Sacroiliac Joint Dysfunction
The sacroiliac (SI) joint is where the base of the spine (sacrum) meets the pelvis. SI joint dysfunction involves injury or weakness at this joint, causing pain in the lower back and hips. Under the VA rating schedule (DC 5236), this condition is rated based on limitation of range of motion of the thoracolumbar spine, hips, or arthritis - whichever is the primary disability. The SI joint is categorized as a minor joint for arthritis rating purposes.
VA Rating Levels
If rated on thoracolumbar ROM: forward flexion more than 60 degrees but no more than 85 degrees, or combined ROM between 125 and 240 degrees. If rated on hip ROM or arthritis: per the applicable schedule.
If rated on thoracolumbar ROM: forward flexion more than 30 degrees but no more than 60 degrees, or combined ROM of 120 degrees or less. Also if abnormal spinal contour.
Forward flexion 30 degrees or less, or thoracolumbar spine frozen in a favorable position.
Entire thoracolumbar spine frozen in an unfavorable position.
Exam Tips & Key Evidence
- →SI joint dysfunction can be rated on thoracolumbar spine ROM, hip ROM, or arthritis - whichever results in the highest evaluation. Explore each option with your representative.
- →Pain with motion alone warrants at least a 10% rating.
- →This condition is commonly associated with lower back conditions. If you already have a thoracolumbar spine rating, adding a separate SI joint rating may involve pyramiding concerns. Discuss with your representative.
- →Radiculopathy and other nerve conditions can be claimed as secondary conditions if the SI joint dysfunction causes nerve symptoms.
- →The examiner must consider flare-ups in ROM measurements.
Commonly Related Conditions
38 CFR Reference
38 CFR 4.71a, DC 5236