VA BENEFITS REFERENCE
The Musculoskeletal System: Shared Criteria For DC 5235 Through 5243
Read the musculoskeletal system criteria for DC 5235 through 5243: 9 listed codes, their distinct instructions, shared formulas and official notes.
Published criteria from 38 CFR 4.71a, current through 2026-10-22. Historical decisions may require a different version. This reference does not diagnose a condition or determine an evaluation.
The Musculoskeletal System · All Diagnostic Codes
DC 5235: Vertebral Fracture Or Dislocation
Diagnostic code 5235 addresses Vertebral fracture or dislocation. Read its specific instructions together with any shared formula, notes and linked provisions. These criteria describe evaluation after the applicable entitlement requirements are met; this reference does not diagnose a condition or determine a claim.
| Rating | |
|---|---|
| 5235 Vertebral fracture or dislocation |
Read the shared provisions referenced by this code: General Spine Formula.
What The Criteria Measure
- Does the decision identify diagnostic code 5235, and does the medical record describe the condition named by this code?
- Do the examination findings record the relevant movement measurements and explain functional limitations, flare-ups and repeated use where applicable?
- Do dated records describe the frequency and duration specified by this particular provision, using its definitions?
- Have the code-specific notes and cross-references been read before comparing any listed evaluation?
Related Public DBQs
Editorial subject matches, not official VA code-to-form assignments. Read the form scope and clinician instructions.
Regulatory Cross-References
- DC 5236: Sacroiliac injury and weakness
- DC 5237: Lumbosacral or cervical strain
- DC 5238: Spinal stenosis
- DC 5239: Spondylolisthesis or segmental instability
- DC 5240: Ankylosing spondylitis
- DC 5241: Spinal fusion
- DC 5242: Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (also, see either DC 5003 or 5010)
- DC 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
DC 5236: Sacroiliac Injury And Weakness
Diagnostic code 5236 addresses Sacroiliac injury and weakness. Read its specific instructions together with any shared formula, notes and linked provisions. These criteria describe evaluation after the applicable entitlement requirements are met; this reference does not diagnose a condition or determine a claim.
| Rating | |
|---|---|
| 5236 Sacroiliac injury and weakness |
Read the shared provisions referenced by this code: General Spine Formula.
What The Criteria Measure
- Does the decision identify diagnostic code 5236, and does the medical record describe the condition named by this code?
- Do the examination findings record the relevant movement measurements and explain functional limitations, flare-ups and repeated use where applicable?
- Do dated records describe the frequency and duration specified by this particular provision, using its definitions?
- Have the code-specific notes and cross-references been read before comparing any listed evaluation?
Related Public DBQs
Editorial subject matches, not official VA code-to-form assignments. Read the form scope and clinician instructions.
Regulatory Cross-References
- DC 5235: Vertebral fracture or dislocation
- DC 5237: Lumbosacral or cervical strain
- DC 5238: Spinal stenosis
- DC 5239: Spondylolisthesis or segmental instability
- DC 5240: Ankylosing spondylitis
- DC 5241: Spinal fusion
- DC 5242: Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (also, see either DC 5003 or 5010)
- DC 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
DC 5237: Lumbosacral Or Cervical Strain
Diagnostic code 5237 addresses Lumbosacral or cervical strain. Read its specific instructions together with any shared formula, notes and linked provisions. These criteria describe evaluation after the applicable entitlement requirements are met; this reference does not diagnose a condition or determine a claim.
| Rating | |
|---|---|
| 5237 Lumbosacral or cervical strain |
Read the shared provisions referenced by this code: General Spine Formula.
What The Criteria Measure
- Does the decision identify diagnostic code 5237, and does the medical record describe the condition named by this code?
- Do the examination findings record the relevant movement measurements and explain functional limitations, flare-ups and repeated use where applicable?
- Do dated records describe the frequency and duration specified by this particular provision, using its definitions?
- Have the code-specific notes and cross-references been read before comparing any listed evaluation?
Related Public DBQs
Editorial subject matches, not official VA code-to-form assignments. Read the form scope and clinician instructions.
Regulatory Cross-References
- DC 5235: Vertebral fracture or dislocation
- DC 5236: Sacroiliac injury and weakness
- DC 5238: Spinal stenosis
- DC 5239: Spondylolisthesis or segmental instability
- DC 5240: Ankylosing spondylitis
- DC 5241: Spinal fusion
- DC 5242: Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (also, see either DC 5003 or 5010)
- DC 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
DC 5238: Spinal Stenosis
Diagnostic code 5238 addresses Spinal stenosis. Read its specific instructions together with any shared formula, notes and linked provisions. These criteria describe evaluation after the applicable entitlement requirements are met; this reference does not diagnose a condition or determine a claim.
| Rating | |
|---|---|
| 5238 Spinal stenosis |
Read the shared provisions referenced by this code: General Spine Formula.
What The Criteria Measure
- Does the decision identify diagnostic code 5238, and does the medical record describe the condition named by this code?
- Do the examination findings record the relevant movement measurements and explain functional limitations, flare-ups and repeated use where applicable?
- Do dated records describe the frequency and duration specified by this particular provision, using its definitions?
- Have the code-specific notes and cross-references been read before comparing any listed evaluation?
Related Public DBQs
Editorial subject matches, not official VA code-to-form assignments. Read the form scope and clinician instructions.
Regulatory Cross-References
- DC 5235: Vertebral fracture or dislocation
- DC 5236: Sacroiliac injury and weakness
- DC 5237: Lumbosacral or cervical strain
- DC 5239: Spondylolisthesis or segmental instability
- DC 5240: Ankylosing spondylitis
- DC 5241: Spinal fusion
- DC 5242: Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (also, see either DC 5003 or 5010)
- DC 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
DC 5239: Spondylolisthesis Or Segmental Instability
Diagnostic code 5239 addresses Spondylolisthesis or segmental instability. Read its specific instructions together with any shared formula, notes and linked provisions. These criteria describe evaluation after the applicable entitlement requirements are met; this reference does not diagnose a condition or determine a claim.
| Rating | |
|---|---|
| 5239 Spondylolisthesis or segmental instability |
Read the shared provisions referenced by this code: General Spine Formula.
What The Criteria Measure
- Does the decision identify diagnostic code 5239, and does the medical record describe the condition named by this code?
- Do the examination findings record the relevant movement measurements and explain functional limitations, flare-ups and repeated use where applicable?
- Do dated records describe the frequency and duration specified by this particular provision, using its definitions?
- Have the code-specific notes and cross-references been read before comparing any listed evaluation?
Related Public DBQs
Editorial subject matches, not official VA code-to-form assignments. Read the form scope and clinician instructions.
Regulatory Cross-References
- DC 5235: Vertebral fracture or dislocation
- DC 5236: Sacroiliac injury and weakness
- DC 5237: Lumbosacral or cervical strain
- DC 5238: Spinal stenosis
- DC 5240: Ankylosing spondylitis
- DC 5241: Spinal fusion
- DC 5242: Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (also, see either DC 5003 or 5010)
- DC 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
DC 5240: Ankylosing Spondylitis
Diagnostic code 5240 addresses Ankylosing spondylitis. Read its specific instructions together with any shared formula, notes and linked provisions. These criteria describe evaluation after the applicable entitlement requirements are met; this reference does not diagnose a condition or determine a claim.
| Rating | |
|---|---|
| 5240 Ankylosing spondylitis |
Read the shared provisions referenced by this code: General Spine Formula.
What The Criteria Measure
- Does the decision identify diagnostic code 5240, and does the medical record describe the condition named by this code?
- Do the examination findings record the relevant movement measurements and explain functional limitations, flare-ups and repeated use where applicable?
- Do dated records describe the frequency and duration specified by this particular provision, using its definitions?
- Have the code-specific notes and cross-references been read before comparing any listed evaluation?
Related Public DBQs
Editorial subject matches, not official VA code-to-form assignments. Read the form scope and clinician instructions.
Regulatory Cross-References
- DC 5235: Vertebral fracture or dislocation
- DC 5236: Sacroiliac injury and weakness
- DC 5237: Lumbosacral or cervical strain
- DC 5238: Spinal stenosis
- DC 5239: Spondylolisthesis or segmental instability
- DC 5241: Spinal fusion
- DC 5242: Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (also, see either DC 5003 or 5010)
- DC 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
DC 5241: Spinal Fusion
Diagnostic code 5241 addresses Spinal fusion. Read its specific instructions together with any shared formula, notes and linked provisions. These criteria describe evaluation after the applicable entitlement requirements are met; this reference does not diagnose a condition or determine a claim.
| Rating | |
|---|---|
| 5241 Spinal fusion |
Read the shared provisions referenced by this code: General Spine Formula.
What The Criteria Measure
- Does the decision identify diagnostic code 5241, and does the medical record describe the condition named by this code?
- Do the examination findings record the relevant movement measurements and explain functional limitations, flare-ups and repeated use where applicable?
- Do dated records describe the frequency and duration specified by this particular provision, using its definitions?
- Have the code-specific notes and cross-references been read before comparing any listed evaluation?
Related Public DBQs
Editorial subject matches, not official VA code-to-form assignments. Read the form scope and clinician instructions.
Regulatory Cross-References
- DC 5235: Vertebral fracture or dislocation
- DC 5236: Sacroiliac injury and weakness
- DC 5237: Lumbosacral or cervical strain
- DC 5238: Spinal stenosis
- DC 5239: Spondylolisthesis or segmental instability
- DC 5240: Ankylosing spondylitis
- DC 5242: Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (also, see either DC 5003 or 5010)
- DC 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
DC 5242: Degenerative Arthritis, Degenerative Disc Disease Other Than Intervertebral Disc Syndrome (Also, See Either DC 5003 Or 5010)
Diagnostic code 5242 addresses Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (also, see either DC 5003 or 5010). Read its specific instructions together with any shared formula, notes and linked provisions. These criteria describe evaluation after the applicable entitlement requirements are met; this reference does not diagnose a condition or determine a claim.
| Rating | |
|---|---|
| 5242 Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (also, see either DC 5003 or 5010) |
Read the shared provisions referenced by this code: General Spine Formula.
What The Criteria Measure
- Does the decision identify diagnostic code 5242, and does the medical record describe the condition named by this code?
- Do the examination findings record the relevant movement measurements and explain functional limitations, flare-ups and repeated use where applicable?
- Do dated records describe the frequency and duration specified by this particular provision, using its definitions?
- Have the code-specific notes and cross-references been read before comparing any listed evaluation?
Related Public DBQs
Editorial subject matches, not official VA code-to-form assignments. Read the form scope and clinician instructions.
Regulatory Cross-References
- DC 5003: Degenerative arthritis, other than post-traumatic
- DC 5010: Post-traumatic arthritis: Rate as limitation of motion, dislocation, or other specified instability under the affected joint. If there are 2 or more joints affected, each rating shall be combined in accordance with § 4.25
- DC 5235: Vertebral fracture or dislocation
- DC 5236: Sacroiliac injury and weakness
- DC 5237: Lumbosacral or cervical strain
- DC 5238: Spinal stenosis
- DC 5239: Spondylolisthesis or segmental instability
- DC 5240: Ankylosing spondylitis
- DC 5241: Spinal fusion
- DC 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
DC 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
Diagnostic code 5243 addresses 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. Read its specific instructions together with any shared formula, notes and linked provisions. These criteria describe evaluation after the applicable entitlement requirements are met; this reference does not diagnose a condition or determine a claim.
| 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. |
| 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. |
Read the shared provisions referenced by this code: General Spine Formula.
What The Criteria Measure
- Does the decision identify diagnostic code 5243, and does the medical record describe the condition named by this code?
- Do the examination findings record the relevant movement measurements and explain functional limitations, flare-ups and repeated use where applicable?
- Do dated records describe the frequency and duration specified by this particular provision, using its definitions?
- Do records identify the treatment, procedure and relevant dates that the provision actually distinguishes?
- Have the code-specific notes and cross-references been read before comparing any listed evaluation?
Related Public DBQs
Editorial subject matches, not official VA code-to-form assignments. Read the form scope and clinician instructions.
Regulatory Cross-References
- DC 5235: Vertebral fracture or dislocation
- DC 5236: Sacroiliac injury and weakness
- DC 5237: Lumbosacral or cervical strain
- DC 5238: Spinal stenosis
- DC 5239: Spondylolisthesis or segmental instability
- DC 5240: Ankylosing spondylitis
- DC 5241: Spinal fusion
- DC 5242: Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (also, see either DC 5003 or 5010)
General Spine Formula
Referenced by DC 5235, DC 5236, DC 5237, DC 5238, DC 5239, DC 5240, DC 5241, DC 5242, DC 5243. Apply only as each code directs, including its conditions and exceptions.
| 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. |
Shared Rules And Regulatory Context
- 38 CFR 4.71a Context And Notes
- 38 CFR 4.40 Context And Notes
- 38 CFR 4.41 Context And Notes
- 38 CFR 4.42 Context And Notes
- 38 CFR 4.43 Context And Notes
- 38 CFR 4.44 Context And Notes
- 38 CFR 4.45 Context And Notes
- 38 CFR 4.46 Context And Notes
- 38 CFR 4.57 Context And Notes
- 38 CFR 4.58 Context And Notes
- 38 CFR 4.59 Context And Notes
- 38 CFR 4.61 Context And Notes
- 38 CFR 4.62 Context And Notes
- 38 CFR 4.63 Context And Notes
- 38 CFR 4.64 Context And Notes
- 38 CFR 4.66 Context And Notes
- 38 CFR 4.67 Context And Notes
- 38 CFR 4.68 Context And Notes
- 38 CFR 4.69 Context And Notes
- 38 CFR 4.70 Context And Notes
- 38 CFR 4.71 Context And Notes
Context provisions do not create an additional evaluation automatically assigned to every condition.
Related Guides
Official Sources
Last verified 2026-10-25. Source publication or legal effective dates are shown separately where available.
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.71a
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.40
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.41
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.42
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.43
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.44
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.45
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.46
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.57
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.58
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.59
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.61
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.62
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.63
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.64
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.66
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.67
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.68
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.69
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.70
- www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.71
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