Diagnostic Code 5237 · 38 CFR §4.71a
Lumbosacral strain is an injury to the muscles, tendons, or ligaments of the lower back. It is one of the most commonly claimed VA disability conditions. Veterans develop lower back problems from carrying heavy equipment, rucking, parachute landings, vehicle vibrations, heavy lifting, and the general physical demands of military service. The VA rates lumbosacral strain under the General Rating Formula for Diseases and Injuries of the Spine, which applies the same criteria to most spinal conditions. The rating is based primarily on range of motion measurements, with additional consideration for muscle spasm, abnormal gait, and spinal contour abnormality.
| Rating | Criteria |
|---|---|
| 10% | Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 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% or more of the height. |
| 20% | Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or combined range of motion not greater than 120 degrees; or muscle spasm or guarding severe enough to result in abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. |
| 40% | Forward flexion of the thoracolumbar spine 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. |
Range of motion measurements of the thoracolumbar spine are the primary evidence. The C&P examiner measures forward flexion, extension, bilateral lateral flexion, and bilateral rotation using a goniometer. Medical records documenting back injuries during service, imaging (X-rays, MRI of the lumbar spine), and treatment records showing ongoing back problems are important. Evidence of associated radiculopathy (nerve pain radiating into the legs) should be documented separately because it receives its own rating. Document any incapacitating episodes that required bed rest prescribed by a physician, as the alternative IVDS formula may yield a higher rating.
The combined ROM is the sum of forward flexion, extension, right lateral flexion, left lateral flexion, right rotation, and left rotation. Normal combined ROM is 240 degrees. The VA uses this combined measurement as one of the criteria for determining the rating level.
Yes. The General Rating Formula for Diseases of the Spine specifically states that associated objective neurological abnormalities, including radiculopathy, should be evaluated separately under the appropriate diagnostic code. Claiming radiculopathy in each affected leg in addition to the back condition itself is proper and can substantially increase your combined rating.
Ankylosis is the immobility or fixation of a joint. For the spine, favorable ankylosis means the spine is fixed in a neutral (upright) position. Unfavorable ankylosis means the spine is fixed in a flexed or other non-neutral position. Ankylosis of the entire thoracolumbar spine warrants a 50% rating, and ankylosis of the entire spine warrants 100%.