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Spinal stenosis
Diagnostic code 5238 · Musculoskeletal system · 38 CFR 4.71a
Rating criteria: the exact regulation text
Quoted from 38 CFR 4.71a. The "Rating" column is the percentage VA assigns for that level.
| Criteria | Rating |
|---|---|
| 5238 Spinal stenosis |
General Rating Formula for Diseases and Injuries of the Spine
The formula's heading lists diagnostic code 5238.
| 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. |
Related codes in the regulation
- 5235 Vertebral fracture or dislocationSame formula
- 5236 Sacroiliac injury and weaknessSame formula
- 5237 Lumbosacral or cervical strainSame formula
- 5239 Spondylolisthesis or segmental instabilitySame formula
- 5240 Ankylosing spondylitisSame formula
- 5241 Spinal fusionSame formula
- 5242 Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (also, see either DC 5003 or 5010)Same formula
- 5243 Intervertebral disc syndromeSame formula
- 8520 Sciatic nerve, paralysisRated separately
- 8510 Upper radicular group, paralysisRated separately
- 8511 Middle radicular group, paralysisRated separately
- 8512 Lower radicular group, paralysisRated separately
- 8513 All radicular groups, paralysisRated separately
The VA exam form for this condition
VA examiners record their findings on a Disability Benefits Questionnaire (DBQ). Reading it shows you what the exam will measure and ask.
- Back (Thoracolumbar Spine) (PDF, VA)
- Neck (Cervical Spine) (PDF, VA) · Depending on the body part
Rules that apply to this body system
Where this comes from
38 CFR 4.71a, VA's Schedule for Rating Disabilities, from the official eCFR.
Regulation text current as of October 16, 2026.
Change history for this code (38 CFR Part 4, Appendix A): Replaces 5285-5295 September 26, 2003.
Read it on eCFR.govInformation, not advice
This page shows the text of VA's rating regulation for information. It is not a rating estimate, and it is not legal or medical advice. VA decides every rating on the evidence in your file.
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