Degenerative Disc Disease (DDD): How VA Rates It
DDD of the back or neck is rated mainly on how much motion you've lost, not on what your MRI says. Here is the actual formula, in plain language, and the parts of it most veterans never get shown.
DC 5242 — the full title matters
"Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (also, see either DC 5003 or 5010)."
- That parenthetical is a second rating path — see the box below on Diagnostic Code 5003.
- If a disc is herniated and pressing on or irritating a nerve root, it is rated instead under Diagnostic Code 5243, intervertebral disc syndrome (IVDS) — covered further down this page. Every other disc diagnosis stays under DC 5242.
- Both your low back (thoracolumbar spine) and your neck (cervical spine) are rated under this same formula, on their own separate tables.
Thoracolumbar spine
| Rating | Criteria (any one qualifies) |
|---|---|
| 10% | Forward flexion greater than 60° but not greater than 85°; or combined range of motion greater than 120° but not greater than 235°; 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 height. |
| 20% | Forward flexion greater than 30° but not greater than 60°; or combined range of motion not greater than 120°; or muscle spasm or guarding severe enough to cause abnormal gait or abnormal spinal contour (such as scoliosis, reversed lordosis, or abnormal kyphosis). |
| 40% | Forward flexion 30° or less; or favorable ankylosis of the entire thoracolumbar spine. |
| 50% | Unfavorable ankylosis of the entire thoracolumbar spine. |
Cervical spine
| Rating | Criteria (any one qualifies) |
|---|---|
| 10% | Forward flexion greater than 30° but not greater than 40°; or combined range of motion greater than 170° but not greater than 335°; 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 height. |
| 20% | Forward flexion greater than 15° but not greater than 30°; or combined range of motion not greater than 170°; or muscle spasm or guarding severe enough to result in abnormal gait or abnormal spinal contour (such as scoliosis, reversed lordosis, or abnormal kyphosis). |
| 30% | Forward flexion 15° or less; or favorable ankylosis of the entire cervical spine. |
| 40% | Unfavorable ankylosis of the entire cervical spine. |
100% — unfavorable ankylosis of the entire spine (neck and low back both fixed).
Below 10 percent? You may still qualify
If your flexion measured better than the 10% line on imaging-confirmed DDD, that is not the end of your claim. File anyway.
Pain is not ignored — it's just not in the table
- The tables above apply "with or without symptoms such as pain (whether or not it radiates), stiffness, or aching" — pain is assumed to be present, not a separate box to check.
- Under 38 CFR 4.59, a joint that is actually painful is entitled to at least the minimum compensable rating for that joint.
- Under 38 CFR 4.40 and 4.45, your exam has to account for pain, weakness, fatigability, and incoordination — and measure your range of motion during flare-ups and after repetitive use, not only on a good day in the exam room.
Tell the examiner about your flare-ups. Ask that flare-up range of motion be written down.
What "ankylosis" means
Ankylosis means the spine is fixed — it will not bend — in that section. VA's definition: the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and that fixation causes one or more of: difficulty walking from a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms from pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms from nerve root stretching.
Fixation at zero degrees (neutral position) always counts as favorable ankylosis.
Numbers to check on your own C&P exam
- Normal cervical forward flexion is 0–45°; normal combined cervical motion is 340°.
- Normal thoracolumbar forward flexion is 0–90°; normal combined thoracolumbar motion is 240°.
- Range of motion is rounded to the nearest 5° — at a boundary, that rounding can decide a 10% versus a 20% rating.
Neck and back are rated separately
If DDD affects both your neck and your low back, you get two separate ratings — one for the cervical spine, one for the thoracolumbar spine — combined together under 38 CFR 4.25. The two tables above are not either/or if both parts of your spine are affected. That is money a veteran leaves on the table by assuming one rating covers the whole spine.
If a disc is pressing on a nerve — IVDS, DC 5243
- IVDS is rated under whichever method gives the higher number: the range-of-motion formula above, or the incapacitating-episode table below. VA is required to use whichever is higher — it does not default to one or the other.
- An incapacitating episode is a period of acute symptoms that required bed rest prescribed by a physician and treatment by a physician. Self-imposed rest, sick days, or time off work do not count — your medical record has to show a physician ordered the bed rest.
| Rating | Incapacitating episodes, past 12 months |
|---|---|
| 10% | At least 1 week, less than 2 weeks total |
| 20% | At least 2 weeks, less than 4 weeks total |
| 40% | At least 4 weeks, less than 6 weeks total |
| 60% | 6 weeks or more total |
If IVDS affects more than one part of your spine with clearly distinct effects in each, each part is rated by whichever method gives the higher number for that part, then the two ratings are combined.
Conditions rated separately from the spine
- Nerve damage from a spine condition — radiculopathy affecting the sciatic or femoral nerves — is rated separately when the evidence supports it, on top of your spine rating. The level for each nerve is on Nerve damage VA ratings.
- Bowel or bladder impairment and other objective neurologic abnormalities caused by the spine condition are also rated separately.
- If your spine condition keeps you from holding substantially gainful employment, ask about Total Disability based on Individual Unemployability (TDIU) — a path to compensation at the 100% rate without needing a 100% schedular rating.
- Any condition caused or made worse by your spine condition, or by the medication you take for it, can be filed as a secondary service-connected condition.
Getting help costs nothing to start
An accredited Veterans Service Organization (VSO) representative helps you file for free. An accredited attorney or claims agent may only charge a fee after VA issues its initial decision on the claim — up to 20% of past-due benefits is presumed reasonable under 38 CFR 14.636. You never have to pay anyone up front to file a claim.
If your rating comes back too low
- A Higher-Level Review or a Board Appeal must be filed within 1 year of the date on your decision letter.
- A Supplemental Claim has no filing deadline — but file it within 1 year of the decision notice to protect your original effective date. File later, and back pay generally runs only from the new filing date instead of reaching back to your original claim.