Lumbosacral Strain (Low Back Strain)
Chronic strain of the low back muscles and ligaments, one of the most commonly claimed VA disabilities. VA rates it on how far you can bend and move your low back, not on how much it hurts.
How the VA rates it
Rated under the General Rating Formula for Diseases and Injuries of the Spine, which applies with or without pain (even pain that radiates). The rating is driven by measured range of motion (especially forward flexion of the thoracolumbar spine), muscle spasm or guarding that affects gait or spinal curvature, and ankylosis (a spine frozen in place) at the highest levels. Under 38 CFR 4.59, a back with painful motion generally warrants at least the minimum 10 percent rating even if measured motion alone would be noncompensable. Nerve symptoms like sciatica are rated separately on top of the back rating.
Rating criteria by percentage
Rated up to 100%Unfavorable ankylosis of the entire spine (the whole spine is fixed in a disadvantageous position).
Unfavorable ankylosis of the entire thoracolumbar (mid and lower) spine.
Forward flexion of the thoracolumbar spine 30 degrees or less, or favorable ankylosis of the entire thoracolumbar spine.
Forward flexion greater than 30 but not greater than 60 degrees; or combined thoracolumbar range of motion 120 degrees or less; or muscle spasm or guarding severe enough to cause abnormal gait or abnormal spinal contour (such as scoliosis or reversed lordosis).
Forward flexion greater than 60 but not greater than 85 degrees; or combined range of motion greater than 120 but not greater than 235 degrees; or muscle spasm, guarding, or localized tenderness without abnormal gait or contour; or a vertebral body fracture with 50 percent or more loss of height.
What those terms mean
- ankylosis
- — The joint or spine is frozen stiff and cannot move. 'Favorable' means stuck in a usable position; 'unfavorable' means stuck in a position that makes daily life harder.
- range of motion
- — How far you can move the joint, measured in degrees with a goniometer at your C&P exam. Painful motion counts against the range.
- flexion
- — Bending the joint (e.g., bending your knee or leaning forward).
Secondary condition strategy
Commonly claimed secondary to this
Conditions veterans often develop from this one — each can be its own rating under 38 CFR 3.310.
- Sciatic Radiculopathy — Low back conditions commonly compress or irritate the sciatic nerve roots, causing radiating pain, numbness, or weakness down the leg. Radiculopathy is rated separately from the back itself.
- Major Depressive Disorder — Depression secondary to chronic low back pain and the activity limits it imposes is a well-recognized secondary claim.
- Limited Motion of the Hip — An antalgic (pain-avoiding) gait from a bad back can overload the hips over time.
This is often secondary to
If you already have one of these service-connected, it may support connecting this condition.
- Flat Feet (Pes Planus) — Altered gait and poor shock absorption from flat feet can cause or aggravate low back strain.
- Knee Instability — Compensating for an unstable knee changes gait mechanics and can aggravate the low back.
Evidence that strengthens this claim
- The C&P exam rating turns on range-of-motion measurements in degrees, so describe your worst days: tell the examiner how much further motion is limited during flare-ups and after repetitive use.
- Document muscle spasms, guarding, or a visible limp in treatment notes; spasm severe enough to alter your gait supports 20 percent even with decent flexion numbers.
- If pain, numbness, or tingling radiates into either leg, say so explicitly and consider claiming radiculopathy secondary to the back condition; it is rated separately.
- Continuity matters: in-service complaints (sick call, physical therapy, profiles) plus current treatment records make the service connection nexus much stronger.
Rating rules to know
Only one rating is assigned per spine segment under the spine formula; you cannot stack 5237 with 5242 or 5243 for the same low back. However, associated objective neurologic problems (radiculopathy, bowel or bladder impairment) are rated separately and combined with the back rating; that is not pyramiding.
Related diagnostic codes
More musculoskeletal conditions
Limitation of Knee Flexion
The most commonly rated knee disability: how far you can bend the knee. Ratings run 0 to 30 percent based on measured flexion, with a 10 percent floor for a painful knee under the painful-motion rule.
Rated up to 30%
Degenerative Arthritis (Osteoarthritis)
Wear-and-tear arthritis confirmed by X-ray. VA rates it through the motion limits of each affected joint, with a 10 percent floor for a painful arthritic joint even when motion is nearly normal.
Rated up to 20%
Cervical Strain (Neck Strain)
Chronic strain of the neck muscles and ligaments. VA rates it on how far you can move your neck under the same spine formula used for the low back, with neck-specific degree thresholds.
Rated up to 100%
Degenerative Disc Disease (DDD)
Wear-and-tear breakdown of the spinal discs and joints, in the low back or neck. VA rates it on measured spinal motion under the same formula used for back and neck strain.
Rated up to 100%
Plantar Fasciitis
Inflammation of the tissue band supporting the arch, causing heel and arch pain. VA gave it its own diagnostic code in 2021, rated 10 to 30 percent based mainly on whether treatment provides relief.
Rated up to 40%
Limited Motion of the Ankle
Chronic ankle conditions (often old sprains or arthritis) are rated 10 or 20 percent based on measured loss of up-and-down motion, using specific degree cutoffs added to the rule in 2021.
Rated up to 20%
Disclaimer: Valor Rating is not affiliated with the U.S. Department of Veterans Affairs. This content is for educational purposes only and does not constitute legal or medical advice. Always review your documents carefully before submitting to the VA. For official guidance, consult an accredited VSO, claims agent, or attorney.