VA Disability Rating for Sacroiliac Injury and Weakness
Diagnostic Code 5236 · 38 CFR §4.71a
What Is It?
The sacroiliac joint connects the base of your spine to your pelvis. Sacroiliac joint dysfunction causes pain in the lower back, buttocks, and sometimes down the leg, and can significantly affect walking, sitting, and standing. The condition can result from direct trauma to the pelvis, repetitive heavy lifting, parachute landings, pregnancy-related pelvic changes, or the cumulative impact of running and rucking during service. It is a commonly underdiagnosed source of low back pain that many veterans attribute to their lumbar spine when the sacroiliac joint is actually the primary pain generator.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Unfavorable ankylosis of the entire spine |
| 50% | Unfavorable ankylosis of the entire thoracolumbar spine |
| 40% | Forward flexion of the thoracolumbar spine 30 degrees or less |
| 20% | Forward flexion greater than 30 but not greater than 60 degrees, or muscle spasm causing abnormal gait or spinal contour |
| 10% | Forward flexion greater than 60 but not greater than 85 degrees, or muscle spasm not resulting in abnormal gait |
Evidence Needed
- Medical records documenting sacroiliac joint dysfunction connected to service
- Imaging of the sacroiliac joints showing abnormality
- Positive provocative testing for sacroiliac joint dysfunction
- Spinal range of motion measurements
- Documentation of how the condition affects walking and daily activities
C&P Exam Tips
- Make sure the examiner performs sacroiliac joint-specific tests
- Describe pain location in the lower back and buttocks area
- Mention if the pain refers down your leg, which can mimic sciatica
- Report difficulty with prolonged sitting, standing, or walking
- Describe how the condition affects your gait
How to File
File under DC 5236 for sacroiliac injury and weakness. This condition is rated using the same General Rating Formula for the Spine as other spinal conditions. Include sacroiliac joint-specific testing results and imaging to distinguish this from lumbar spine conditions.
Common Mistakes
Having sacroiliac pain diagnosed as generic low back pain without proper joint testing Not getting sacroiliac joint-specific imaging or diagnostic injections Failing to distinguish SI joint dysfunction from lumbar spine conditions Not describing the specific pain pattern that points to the sacroiliac joint
Frequently Asked Questions
How is sacroiliac joint pain different from lumbar spine pain?
Sacroiliac joint pain typically centers in the buttock area and lower back just to one side of the spine, while lumbar pain tends to be more central. SI joint pain can radiate into the groin and thigh but usually does not go below the knee. Specific physical exam tests can help identify SI joint dysfunction.
Can I have both a sacroiliac condition and a lumbar spine condition?
Yes, but VA generally rates all thoracolumbar spine conditions together under one rating using the General Rating Formula. You cannot receive separate ratings for the lumbar spine and the sacroiliac joint, but you can receive separate ratings for any associated nerve conditions.