The Playbook › Condition guides
Back pain is among the most common VA claims: lumbar strain, degenerative disc disease, herniated discs, arthritis of the spine. Whatever the diagnosis, VA rates nearly all of them the same way, using the General Rating Formula for Diseases and Injuries of the Spine. The rating depends mainly on how far you can bend.
That makes the range of motion measurements at your C&P exam extremely important.
The short version
- The lower back (thoracolumbar spine) is rated at 10%, 20%, 40%, 50%, or 100%.
- Forward flexion is the measurement that matters most.
- Pain, flare-ups, and loss of motion after repeated use must be considered, not just one measurement.
- Nerve symptoms in the legs (radiculopathy) are rated separately, for each leg.
- A painful back with near-normal motion is generally entitled to at least 10%.
On this page
Lower back pain ratings
Normal forward flexion of the lower back is 90 degrees. Normal combined range of motion, adding up all six directions, is 240 degrees.
| Rating | Criteria (any one is enough) |
|---|---|
| 10% | 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 that does not cause an abnormal gait or spinal contour |
| 20% | Forward flexion greater than 30 but not greater than 60 degrees; or combined range of motion not greater than 120 degrees; or muscle spasm or guarding severe enough to cause an abnormal gait or abnormal spinal contour |
| 40% | Forward flexion of 30 degrees or less; or favorable ankylosis of the entire thoracolumbar spine |
| 50% | Unfavorable ankylosis of the entire thoracolumbar spine |
| 100% | Unfavorable ankylosis of the entire spine |
Ankylosis means the spine is fixed in place. Most veterans are rated at 10%, 20%, or 40%. Note that there is no 30% for the lower back.
Neck ratings
Normal forward flexion of the neck is 45 degrees.
| Rating | Criteria |
|---|---|
| 10% | Forward flexion greater than 30 but not greater than 40 degrees; or combined range of motion greater than 170 but not greater than 335 degrees; or spasm, guarding, or tenderness without abnormal gait or contour |
| 20% | Forward flexion greater than 15 but not greater than 30 degrees; or combined range of motion not greater than 170 degrees; or spasm or guarding causing abnormal gait or contour |
| 30% | Forward flexion of 15 degrees or less; or favorable ankylosis of the entire cervical spine |
| 40% | Unfavorable ankylosis of the entire cervical spine |
The neck and the lower back are rated separately. You can have a rating for each.
Pain, flare-ups, and repeated use
A single measurement on a good day does not tell the whole story, and the rules recognize that. The examiner is required to:
- Note where pain begins during movement, not only where movement ends
- Test motion again after repetitive use
- Estimate additional loss of motion during flare-ups, based on what you describe, even if you are not having one that day
- Record functional loss from pain, weakness, fatigue, and incoordination
So tell the examiner: how often flare-ups happen, how long they last, what triggers them, and what you cannot do during one. “During a flare-up I cannot bend forward at all for two or three days” is information the examiner must take into account.
If your back hurts on movement but your range of motion is close to normal, painful motion generally supports at least the minimum compensable rating.
The alternative: incapacitating episodes
For intervertebral disc syndrome, VA can rate on incapacitating episodes if that gives a higher result. An incapacitating episode means bed rest prescribed by a physician and treatment by a physician.
| Rating | Total duration in the past 12 months |
|---|---|
| 10% | At least 1 week but less than 2 weeks |
| 20% | At least 2 weeks but less than 4 weeks |
| 40% | At least 4 weeks but less than 6 weeks |
| 60% | At least 6 weeks |
Because it requires doctor-prescribed bed rest, which is rarely ordered now, few veterans are rated this way.
Radiculopathy: the separate rating many miss
If your back condition causes pain, numbness, tingling, or weakness running into a leg or arm, that is rated on top of the spine rating, separately for each limb. For the sciatic nerve:
| Rating | Severity of incomplete paralysis |
|---|---|
| 10% | Mild |
| 20% | Moderate |
| 40% | Moderately severe |
| 60% | Severe, with marked muscle atrophy |
| 80% | Complete paralysis |
A veteran with a 20% back and 20% radiculopathy in each leg ends up with a far higher combined rating than 20%, and the bilateral factor applies to the two legs. Tell the examiner about every leg symptom. The full criteria, including arm ratings, are in the radiculopathy guide. Bowel or bladder problems caused by the spine condition are also rated separately.
At the C&P exam
- Stop where the pain starts. Do not push further to be helpful.
- Do not take extra pain medication beforehand to get through it. Take what you normally take.
- Describe flare-ups with frequency and duration.
- Mention every nerve symptom, in each leg.
- Bring any brace, cane, or TENS unit you use.
- Explain the effect on work: sitting, standing, lifting, driving.
The examiner should use a goniometer to measure angles. If they estimate by eye, note it afterward. See the C&P exam guide.
Getting back pain service connected
- Direct. An injury or treatment in service, with ongoing symptoms. Heavy load carriage, parachute jumps, vehicle accidents, and repetitive lifting are common causes. Arthritis is a chronic disease, so continuous symptoms since service can establish the link.
- Secondary. Back problems often follow service-connected knee, hip, ankle, or foot conditions because of altered gait. See secondary conditions.
Conditions that follow from back pain
- Radiculopathy, as above
- Depression from chronic pain. See depression and anxiety.
- Hip and knee problems
- Erectile dysfunction, which can qualify for SMC-K
When the back keeps you from working
A 40% back with radiculopathy in both legs can reach the thresholds for TDIU, since orthopedic and related neurological ratings can be counted together as one disability for that purpose.
Free printable checklist. Everything to gather before you file, what to bring to your C&P exam, and what to check in your decision, on two pages.
Last reviewed October 2026. This guide is general educational information, not legal or medical advice, and this site is not affiliated with the Department of Veterans Affairs. Rules and rates change. Confirm details on VA.gov or with an accredited representative. See our disclaimer and editorial policy.