Muscle Group XXIII VA Disability Rating
Diagnostic Code 5323 · 38 CFR §4.73
What Is It?
Muscle Group XXIII includes the muscles of the posterior and lateral neck that extend and rotate the head backward and to the sides. These include the suboccipital muscles, splenius, semispinalis, and other posterior cervical muscles. These muscles hold your head upright against gravity, control backward head tilt, and assist with looking up and turning. When damaged, maintaining head position becomes fatiguing, and looking up or turning the head becomes painful and limited.
Rating Criteria
| Rating | Criteria |
|---|---|
| 30% | Severe injury with major loss of posterior neck muscle function and difficulty maintaining head position. |
| 20% | Moderately severe injury with significant impairment of head extension and postural control. |
| 10% | Moderate injury with some difficulty holding the head upright or looking upward. |
| 0% | Slight injury with minimal functional impact. |
Evidence Needed
- Service records documenting the posterior neck muscle injury
- Treatment records for the wound or injury
- Cervical extension and rotation range of motion testing
- Documentation of head posture abnormalities or forward head position
- Statements about difficulty holding the head upright, looking up, and headaches from muscle fatigue
C&P Exam Tips
- Have cervical extension specifically tested — how far can you look up
- Report fatigue with holding your head upright for prolonged periods
- Describe headaches caused by neck muscle strain
- Mention limitations with activities requiring upward gaze like working overhead
- Show posterior neck scarring from the injury
How to File
File under DC 5323 with evidence of the posterior neck muscle injury and cervical extension testing. Chronic headaches resulting from the muscle damage should be documented and filed as a secondary condition.
Common Mistakes
Not having cervical extension specifically measured Failing to claim tension headaches as a secondary condition Not documenting forward head posture which is a visible sign of posterior neck muscle weakness Confusing posterior neck muscle injury with cervical spine disc or joint problems
Frequently Asked Questions
Can posterior neck muscle injuries cause headaches?
Yes. When the posterior neck muscles are damaged and weakened, the remaining muscles have to work harder to hold your head upright. This increased strain commonly causes tension headaches that radiate from the back of the neck over the top of the head. These headaches can be claimed as a secondary condition.
What is forward head posture?
Forward head posture occurs when the posterior neck muscles are too weak to hold the head in proper alignment over the shoulders. The head drifts forward, increasing strain on the neck and upper back. This visible postural change is evidence of significant posterior neck muscle weakness.