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Lumbosacral or cervical strain is diagnostic code 5237 in 38 CFR 4.71a. It uses the General Rating Formula for Diseases and Injuries of the Spine. For a low-back strain, the thoracolumbar measurements are the ones that match the back. The same rows also state cervical measurements, because DC 5237 covers cervical strain too.
General Rating Formula
The formula applies to diagnostic codes 5235 to 5243 unless 5243 is evaluated under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes. DC 5243 is a different code. This page does not restate that formula. The spine 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.
| Rating | Criteria in 38 CFR 4.71a | 2026 monthly, veteran alone |
|---|---|---|
| 100% | Unfavorable ankylosis of the entire spine | $3,938.58 |
| 50% | Unfavorable ankylosis of the entire thoracolumbar spine | $1,132.90 |
| 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 | $795.84 |
| 30% | Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine | $552.47 |
| 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 | $356.66 |
| 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 | $180.42 |
The formula does not list a 0% level. The 30% row, as written, states cervical criteria only. Dependent amounts start at 30%. See the 2026 pay chart, 50%, and 100%.
Open the calculator with 40% filled in, 20%, 10%, or 50%. A separate nerve rating, if VA assigns one, is another entry. Read how VA math combines them.
How the regulation measures motion
- Note (2): 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 is the sum of forward flexion, extension, left and right lateral flexion, and left and right rotation. The normal combined range of motion of the thoracolumbar spine is 240 degrees. For the cervical spine, normal forward flexion and extension are each zero to 45 degrees, left and right lateral flexion are each zero to 45 degrees, and left and right lateral rotation are each zero to 80 degrees. The normal combined cervical range is 340 degrees. Each component’s normal range in this note is the maximum used to calculate the combined range.
- Note (4): Round each range of motion measurement to the nearest five degrees.
- Note (5): 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.
Note (3) allows an examiner, in exceptional cases and with an explanation, to treat a range as normal for that person when age, body habitus, neurologic disease, or another factor not resulting from disease or injury of the spine accounts for the difference from Note (2). The eCFR citation for 4.71a runs through 86 FR 8142, Feb. 4, 2021.
Radiculopathy is a separate code
Note (1): Evaluate any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, separately, under an appropriate diagnostic code.
One code the schedule provides is 38 CFR 4.124a diagnostic code 8520, paralysis of the sciatic nerve:
| Rating | Criteria | 2026 monthly, veteran alone |
|---|---|---|
| 80% | Complete; the foot dangles and drops, no active movement possible of muscles below the knee, flexion of knee weakened or (very rarely) lost | $2,102.15 |
| 60% | Incomplete: severe, with marked muscular atrophy | $1,435.02 |
| 40% | Incomplete: moderately severe | $795.84 |
| 20% | Incomplete: moderate | $356.66 |
| 10% | Incomplete: mild | $180.42 |
The same heading lists 8620 neuritis and 8720 neuralgia without a percentage on those rows. This page does not assign them a rate. The schedule also does not define “mild,” “moderate,” “moderately severe,” or “severe” beyond the words in the 8520 rows. A separate 8520 evaluation is combined with the spine evaluation under 38 CFR 4.25. It is not added to the spine percentage.
Sources
- 38 CFR 4.71a, diagnostic code 5237 and the General Rating Formula for Diseases and Injuries of the Spine. eCFR title 38 latest issue date August 27, 2026 (up to date as of October 16, 2026). Retrieved October 20, 2026.
- 38 CFR 4.124a, diagnostic code 8520, sciatic nerve. Same issue date.
- 38 CFR 4.25 for combining a separate neurologic evaluation with the spine evaluation.
- Pay: VA.gov veteran rates, effective December 1, 2025, checked October 19, 2026.
Last checked October 20, 2026. Estimates only. Not a rating decision.
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Related
- All condition guides
- 50% VA disability pay and 100% VA disability pay
- VA disability calculator
- 2026 pay chart
- How VA math works
- TDIU percentage check
Frequently asked questions
Which diagnostic code is lumbosacral strain?
Diagnostic code 5237, “Lumbosacral or cervical strain,” in 38 CFR 4.71a. It is rated under the General Rating Formula for Diseases and Injuries of the Spine unless a different instruction applies. The formula covers diagnostic codes 5235 to 5243, except when 5243 is evaluated under the formula for incapacitating episodes.
Is there a 30% rating for the low back under this formula?
The 30% row states cervical criteria only: forward flexion of the cervical spine 15 degrees or less, or favorable ankylosis of the entire cervical spine. Thoracolumbar forward flexion of 30 degrees or less, or favorable ankylosis of the entire thoracolumbar spine, is in the 40% row.
Is radiculopathy part of the back rating?
Note (1) to the General Rating Formula says to evaluate any associated objective neurologic abnormalities, including bowel or bladder impairment, separately, under an appropriate diagnostic code. The sciatic nerve is diagnostic code 8520 in 38 CFR 4.124a. A separate neurologic evaluation is then combined under 38 CFR 4.25. It is not added to the spine percentage.