Condition Guide · Range of motion
Lower back VA rating 2026 — DC 5237 lumbar strain
Updated June 2026 · CFR source: 38 CFR §4.71a
Lower back pain (lumbosacral strain, lumbar degenerative disc disease, and related conditions) is one of the most common service-connected musculoskeletal conditions. It is rated under the General Rating Formula for Diseases and Injuries of the Spine, primarily using forward flexion range of motion as the key measurement.
Rating schedule — DC 5237 (General Spine Formula)
| Rating | 2026 monthly | Criteria |
|---|---|---|
| 40% | $795.84 | Unfavorable ankylosis of the thoracolumbar spine; or forward flexion of the thoracolumbar spine 30° or less; or combined range of motion 120° or less; or muscle spasm/guarding in a rigid position. |
| 20% | $356.66 | Forward flexion 30–60°; or combined range of motion not greater than 120°; or muscle spasm or guarding severe enough to result in abnormal gait or abnormal spinal contour such as scoliosis. |
| 10% | $180.42 | Forward flexion 60–85°; or combined range of motion 120–235°; or muscle spasm, guarding, or localized tenderness not resulting in abnormal gait; or vertebral body fracture with loss of 50% or more of height. |
Note: Normal thoracolumbar forward flexion is 0–90°. Normal combined range of motion is 240°.
Service connection for lower back conditions
Service connection for a lumbar or lumbosacral condition requires:
- Current diagnosis. A physician-confirmed diagnosis — lumbar strain, degenerative disc disease, herniated nucleus pulposus, spondylosis, or related condition — documented in medical records.
- In-service event or injury. Evidence of back injury, heavy lifting duty, parachute operations, vehicle operations on rough terrain, or sustained physical demands during service. Service treatment records documenting back complaints are the strongest evidence; even a single sick-call visit noting back pain is valuable.
- Nexus. A medical opinion linking the current condition to service. For conditions that developed gradually, a nexus letter from a physician stating the condition is "at least as likely as not" related to military service is typically required.
Secondary service connection is common for back conditions. A lower-back condition can be service-connected as secondary to an SC knee or hip condition that altered gait and placed abnormal stress on the lumbar spine, or secondary to weight gain caused by SC conditions that restricted activity.
Neurological residuals — separate rating potential
When a back condition causes neurological symptoms — radiculopathy, numbness, sciatica — those neurological deficits can be separately rated in addition to the spine rating:
- DC 8520 (sciatic nerve paralysis): 10%–80% depending on severity.
- DC 8620 (sciatic nerve neuritis): Incomplete paralysis with active inflammation, 10%–40%.
- DC 8720 (sciatic nerve neuralgia): Sensory radiculopathy — numbness or tingling down the leg, milder grades.
If you have both a back condition and documented radiculopathy (pain, weakness, or numbness radiating down the leg), claim both. The neurological rating is separate from and in addition to the spine rating — this is not pyramiding because they reflect distinct disabilities.
What to document at the C&P exam
- State the angle at which pain begins, not just the maximum range. Under §4.40 (functional loss) and §4.59 (painful motion), pain onset matters even when maximum ROM is within normal limits.
- Describe flare-ups — how often, how long, and what you cannot do during a flare.
- Mention daily functional limitations — sitting, standing, walking, lifting, and any use of assistive devices.
- Report radiation of pain — down the legs, numbness, tingling, weakness — for potential neurological rating.
FAQ
What is the most common lower back rating VA grants?
10% is by far the most common initial rating for lumbar strain and lumbosacral conditions. 20% requires forward flexion limited to 30–60° or significant functional loss, which many veterans can document with a thorough C&P exam and contemporaneous pain notation.
Does intervertebral disc syndrome (IVDS) rate differently?
Yes. IVDS can be rated under its own formula (38 CFR §4.71a, DC 5243) based on incapacitating episodes requiring bed rest prescribed by a physician. This can produce 10%–60% ratings and sometimes rates higher than the general spine formula. VA should rate under whichever code produces the higher result.
Can I get a higher rating for pain?
Under 38 CFR §4.59 (painful motion), VA must give a minimum compensable evaluation for joints that are painful on use even if ROM is within normal limits. Document pain onset angle during your C&P exam. Under §4.40 (functional loss), additional rating credit can be given when pain, weakness, or incoordination prevents normal joint use.
What is the difference between 5237 and 5235?
DC 5237 covers lumbosacral or cervical strain — the soft tissue diagnosis for back pain without structural diagnosis. DC 5235 covers vertebral fracture with residuals. Most service-connected back conditions without fracture are rated under DC 5237 using the General Rating Formula for Diseases and Injuries of the Spine.
Related: Cervical spine/neck · Knee · Bilateral factor