Diagnostic Code 5285 · 38 CFR §4.71a
DC 5285 is the legacy diagnostic code for residuals of a vertebra fracture under the spine rating schedule the VA used before the September 2003 amendment to 38 CFR §4.71a. The 2003 amendment consolidated the spine codes into the unified General Rating Formula now applied under DCs 5235 through 5243, and new claims for vertebral fracture are evaluated under the current formula plus a separate 10% add-on for vertebral body fracture with loss of 50 percent or more of vertebral body height. The legacy code itself is no longer assigned to new claims, but veterans rated under DC 5285 before 2003 keep that rating under the protection rules of 38 CFR §3.951. The legacy criteria are distinctive: a 10% increment is added for the demonstrable deformity of the vertebra body, the rating itself is based on residual limitation of motion or muscle spasm, and a separate 60% or 100% pathway exists for cord involvement. Understanding the structure matters when filing for increase, addressing a reduction proposal, or working through a reopened claim under the Appeals Modernization Act.
| Rating | Criteria |
|---|---|
| 10% | Vertebra fracture residuals with demonstrable deformity of the vertebra body — a 10% rating is added to the rating assigned for the residual limitation of motion or muscle spasm under the applicable spine code. |
| 60% | Vertebra fracture residuals without cord involvement but with abnormal mobility requiring neck brace (jury mast), OR fracture residuals with neurological symptoms — radiculopathy, sensory loss, motor weakness — short of cord injury. |
| 100% | Vertebra fracture with cord involvement — bedridden, OR requiring long leg braces or a wheelchair, OR with paralysis of substantial functional extent. Special Monthly Compensation under 38 USC 1114 applies in addition based on the specific functional losses. |
The original rating decision letter establishing the DC 5285 evaluation is the anchor — it locks in the protected status. Spine X-rays or CT showing the residual vertebral deformity document the demonstrable-deformity 10% increment. MRI of the spine documents any cord, nerve root, or disc involvement. Neurological examination findings (sensory and motor function below the fracture level, reflexes, gait) characterize the residuals. Service medical records establishing the in-service fracture event — combat trauma, MVA, parachute landing, training injury — support the protected service connection. If the veteran has been notified of a proposed re-evaluation under the current general spine formula, that proposal letter and basis should be reviewed before agreeing to anything because the protection rules favor keeping the legacy rating.
The 2003 amendment to the spine schedule did not retroactively re-rate existing claims. Veterans rated under the pre-2003 spine codes — DC 5285 through 5295 — kept those ratings under the principle that an existing favorable rating cannot be reduced by a regulatory change. New claims and reopened claims use the current general spine formula, but the legacy ratings remain in force for tens of thousands of veterans.
Under DC 5285, a 10% rating is added to the underlying rating when imaging shows persistent deformity of the fractured vertebra body — a wedged vertebra, a compressed body, or other structural distortion that persists after healing. The add-on is on top of whatever rating the residual limitation of motion or muscle spasm earns under the applicable spine code. It is a specific finding that should be documented explicitly in the rating decision; if it was not, that may be a basis for filing for increase.
Worsening neurological function below the fracture level supports a rating increase under the 100% tier and triggers evaluation for Special Monthly Compensation. SMC is paid in addition to the schedular rating for veterans with loss of use of limbs, bowel/bladder dysfunction, or the need for aid and attendance. As cord-level functional losses progress, the SMC tier should be re-evaluated annually or whenever a change is documented.