Degenerative Disc Disease (DDD)
Degenerative Disc Disease (DDD) refers to the breakdown of the spinal discs over time. It encompasses many related conditions including herniated disc, bulging disc, slipped disc, ruptured disc, protruded disc, prolapsed disc, and discogenic pain syndrome. DDD can be rated under the spine ROM table (DC 5242 for degenerative arthritis of the spine) or under Intervertebral Disc Syndrome (IVDS, DC 5243) if the veteran has incapacitating episodes requiring prescribed bed rest. The veteran receives whichever rating is higher - ROM-based or incapacitating episode-based - but NOT both. If rated under IVDS incapacitating episodes, separate ratings for related nerve conditions are NOT allowed. An important distinction: DDD is NOT considered arthritis by the VA and is NOT subject to presumptive service-connection time limits.
VA Rating Levels
ROM-based: forward flexion more than 60 degrees but no more than 85 degrees (thoracolumbar) or more than 30 degrees but less than 45 degrees (cervical). IVDS: at least 1 but less than 2 weeks of incapacitating episodes per year.
ROM-based: forward flexion more than 30 degrees but no more than 60 degrees (thoracolumbar) or more than 15 degrees but no more than 30 degrees (cervical). IVDS: at least 2 but less than 4 weeks of incapacitating episodes per year.
ROM-based: forward flexion 30 degrees or less (thoracolumbar) or cervical frozen favorable. IVDS: at least 4 but less than 6 weeks of incapacitating episodes per year.
IVDS: more than 6 weeks of incapacitating episodes per year.
Entire spine frozen in an unfavorable position (ROM-based only).
Exam Tips & Key Evidence
- →DDD is NOT considered arthritis by the VA. This means it is NOT subject to the one-year presumptive service-connection window that applies to arthritis. This is an important distinction that many veterans are not aware of.
- →The ROM-based rating and the IVDS incapacitating episode rating are alternatives - you receive whichever is higher, not both.
- →If rated under IVDS incapacitating episodes, separate ratings for related spine nerve conditions are NOT allowed. Under ROM-based rating, you CAN get separate nerve ratings (radiculopathy). Compare both options carefully.
- →Incapacitating episodes must involve PRESCRIBED bed rest - meaning a doctor specifically prescribed bed rest. Simply staying in bed on your own does not count.
- →Radiculopathy is a very common secondary condition. If your DDD causes nerve symptoms in the arms or legs, claim those separately.
- →The examiner must consider flare-ups in ROM measurements. Report your worst-day symptoms honestly at your C&P exam.
Commonly Related Conditions
38 CFR Reference
38 CFR 4.71a, DC 5242/5243