Lumbar Spine (Lower Back)
Back conditions are rated under the General Rating Formula for Diseases and Injuries of the Spine (38 CFR § 4.71a). The VA primarily measures range of motion (how far you can bend forward) and whether you have incapacitating episodes.
VA Rating Levels
Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees. Or combined range of motion greater than 120 degrees but not greater than 235 degrees. Or muscle spasm, guarding, or localized tenderness not resulting in abnormal gait. In plain terms: you can still bend forward pretty well, but you have pain and stiffness.
Forward flexion greater than 30 degrees but not greater than 60 degrees. Or combined range of motion not greater than 120 degrees. Or muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour (like scoliosis or reversed lordosis). Basically: you can only bend about halfway and it's visibly affecting how you walk or stand.
Forward flexion of the thoracolumbar spine 30 degrees or less. Or favorable ankylosis (partial fusion/stiffness) of the entire thoracolumbar spine. This means you can barely bend forward at all.
Unfavorable ankylosis of the entire thoracolumbar spine. Your whole mid-to-lower spine is essentially fused/locked in a position that isn't straight.
Unfavorable ankylosis of the entire spine — your whole spine from neck to tailbone is locked/fused.
Exam Tips & Key Evidence
- →Range of motion is measured on your WORST days — tell the examiner about flare-ups
- →If you have radiculopathy (pain/numbness shooting into your legs), that's rated SEPARATELY under nerve damage codes — each leg can be its own rating
- →Intervertebral disc syndrome (IVDS) can also be rated based on incapacitating episodes (doctor-prescribed bed rest) if that gives a higher rating
- →Always mention pain on motion, pain after repetitive use, and difficulty with daily activities
Commonly Related Conditions
38 CFR Reference
38 CFR § 4.71a, Diagnostic Codes 5237-5243