Spinal Stenosis
Spinal stenosis is the narrowing of the spinal canal, which can put pressure on the spinal cord and nerves. It can occur in the cervical spine (neck) or thoracolumbar spine (mid and lower back). Under the VA, spinal stenosis (DC 5238) is rated under the same ROM-based spine table as other spine conditions. Cervical stenosis is rated on cervical spine ROM, and lumbar/thoracic stenosis is rated on thoracolumbar spine ROM. Multiple conditions affecting the same section of spine result in one rating for that section. Secondary nerve conditions (radiculopathy) are commonly claimed alongside spinal stenosis.
VA Rating Levels
Thoracolumbar: forward flexion more than 60 degrees but no more than 85 degrees, or combined ROM between 125 and 240 degrees. Cervical: forward flexion more than 30 degrees but less than 45 degrees, or combined ROM between 175 and 340 degrees.
Thoracolumbar: forward flexion more than 30 degrees but no more than 60 degrees, or combined ROM of 120 degrees or less. Cervical: forward flexion more than 15 degrees but no more than 30 degrees, or combined ROM of 170 degrees or less.
Cervical only: forward flexion 15 degrees or less, or entire cervical spine frozen in a favorable position.
Thoracolumbar: forward flexion 30 degrees or less, or frozen in a favorable position. Cervical: entire cervical spine frozen in an unfavorable position.
Entire thoracolumbar spine frozen in an unfavorable position.
Entire spine (cervical and thoracolumbar) frozen in an unfavorable position.
Exam Tips & Key Evidence
- →Spinal stenosis often causes radiculopathy (nerve symptoms in the arms or legs). These nerve conditions can be claimed as secondary conditions and rated separately from the spine itself.
- →The examiner is required to consider flare-ups when measuring ROM. If you are not having a bad day during your exam, the examiner must still estimate your worst-day impairment.
- →Veterans can receive separate ratings for cervical spine and thoracolumbar spine if both are affected by stenosis.
- →Pain with motion warrants at least a 10% rating even if ROM measurements alone would not qualify.
- →Bowel and bladder impairment are potential secondary conditions to spinal stenosis that can be rated separately.
- →If spinal stenosis causes nerve-based secondary conditions, those are effectively a presumptive grant per VA policy.
Commonly Related Conditions
38 CFR Reference
38 CFR 4.71a, DC 5238