How the VA rates scoliosis, spondylosis, spinal arthritis and ankylosis

The rating schedule has no diagnostic code named scoliosis or spondylosis. Both are rated through the spine formula, which measures what the spine can do, not what the X-ray looks like.

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

Scoliosis is a sideways curve of the spine. Spondylosis is a medical term for degenerative change in the spine, generally arthritis of the vertebrae. Veterans often search for a rating for the diagnosis by name and find none. The reason is that 38 CFR § 4.71a lists spine conditions by kind and then rates nearly all of them with one shared rule, the General Rating Formula for Diseases and Injuries of the Spine.

The spine codes the schedule actually lists

DCs 5235 to 5243 all use the General Rating Formula, and DC 5243 can alternatively use the incapacitating-episode formula. The range-of-motion tiers are in the back pain guide and the neck guide. This page covers the conditions that do not fit neatly, and the ankylosis tiers that sit at the top of the formula.

How scoliosis is rated

The word scoliosis appears in the schedule once, inside the 20% criteria: "muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis." As written, the trigger is the muscle spasm or guarding, with the curve as one example of what severe spasm can cause. The formula has no tier for the size of a curve.

For a condition the schedule does not list, § 4.20 allows rating under a closely related condition whose affected functions, anatomical location, and symptoms are closely analogous, and warns against conjectural analogies. Section 4.27 says an unlisted condition rated by analogy gets a built-up code ending in 99, which for a spine condition would look like 5299. That is the practical answer to "what is the code for scoliosis": it depends on how the rater analogizes it, and the spine tiers then apply.

Spondylosis and spinal arthritis

The schedule has no code named spondylosis. Its closest listed code is DC 5242, degenerative arthritis, and the DC 5242 entry says "also, see either DC 5003 or 5010." Those two codes are the arthritis rules. Under DC 5003, arthritis confirmed by X-ray is rated on limitation of motion under the codes for the joint involved. If that limitation is not compensable, DC 5003 allows a 10% rating for each group of minor joints affected, as long as the limited motion is objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. Section 4.45 lists the cervical, dorsal and lumbar vertebrae as groups of minor joints for arthritis ratings. DC 5010 covers post-traumatic arthritis, which it rates as limitation of motion under the affected joint.

DC 5239 covers spondylolisthesis, a vertebra slipping out of line, and segmental instability. DC 5240 covers ankylosing spondylitis, a form of inflammatory arthritis that can fuse the spine. DC 5241 covers spinal fusion. All of them use the same formula, so the measurements still decide the percentage.

Favorable and unfavorable ankylosis

Ankylosis is a spine fixed in place. It sits at the top of the formula, and the schedule splits it into two kinds with very different ratings. Note (5) defines the kinds:

• 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 fixation 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.
• Favorable ankylosis is fixation that falls short of that definition. Note (5) adds that fixation of a spinal segment in neutral position, zero degrees, always represents favorable ankylosis.

The word "entire" matters, because every ankylosis tier describes an entire segment fixed in place. Short of that, the range-of-motion tiers apply. Under Note (6), the neck and back are rated as separate segments, unless both are unfavorably ankylosed, in which case they are rated as a single disability.

Born with it, or developed in service

Scoliosis and some other spine conditions can be congenital (present from birth) or developmental (they appear as the body grows). The regulations draw a line here. Section 3.303(c) says congenital or developmental defects "as such are not diseases or injuries within the meaning of applicable legislation," and § 4.9 says the same of "mere congenital or developmental defects." A defect on its own cannot be service connected.

VA's General Counsel drew the line more precisely in VAOPGCPREC 82-90, which originated as General Counsel Opinion 1-85. It holds that service connection may be granted for diseases, but not defects, of congenital, developmental or familial origin. For a disease, the usual question is whether it was aggravated in service. For a defect, the opinion adds that many can be subject to superimposed disease or injury, and if that happens during service, service connection may be warranted for the resulting disability.

Three details decide how this plays out:

• What the entrance exam recorded. Under § 3.304(b), a veteran is presumed sound except for conditions noted at entry, and only conditions recorded in the exam report count as noted. A history of the condition does not count as a notation.
• Whether it got worse. Under § 3.306, a preexisting condition is considered aggravated when there is an increase in disability during service, unless a specific finding attributes the increase to the natural progress of the condition. In wartime service, and peacetime service after December 31, 1946, clear and unmistakable evidence is needed to rebut that presumption once the condition has increased in severity.
• A medical judgment. Whether a particular spine is a defect or a disease is a medical question, and VAOPGCPREC 82-90 notes that adjudicators may need guidance from medical authorities. A medical opinion that addresses it, and any in-service increase, is evidence the claim can use.

Evidence checklist

1. The entrance exam, the separation exam, and any in-service spine imaging, to show what was noted and when.
2. Current imaging naming the condition and the segment: cervical, thoracic, or lumbar.
3. Range-of-motion readings in degrees, plus flare-up and repeated-use estimates.
4. For a congenital or developmental condition, a medical opinion on whether it is a disease or a defect, and what service added.

Sources

• 38 CFR § 4.71a, Schedule of ratings: musculoskeletal system. DCs 5235 to 5243, the General Rating Formula, Notes (4) to (6) on rounding and ankylosis, and DCs 5003 and 5010.
• 38 CFR § 4.20, Analogous ratings. Rating an unlisted condition under a closely related one.
• 38 CFR § 4.45, The joints. The vertebrae as groups of minor joints for arthritis ratings.
• 38 CFR § 4.9, Congenital or developmental defects. Mere defects are not diseases or injuries for compensation.
• 38 CFR § 3.303, Principles relating to service connection. Paragraph (c) on preservice conditions noted in service and congenital or developmental defects.
• 38 CFR § 3.304, Direct service connection; wartime and peacetime. Paragraph (b), the presumption of soundness.
• 38 CFR § 3.306, Aggravation of preservice disability. Increase in disability during service and the natural-progress exception.
• VA General Counsel, VAOPGCPREC 82-90 (originally General Counsel Opinion 1-85, Mar. 5, 1985). Congenital and developmental conditions under 38 CFR 3.303(c): diseases may be service connected, defects may not.