The exam form
The examiner fills out VA's "Back (Thoracolumbar Spine) Conditions" form (a Disability Benefits Questionnaire, or DBQ). See the form on VA.gov
Form version checked: Updated on 2024-12-20 (v24_4).
What the exam is for
The exam records your back diagnosis and how much your back limits you: how far you can move, where pain starts, flare-ups, and any nerve problems in your legs.
What the examiner will ask and measure
- Your diagnosis, and the history of your back condition: how it started and how it has changed.
- Flare-ups: how often they happen, how long they last, what sets them off, what helps, and what you can't do during one.
- Functional loss in your own words: what your back stops you from doing, including after repeated use over a day.
- Range of motion with a measuring tool: bending forward, bending backward, bending to each side, and turning to each side. The examiner notes where pain starts.
- Repeated motion: you move at least three times so the examiner can see whether motion gets worse.
- Estimates for bad days: the examiner must estimate how far you could move during a flare-up or after repeated use over time, based partly on what you tell them.
- Muscle spasm, guarding, tenderness, and whether they change how you walk or the curve of your spine.
- Strength, reflexes and feeling in your legs, and a straight-leg-raise test, to check for nerve problems (radiculopathy, such as sciatica).
- Disc problems (IVDS): whether a doctor prescribed bed rest in the past 12 months, and for how long in total.
- Braces, canes or other devices you use, and how often.
- X-rays or other imaging. Once arthritis shows on an X-ray, VA doesn't need new X-rays for it.
- How your back affects work tasks like sitting, standing, walking and lifting.
Be ready to describe
- When and how your back problem started in service.
- What a normal day is like, and what a bad day is like.
- How often flare-ups happen, how long they last, and what you can't do during them.
- Pain, numbness or tingling that runs into your legs.
- Any time a doctor told you to stay in bed, with dates if you have them.
- Medicines and side effects, physical therapy, injections, surgery.
- How long you can sit, stand or walk before you have to stop. How your back affects work, chores, driving and sleep.
Common mistakes
- Pushing past pain during the range of motion test, or stopping short of what you can do. Move as far as you normally can, and tell the examiner the moment pain starts.
- Saying "it's fine today" and leaving out flare-ups. The form asks about flare-ups for a reason.
- Not mentioning leg symptoms. Nerve problems are checked and rated separately from the back.
- Not mentioning prescribed bed rest because it was a while ago. The form asks about the past 12 months.
How VA rates it
VA rates most back conditions on the General Rating Formula for Diseases and Injuries of the Spine. It looks mostly at how far you can bend forward and your total range of motion, counting where pain or other problems limit you. Disc disease (IVDS) can instead be rated on doctor-prescribed bed rest, if that gives a higher rating. Nerve problems in the legs are rated on their own.
In plain English
These are the levels for the middle and lower back (thoracolumbar spine).
- 100%: Your whole spine, neck included, is fixed in a bad position (unfavorable ankylosis of the entire spine).
- 50%: Your whole middle and lower back is fixed in a bad position (unfavorable ankylosis).
- 40%: You can bend forward 30 degrees or less, or your whole middle and lower back is fixed in a neutral or other favorable position (favorable ankylosis).
- 20%: You can bend forward more than 30 but not more than 60 degrees; or your total motion in all six directions is 120 degrees or less; or muscle spasm or guarding is bad enough to cause an abnormal walk or an abnormal curve of the spine.
- 10%: You can bend forward more than 60 but not more than 85 degrees; or your total motion is more than 120 but not more than 235 degrees; or you have muscle spasm, guarding or tenderness that doesn't change how you walk or the curve of your spine; or a broken vertebra has lost half or more of its height.
- For VA, normal forward bending is 0 to 90 degrees, and normal total motion is 240 degrees. Each measurement is rounded to the nearest 5 degrees.
- Disc disease (IVDS), rated on bed rest instead: 10% for at least 1 but less than 2 weeks of doctor-prescribed bed rest in the past 12 months; 20% for at least 2 but less than 4 weeks; 40% for at least 4 but less than 6 weeks; 60% for 6 weeks or more. It counts only when a physician prescribed the bed rest and treated you.
- Nerve problems (such as sciatica) and bowel or bladder problems are rated separately. Your neck is rated separately from your back.
The regulation, word for word
Quoted from 38 CFR Part 4 (current as of October 16, 2026). This is what VA applies. The plain-English version above is our summary of it.
VA rates this code with the formula below.
38 CFR 4.71a, diagnostic code 5242: Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (also, see either DC 5003 or 5010) Open in the Rating Criteria Lookup
VA rates this code with the formula below.
| Criteria | Rating |
|---|
| 5243 Intervertebral disc syndrome: Assign this diagnostic code only when there is disc herniation with compression and/or irritation of the adjacent nerve root; assign diagnostic code 5242 for all other disc diagnoses. | |
| Evaluate intervertebral disc syndrome (preoperatively or postoperatively) either under the General Rating Formula for Diseases and Injuries of the Spine or under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes, whichever method results in the higher evaluation when all disabilities are combined under § 4.25. | |
General Rating Formula for Diseases and Injuries of the Spine
| Criteria | Rating |
|---|
| General Rating Formula for Diseases and Injuries of the Spine | |
| (For diagnostic codes 5235 to 5243 unless 5243 is evaluated under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes): | |
| 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 | |
| Unfavorable ankylosis of the entire spine | 100 |
| Unfavorable ankylosis of the entire thoracolumbar spine | 50 |
| 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 | 40 |
| Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine | 30 |
| 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 | 20 |
| 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 | 10 |
| Note (1): Evaluate any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, separately, under an appropriate diagnostic code. | |
| Note (2): (See also Plate V.) For VA compensation purposes, normal forward flexion of the cervical spine is zero to 45 degrees, extension is zero to 45 degrees, left and right lateral flexion are zero to 45 degrees, and left and right lateral rotation are zero to 80 degrees. 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 refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. The normal combined range of motion of the cervical spine is 340 degrees and of the thoracolumbar spine is 240 degrees. The normal ranges of motion for each component of spinal motion provided in this note are the maximum that can be used for calculation of the combined range of motion. | |
| Note (3): In exceptional cases, an examiner may state that because of age, body habitus, neurologic disease, or other factors not the result of disease or injury of the spine, the range of motion of the spine in a particular individual should be considered normal for that individual, even though it does not conform to the normal range of motion stated in Note (2). Provided that the examiner supplies an explanation, the examiner's assessment that the range of motion is normal for that individual will be accepted. | |
| Note (4): Round each range of motion measurement to the nearest five degrees. | |
| Note (5): For VA compensation purposes, 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. | |
Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes
| Criteria | Rating |
|---|
| Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes | |
| With incapacitating episodes having a total duration of at least 6 weeks during the past 12 months | 60 |
| With incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months | 40 |
| With incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months | 20 |
| With incapacitating episodes having a total duration of at least one week but less than 2 weeks during the past 12 months | 10 |
| Note (1): For purposes of evaluations under diagnostic code 5243, an incapacitating episode is a period of acute signs and symptoms due to intervertebral disc syndrome that requires bed rest prescribed by a physician and treatment by a physician. | |
| Note (2): If intervertebral disc syndrome is present in more than one spinal segment, provided that the effects in each spinal segment are clearly distinct, evaluate each segment on the basis of incapacitating episodes or under the General Rating Formula for Diseases and Injuries of the Spine, whichever method results in a higher evaluation for that segment. | |
Related
About every C&P exam
What is it?
After you file a claim, VA may ask you to have a claim exam, also called a compensation and pension (C&P) exam. It helps VA decide whether your condition is connected to your service, and how severe it is. It isn't treatment: the examiner won't treat you, prescribe medicine or refer you to anyone.
Who does it?
A VA provider or a provider from one of VA's exam contractors (Loyal Source, OptumServe, QTC or VES). VA picks; you can't choose. Hearing, mental health, eye and dental exams are done by specialists. For a reproductive, breast, rectal or mental health exam, or a claim related to military sexual trauma, you can ask for a male or female examiner.
How long does it take?
VA says anywhere from 15 minutes to an hour or more, depending on what you claimed. Some exams are by phone or video. If you claimed more than one condition, VA tries to schedule them on the same day.
Does the examiner decide my claim?
No. The examiner writes a report on a standard form (a Disability Benefits Questionnaire, or DBQ) and sends it to VA. VA decides your claim using all the evidence: the report, your medical and service records, and statements from you and others. The examiner can't tell you the results or answer questions about your claim.
Does everyone get one?
No. If your records already have what VA needs, VA can decide from the records alone (VA calls this Acceptable Clinical Evidence, or ACE).
What if I can't make it?
Call the number on your appointment letter at least 48 hours ahead to reschedule. Missing an exam delays your claim. VA may decide your claim on the evidence it already has, and some claims, such as a claim for an increase, are denied (38 CFR 3.655). If you had a good reason, such as being in the hospital or a death in your family, tell VA and ask for a new exam.
What should I bring?
VA says you don't need to bring anything. Send any new medical records to VA before the exam, because the examiner can't send them in for you. Arrive 15 minutes early and wear clothes you can move in. Many veterans find it helps to bring a short list of their symptoms, medicines and side effects, and key dates, so nothing is forgotten.
Can someone come with me?
You can ask the examiner. They may ask family members or caregivers to wait outside. For a sensitive physical exam, you can ask for a chaperone in the room.
Can I get a copy of the report?
Yes. Ask VA with a Freedom of Information Act or Privacy Act request (VA Form 20-10206). VetEZ Claim can help you fill it out and send it.
Can my own doctor fill out the form instead?
For many conditions, yes. VA publishes the exam forms (DBQs) your own doctor can fill out and you can send in. VA doesn't pay for this. A few exam forms are for VA's own examiners.
Checked against VA's forms and rules on October 16, 2026. General information only, not medical or legal advice about your claim. VA decides every claim.
