eligible to be rated for both a back condition and Radiculopathy secondary to lower back pain.

Related: Top Secondary Conditions to Lower Back Pain

Conclusion

If back pain from your military service is impacting your life, you may be entitled to VA disability benefits—sometimes at much higher levels than you think. The VA’s rating system considers more than just range of motion; painful motion, functional loss, and related secondary conditions can all increase your overall rating.

By understanding the rating criteria, documenting your symptoms thoroughly, and clearly linking your condition to your service, you can give your claim the strongest possible foundation. Don’t settle for less than you’ve earned—YOU SERVED. YOU DESERVE.

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