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Guide

Back Pain VA Rating: How the Spine Is Rated

Back conditions are among the most common service-connected disabilities — and one of the few rated mostly by a tape-measure number: how far forward you can bend. Understanding that number tells you what rating to expect.

Rated by forward flexion

The VA uses the General Rating Formula for Diseases and Injuries of the Spine (38 CFR §4.71a). For the lower back (thoracolumbar spine), the main measurement is forward flexion — how many degrees you can bend forward — measured with a goniometer at your C&P exam.

RatingThoracolumbar (lower back) criteria
10%Forward flexion greater than 60° but not more than 85°; or combined range of motion 120°–235°; or muscle spasm/guarding that doesn't change gait or spinal contour.
20%Forward flexion greater than 30° but not more than 60°; or combined range of motion of 120° or less; or muscle spasm/guarding severe enough to cause an abnormal gait or spinal contour.
40%Forward flexion of 30° or less; or favorable ankylosis of the entire thoracolumbar spine.
50%Unfavorable ankylosis of the entire thoracolumbar spine.
100%Unfavorable ankylosis of the entire spine.

("Ankylosis" means the spine is fixed/fused in position.)

The painful-motion rule: if you have pain on movement, you should receive at least 10% even if your range of motion is technically normal (38 CFR §4.59). Pain that further limits motion during flare-ups or repetitive use should also be accounted for.

What it pays in 2026

For a single veteran in 2026: 10% = $180.42, 20% = $356.66, 40% = $795.84 per month. Back conditions often sit at 10–20% on their own — but they frequently bring secondary ratings that add up.

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Sciatica is rated separately

This is the part veterans most often miss. Nerve pain radiating down the leg (radiculopathy / sciatica) is not part of the spine rating — it's rated separately under the nerve codes in 38 CFR §4.124a (e.g., the sciatic nerve), usually 10–20% or more per affected leg. So a single back injury can produce a back rating plus a left-leg rating plus a right-leg rating.

Because the legs are paired, bilateral lower-extremity radiculopathy can also trigger the bilateral factor — an extra 10% on top.

Other common secondaries

Chronic back pain often supports secondary claims for depression or anxiety (mental-health impact of chronic pain) and sleep problems. Those can carry higher ratings than the back itself.

This is general information, not medical or legal advice. Your rating depends on your measured range of motion and records. An accredited representative can help make sure radiculopathy and secondaries aren't left off your claim.

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