musculoskeletalDC 5240

Ankylosing Spondylitis

Ankylosing spondylitis (DC 5240) is a type of inflammatory arthritis that primarily affects the spine, potentially causing vertebrae to fuse together over time. Under the VA rating schedule, it is rated on the same ROM-based spine table as other spine conditions. If the spine becomes completely fused (ankylosed) in an unfavorable position, it can warrant the highest spine ratings. Multiple conditions affecting the same section of the spine result in one rating for that section.

VA Rating Levels

10%

Forward flexion more than 60 degrees but no more than 85 degrees (thoracolumbar), or combined ROM between 125 and 240 degrees.

20%

Forward flexion more than 30 degrees but no more than 60 degrees, or combined ROM of 120 degrees or less.

40%

Forward flexion 30 degrees or less, or entire thoracolumbar spine frozen in a favorable position.

50%

Entire thoracolumbar spine frozen in an unfavorable position.

100%

Entire spine (cervical and thoracolumbar) frozen in an unfavorable position.

Exam Tips & Key Evidence

→Ankylosing spondylitis can progress to full spinal fusion, which can qualify for 50% (thoracolumbar frozen unfavorable) or 100% (entire spine frozen unfavorable).
→Radiculopathy and other nerve conditions can be claimed as secondary conditions if the condition causes nerve impingement.
→The examiner must consider flare-ups when measuring ROM.
→If the condition also qualifies as multi-joint arthritis (DC 5002), compare ratings under both schedules.
→This condition can be rated under multi-joint (rheumatoid) arthritis if spondyloarthropathies are the primary disability.

Commonly Related Conditions

Thoracolumbar Spine (Lower and Mid Back)Cervical Spine (Neck)Rheumatoid Arthritis (Multi-Joint Arthritis)Radiculopathy - Lower Extremities (Lumbar)

38 CFR Reference

38 CFR 4.71a, DC 5240