How the VA rates neck and cervical spine conditions

The neck is rated on how far it bends and turns, counted in degrees. Most neck ratings come down to one measurement, forward flexion, which is how far the chin can drop toward the chest.

Last reviewed October 2026 · Not legal advice, VA.gov always controls

Neck conditions are rated under the same rule as back conditions, the General Rating Formula for Diseases and Injuries of the Spine in 38 CFR § 4.71a. The formula has one set of numbers for the lower and mid back and a different, stricter set for the neck. The diagnosis picks the diagnostic code, and the formula picks the percentage. The back pain guide covers the lower back; this page covers the cervical spine.

Which diagnostic code a neck condition gets

• DC 5237, lumbosacral or cervical strain. The code for a strained or injured neck.
• DC 5242, degenerative arthritis and degenerative disc disease other than intervertebral disc syndrome. Wear-and-tear changes in the neck usually land here. The code also points to DC 5003 and DC 5010 for arthritis.
• DC 5243, intervertebral disc syndrome. Since the 2021 rule change, VA assigns it only when a herniated disc is pressing on or irritating the adjacent nerve root. Every other disc diagnosis goes under DC 5242.
• DC 5238, spinal stenosis, a narrowing of the spinal canal.

DCs 5237, 5238 and 5242 share the same range-of-motion tiers. The code matters most for disc disease, which has a second way to be rated.

The cervical tiers

Note (2) to the formula, which also points to Plate V, the schedule's motion diagram, sets normal neck motion for VA purposes: 45° of forward flexion, 45° of extension, 45° of lateral flexion to each side, and 80° of rotation to each side. Those six numbers add up to a normal combined range of motion of 340°. Because the 10% band stops at 335°, a neck that is only 5° short of normal in total still falls in it.

The criteria in each tier are joined by "or", so meeting any one of them is enough. Ankylosis means the spine is fixed in place, and the scoliosis and ankylosis guide explains favorable versus unfavorable.

Pain, flare-ups and repeated use

The degrees on a single exam day are not supposed to be the whole picture. Three regulations and two court decisions tell the examiner to account for what pain does to motion:

• § 4.40 (functional loss) and § 4.45 (the joints) require the exam to reflect weakness, fatigability, incoordination, and pain on movement, not only the measured arc. Under DeLuca v. Brown (1995), that includes motion lost during flare-ups or after repeated use. The DBQ asks the examiner to estimate that additional loss in degrees. For arthritis ratings, § 4.45 also treats the cervical vertebrae as a group of minor joints, rated on a par with major joints.
• § 4.59 (painful motion) says an actually painful joint is entitled to at least the minimum compensable rating for that joint, which for the spine is 10%, even if the measured motion would not reach it.
• Correia v. McDonald (2016) requires testing for pain on both active and passive motion, in weight-bearing and non-weight-bearing positions. An exam that skips this without explanation is open to challenge as inadequate.

Disc disease and incapacitating episodes

A herniated disc in the neck with nerve root involvement (DC 5243) can be rated under the general formula above or under a separate formula based on incapacitating episodes in the past 12 months, whichever gives the higher result once all disabilities are combined. The tiers are 10% for at least one week but less than two, 20% for at least two weeks but less than four, 40% for at least four weeks but less than six, and 60% for at least six weeks.

An incapacitating episode, by Note (1), is a period of acute signs and symptoms that requires bed rest prescribed by a physician and treatment by a physician. Staying home with a bad neck does not count unless a doctor ordered the bed rest. If disc disease affects more than one spinal segment and the effects are clearly distinct, Note (2) lets each segment use whichever method gives the higher result.

The arm symptoms are rated separately

Note (1) to the spine formula says to rate any associated objective neurologic abnormalities separately under an appropriate code. For a neck, the usual one is radiculopathy: nerve pain, numbness, tingling, or weakness running into an arm or hand. It is rated under the upper radicular group codes in 38 CFR § 4.124a:

• DC 8510, upper radicular group (C5 and C6)
• DC 8511, middle radicular group (C7)
• DC 8512, lower radicular group (C8 and T1)
• DC 8513, all radicular groups

For DCs 8510 to 8512, mild incomplete paralysis is 20%, moderate is 40% for the dominant arm and 30% for the other, severe is 50% and 40%, and complete paralysis is 70% and 60%. DC 8513 runs higher for severe and complete involvement. When the involvement is wholly sensory, the nerve codes say the rating should be mild, or at most moderate. Each affected arm is its own rating, and both arms together take the bilateral factor. The radiculopathy guide covers the tiers.

Neck and back are two separate ratings

Note (6) says to evaluate the thoracolumbar and cervical segments separately. The one exception is unfavorable ankylosis of both segments, which is rated as a single disability. A veteran with neck and lower back conditions therefore has two spine ratings, which combine with each other and with any nerve ratings under the combined rating math.

Sources

• 38 CFR § 4.71a, Schedule of ratings: musculoskeletal system. The cervical tiers, normal motion in Note (2), rounding in Note (4), ankylosis in Note (5), separate segments in Note (6), DCs 5237, 5238, 5242 and 5243, and the incapacitating-episode formula.
• 38 CFR § 4.40, Functional loss. Weakness, fatigability, incoordination, and pain on movement as part of the disability.
• 38 CFR § 4.45, The joints. Factors of joint disability, and the cervical vertebrae as a group of minor joints.
• 38 CFR § 4.59, Painful motion. The minimum compensable rating for a painful joint, and testing on active and passive motion.
• 38 CFR § 4.124a, Schedule of ratings: neurological conditions and convulsive disorders. DCs 8510 to 8513, the wholly-sensory note, and the bilateral rule.
• 38 CFR § 4.25, Combined ratings table. How separate ratings combine and round, as in the worked example.
• VA, Neck (Cervical Spine) Conditions Disability Benefits Questionnaire. Flare-up and repeated-use estimates in degrees, the radiculopathy section by nerve root group, and the ankylosis section.
• Board of Veterans' Appeals, Citation Nr. A24000668 (Jan. 5, 2024). A spine decision applying DeLuca v. Brown, 8 Vet. App. 202 (1995), and Correia v. McDonald, 28 Vet. App. 158 (2016).