Condition Guide · Neurological symptoms
Cervical spine / neck VA rating 2026 — DC 5237
Updated June 2026 · CFR source: 38 CFR §4.71a
Cervical spine conditions (cervical strain, cervical degenerative disc disease, cervical stenosis) are rated under DC 5237 using the General Rating Formula for Diseases and Injuries of the Spine — the same formula as the lumbar spine. Neurological residuals (radiculopathy, arm/hand symptoms) are rated separately under peripheral nerve diagnostic codes in addition to the structural spine rating.
Rating schedule — General Spine Formula (cervical)
| Rating | 2026 monthly | Forward flexion criteria (cervical) |
|---|---|---|
| 40% | $795.84 | Forward flexion ≤15°; or unfavorable ankylosis of the cervical spine. |
| 20% | $356.66 | Forward flexion 16–30°; or combined ROM ≤170°; or muscle spasm causing abnormal gait or spinal contour. |
| 10% | $180.42 | Forward flexion 31–45°; or combined ROM 171–335°; or guarding/tenderness without abnormal gait. |
Normal cervical forward flexion is 0–45°. Normal combined ROM is 340°.
Service connection for cervical spine conditions
Establishing service connection for cervical spine conditions requires:
- Current diagnosis. A physician-confirmed diagnosis of cervical strain, cervical degenerative disc disease, herniated nucleus pulposus, cervical stenosis, or related condition documented in medical records.
- In-service event or injury. Evidence of neck trauma during service — a vehicular accident, fall, parachute landing, or sustained heavy load-bearing duty. Service treatment records noting neck pain, stiffness, or treatment during active duty are valuable even without a formal diagnosis at the time.
- Nexus letter. A medical opinion from a physician stating the current cervical condition is "at least as likely as not" related to in-service activity. For conditions diagnosed years after separation, a nexus letter is typically required to bridge the gap. Nexus letters from treating orthopedists, neurologists, or physiatrists carry the most weight.
Secondary service connection allows a cervical spine condition to be connected as secondary to another SC condition. Examples: cervical degeneration secondary to SC shoulder condition altering posture and neck mechanics; or cervical strain aggravated by an SC sleep condition that causes chronic neck muscle tension.
Neurological residuals — separate ratings
Cervical radiculopathy causing symptoms in the arms/hands can be rated separately:
| Condition | DC | Rating range |
|---|---|---|
| Radial nerve (arm/wrist) | DC 8514 / 8515 | 10%–60% |
| Median nerve (hand/grip) | DC 8512 / 8513 | 10%–60% |
| Ulnar nerve (little/ring finger) | DC 8516 / 8517 | 10%–60% |
| Brachial plexus | DC 8510 / 8511 | 10%–80% |
These neurological ratings are added through §4.25 with the cervical spine rating — they are not pyramiding because they represent distinct nerve vs. structural disabilities.
Secondary conditions
- Cervicogenic headaches → can be rated under DC 8100 (migraines)
- Shoulder impingement secondary to cervical nerve root involvement
- Temporomandibular joint (TMJ) disorder secondary to cervical injury
C&P exam documentation tips
- State the angle at which pain begins during ROM measurement — not just max ROM.
- Report any arm or hand symptoms: numbness, tingling, weakness, dropping objects.
- Describe flare-up frequency and what triggers them.
- Bring imaging reports (X-ray, MRI) documenting structural changes.
FAQ
What is the most common cervical spine rating VA grants?
10% is the most common initial rating, covering forward flexion 45–90° or combined ROM 170–335°. Veterans with documented nerve root impairment or pain limiting ROM below 45° commonly receive 20%–40%. Always ensure the C&P examiner documents pain onset and any radicular symptoms.
Can cervical spine and lumbar spine be rated separately?
Yes. Each spinal region (cervical/thoracic/lumbar) can be rated separately. A veteran with both a cervical strain (neck) and lumbosacral strain (lower back) has two separate service-connected conditions, each rated under the General Rating Formula, with both ratings combining through §4.25.
What neurological symptoms from cervical spine qualify for extra ratings?
Cervical radiculopathy causing arm/hand symptoms — numbness, tingling, weakness — can be rated separately under peripheral nerve diagnostic codes (DC 8510–8516 for brachial plexus and associated nerves). Each nerve group can be separately rated in addition to the cervical spine structural rating.
Does headache qualify for a separate rating secondary to cervical spine?
Yes. Cervicogenic headaches secondary to a service-connected cervical spine condition can be rated under DC 8100 (headaches, migraine type). A physician nexus letter linking the headaches to the cervical condition is required.
Related: Lower back · Migraines · Shoulder