VA Disability Rating for Back Pain: 10% to 100% Criteria
VA rates back pain under diagnostic codes (DC) 5237, 5242 and 5243 in 38 CFR § 4.71a. The schedule has 6 levels: 10%, 20%, 30%, 40%, 50% and 100%. The table below quotes each level word for word from the current CFR text and adds a one-line summary; the 2026 monthly compensation figures that follow are VA's published rates.
Maintained by Archie Chang · Criteria checked against the eCFR and Federal Register October 26, 2026 · Methodology & sources
Back pain (spine) rating criteria in 38 CFR § 4.71a
Diagnostic codes: DC 5237 Lumbosacral or cervical strain; DC 5242 Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome; DC 5243 Intervertebral disc syndrome. Criteria are quoted from the current CFR; the plain-English column is our summary and is not part of the regulation.
Lead-in text printed in the CFR before the rows (quotation):
(For diagnostic codes 5235 to 5243 unless 5243 is evaluated under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes):
With or without symptoms such as pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease
| Rating | Criteria as printed in 38 CFR (quotation) | In plain English (our summary) |
|---|---|---|
| 10% | Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, forward flexion of the cervical spine greater than 30 degrees but not greater than 40 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, combined range of motion of the cervical spine greater than 170 degrees but not greater than 335 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height | Thoracolumbar forward flexion greater than 60 but not greater than 85 degrees, or other listed findings such as localized tenderness or muscle spasm without abnormal gait. |
| 20% | Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, the combined range of motion of the cervical spine not greater than 170 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis | Thoracolumbar forward flexion greater than 30 but not greater than 60 degrees, or other listed findings such as spasm or guarding severe enough to cause an abnormal gait or spinal contour. |
| 30% | Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine | Cervical forward flexion of 15 degrees or less, or favorable ankylosis of the entire cervical spine. |
| 40% | Unfavorable ankylosis of the entire cervical spine; or, forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine | Thoracolumbar forward flexion of 30 degrees or less, favorable ankylosis of the entire thoracolumbar spine, or unfavorable ankylosis of the entire cervical spine. |
| 50% | Unfavorable ankylosis of the entire thoracolumbar spine | Unfavorable ankylosis of the entire thoracolumbar spine. |
| 100% | Unfavorable ankylosis of the entire spine | Unfavorable ankylosis of the entire spine. |
All 6 notes printed with these criteria (quotation):
Note (1): Evaluate any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, separately, under an appropriate diagnostic code.
Note (2): (See also Plate V.) For VA compensation purposes, normal forward flexion of the cervical spine is zero to 45 degrees, extension is zero to 45 degrees, left and right lateral flexion are zero to 45 degrees, and left and right lateral rotation are zero to 80 degrees. Normal forward flexion of the thoracolumbar spine is zero to 90 degrees, extension is zero to 30 degrees, left and right lateral flexion are zero to 30 degrees, and left and right lateral rotation are zero to 30 degrees. The combined range of motion refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. The normal combined range of motion of the cervical spine is 340 degrees and of the thoracolumbar spine is 240 degrees. The normal ranges of motion for each component of spinal motion provided in this note are the maximum that can be used for calculation of the combined range of motion.
Note (3): In exceptional cases, an examiner may state that because of age, body habitus, neurologic disease, or other factors not the result of disease or injury of the spine, the range of motion of the spine in a particular individual should be considered normal for that individual, even though it does not conform to the normal range of motion stated in Note (2). Provided that the examiner supplies an explanation, the examiner's assessment that the range of motion is normal for that individual will be accepted.
Note (4): Round each range of motion measurement to the nearest five degrees.
Note (5): For VA compensation purposes, unfavorable ankylosis is a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching. Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis.
Note (6): Separately evaluate disability of the thoracolumbar and cervical spine segments, except when there is unfavorable ankylosis of both segments, which will be rated as a single disability.
Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes
A second formula in 38 CFR § 4.71a under which the same diagnostic code can be evaluated. Quoted from the current CFR; the plain-English column is our summary.
Lead-in text printed in the CFR before the rows (quotation):
5243 Intervertebral disc syndrome: Assign this diagnostic code only when there is disc herniation with compression and/or irritation of the adjacent nerve root; assign diagnostic code 5242 for all other disc diagnoses.
Evaluate intervertebral disc syndrome (preoperatively or postoperatively) either under the General Rating Formula for Diseases and Injuries of the Spine or under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes, whichever method results in the higher evaluation when all disabilities are combined under § 4.25.
| Rating | Criteria as printed in 38 CFR (quotation) | In plain English (our summary) |
|---|---|---|
| 10% | With incapacitating episodes having a total duration of at least one week but less than 2 weeks during the past 12 months | Incapacitating episodes totaling at least one week but less than 2 weeks during the past 12 months. |
| 20% | With incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months | Incapacitating episodes totaling at least 2 weeks but less than 4 weeks during the past 12 months. |
| 40% | With incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months | Incapacitating episodes totaling at least 4 weeks but less than 6 weeks during the past 12 months. |
| 60% | With incapacitating episodes having a total duration of at least 6 weeks during the past 12 months | Incapacitating episodes totaling at least 6 weeks during the past 12 months. |
All 2 notes printed with these criteria (quotation):
Note (1): For purposes of evaluations under diagnostic code 5243, an incapacitating episode is a period of acute signs and symptoms due to intervertebral disc syndrome that requires bed rest prescribed by a physician and treatment by a physician.
Note (2): If intervertebral disc syndrome is present in more than one spinal segment, provided that the effects in each spinal segment are clearly distinct, evaluate each segment on the basis of incapacitating episodes or under the General Rating Formula for Diseases and Injuries of the Spine, whichever method results in a higher evaluation for that segment.
2026 VA monthly pay at each back pain (spine) rating
| Rating | Veteran alone | With spouse |
|---|---|---|
| 10% | $180.42 | Same as alone; spouse amounts start at 30% |
| 20% | $356.66 | Same as alone; spouse amounts start at 30% |
| 30% | $552.47 | $617.47 |
| 40% | $795.84 | $882.84 |
| 50% | $1,132.90 | $1,241.90 |
| 60% | $1,435.02 | $1,566.02 |
| 100% | $3,938.58 | $4,158.17 |
VA does not add ratings together. When a veteran has more than one rated condition, VA combines them with its combined ratings table (38 CFR § 4.25), so the amounts above apply to a combined rating, not to this condition alone. Work out a combined rating with the VA disability calculator at /va-disability-calculator/.
VA disability calculator · Full VA disability pay chart with children and parents
How the criteria are written
The schedule lists diagnoses, not "back pain" as such. The General Rating Formula applies "with or without symptoms such as pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease", and it covers DC 5235 to 5243: vertebral fracture, sacroiliac injury, lumbosacral or cervical strain, spinal stenosis, spondylolisthesis, ankylosing spondylitis, spinal fusion, degenerative arthritis and intervertebral disc syndrome.
DC 5243 (intervertebral disc syndrome) can also be evaluated under the separate formula based on incapacitating episodes, shown after the General Rating Formula below. The CFR says to use whichever method results in the higher evaluation when all disabilities are combined under § 4.25.
The levels turn on measured range of motion (forward flexion and combined range of motion), ankylosis, and for 20% and 10% also muscle spasm, guarding or tenderness. Note (6) says to evaluate the thoracolumbar and cervical segments separately, except when there is unfavorable ankylosis of both segments.
Note (1) says associated objective neurologic abnormalities, including bowel or bladder impairment, are evaluated separately under an appropriate diagnostic code. The table below shows the thoracolumbar and cervical findings together, as the CFR prints them.
VA publishes Disability Benefits Questionnaires for this area (benefits.va.gov): Back (Thoracolumbar Spine) DBQ · Neck (Cervical Spine) DBQ.
Is this the current rule?
Source text. § 4.71a Schedule of ratings—musculoskeletal system. from the eCFR (38 CFR Part 4), text up to date as of October 22, 2026, retrieved October 26, 2026. Read the section on eCFR.
Latest final rule affecting the section. 86 FR 8142 (final rule), Schedule for Rating Disabilities: Musculoskeletal System and Muscle Injuries; Correction, published February 4, 2021, effective February 7, 2021. Latest entry in the section's amendment history in the eCFR. It corrects the 2020 musculoskeletal rule (85 FR 76453); the spine formula below dates from 2003.
Rule that set these criteria. 68 FR 51454, effective September 26, 2003. The 2003 spine final rule created the General Rating Formula; CFR Appendix A dates the change September 26, 2003.
- DC 5237: Replaces 5285-5295 September 26, 2003.
Upcoming changes. Our Federal Register search on October 26, 2026 found no final rule for this section with an effective date after that day.
Proposed rules. The search found no proposed rule that would change these criteria.
Related conditions
- Migraine: Another pain-related condition, rated in a different part of the schedule (§ 4.124a, DC 8100).
- Radiculopathy: Nerve-root findings are rated under the nerve codes in § 4.124a; Note (1) of the spine formula sends associated neurologic abnormalities to separate evaluation.
- All VA disability ratings by condition
Questions about the Back pain (spine) rating
What diagnostic code does VA use for back pain?
Back pain is rated under diagnostic codes (DC) 5237, 5242 and 5243 in 38 CFR § 4.71a, the Schedule for Rating Disabilities. The code lists are quoted from the eCFR text current as of October 22, 2026.
What are the VA rating levels for back pain?
The schedule has 6 levels for back pain: 10%, 20%, 30%, 40%, 50% and 100%. Each level has its own criteria, quoted in the table on this page. VA decides which level applies to a claim.
How much is VA disability pay for a back pain rating in 2026?
VA's 2026 monthly rates for a veteran alone, with the with-spouse amount for 30% and higher, are 10%: $180.42; 20%: $356.66; 30%: $552.47 ($617.47 with a spouse); 40%: $795.84 ($882.84 with a spouse); 50%: $1,132.90 ($1,241.90 with a spouse); 60%: $1,435.02 ($1,566.02 with a spouse); 100%: $3,938.58 ($4,158.17 with a spouse). Rates took effect December 1, 2025. The amount you are paid depends on your combined rating, not on this condition alone.
Are ratings for back pain added to my other ratings?
No. VA does not add ratings together; it combines them using the combined ratings table in 38 CFR § 4.25. Use the VA disability calculator on this site at /va-disability-calculator/ to see how ratings combine.
Does VA rate the spine by pain?
The General Rating Formula for Diseases and Injuries of the Spine applies "with or without symptoms such as pain", and its levels are written in terms of range of motion, ankylosis, muscle spasm, guarding, localized tenderness and, at 10%, vertebral body fracture with loss of 50 percent or more of the height. Three other sections of 38 CFR Part 4 also speak to pain in the musculoskeletal system: § 4.40 (functional loss, which says it may be due to pain supported by adequate pathology and evidenced by the visible behavior of the claimant undertaking the motion), § 4.45 (the joints) and § 4.59 (painful motion). Section 4.59 says: "It is the intention to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint." How those sections apply to a particular spine claim is for VA to decide.
Is there a different formula for a herniated disc?
DC 5243 (intervertebral disc syndrome) is assigned only when there is disc herniation with compression and/or irritation of the adjacent nerve root. Section 4.71a says to evaluate it either under the General Rating Formula or under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes, whichever method results in the higher evaluation when all disabilities are combined under § 4.25.
Does this page decide my VA rating?
No. FedRateCalc is not affiliated with the Department of Veterans Affairs. This page quotes the rating schedule and VA's published rates for information only; it is not legal or medical advice. VA decides the rating and the payment.