musculoskeletalDC 5237

Lumbosacral Strain

Lumbosacral strain is an injury to the muscles and tendons of the lower back. Under the VA rating schedule, the specific back diagnosis generally does not change how the condition is rated. Lumbosacral strain (DC 5237) is rated under the same thoracolumbar spine range of motion (ROM) table used for most mid and lower back conditions including degenerative arthritis, spinal stenosis, and spondylolisthesis. The rating is based on how far the veteran can bend forward (forward flexion) and the combined range of motion, with consideration for flare-ups. Veterans can receive separate ratings for their neck (cervical spine) and mid/lower back (thoracolumbar spine) if both are affected, but multiple conditions affecting the same section of spine result in only one rating for that section.

VA Rating Levels

Forward flexion of 90 degrees or more, or combined ROM of 240 degrees or more.

10%

Forward flexion more than 60 degrees but no more than 85 degrees, or combined ROM between 125 and 240 degrees. Also covers muscle spasm or guarding NOT resulting in abnormal gait, or vertebral body fracture with 50%+ height loss.

20%

Forward flexion more than 30 degrees but no more than 60 degrees, or combined ROM of 120 degrees or less. Also covers muscle spasm or guarding severe enough to cause abnormal gait, or abnormal spinal contour such as scoliosis.

40%

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

50%

Entire thoracolumbar spine is frozen in an unfavorable position (ankylosis).

100%

Entire spine (neck and back) frozen in an unfavorable position.

Exam Tips & Key Evidence

→The VA is required to consider flare-ups when rating your spine condition. Even if your exam does not occur on your worst day, the examiner must reasonably estimate your impairment during flare-ups, and the rater must use the most impaired ROM measurements.
→If you have multiple lower/mid back diagnoses (for example, lumbosacral strain AND degenerative disc disease), you will only receive ONE rating for the thoracolumbar spine - not separate ratings for each diagnosis.
→Radiculopathy (nerve pain, numbness, or tingling going down the legs) is a very common secondary condition to spine disabilities. Nerve-based secondary conditions linked to the spine are effectively a presumptive grant. Request separate ratings for affected limbs.
→Pain with motion alone warrants at least a 10% rating. Abnormal spinal contour (such as scoliosis or reversed lordosis) warrants at least a 20% rating.
→Bowel and bladder impairment can also be claimed as secondary conditions to spine disabilities.
→Degenerative Disc Disease is NOT considered arthritis and is NOT subject to presumptive service-connection time limits.

Commonly Related Conditions

Thoracolumbar Spine (Lower and Mid Back)Intervertebral Disc Syndrome (IVDS)Radiculopathy - Lower Extremities (Lumbar)Spinal Stenosis Degenerative Disc Disease (DDD)

38 CFR Reference

38 CFR 4.71a, DC 5237