VA Disability Rating for Spinal Stenosis
Diagnostic Code 5238 · 38 CFR §4.71a
What Is It?
Spinal stenosis is a narrowing of the spinal canal that puts pressure on the spinal cord and nerve roots. This narrowing can be caused by bone spurs, thickened ligaments, disc bulging, or a combination of degenerative changes. Symptoms include pain, numbness, and weakness in the arms or legs depending on which part of the spine is affected. Lumbar stenosis typically causes leg pain and weakness that worsens with walking, a pattern called neurogenic claudication. Cervical stenosis can cause arm weakness and balance problems. Veterans commonly develop stenosis from years of heavy physical work, spinal injuries during service, or the natural progression of service-connected disc disease.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Unfavorable ankylosis of the entire spine. |
| 50% | Unfavorable ankylosis of the entire thoracolumbar spine. |
| 40% | Unfavorable ankylosis of the entire cervical spine; or, forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. |
| 30% | Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine. This step is cervical-only; a thoracolumbar stenosis claim moves from 20 percent to 40 percent. |
| 20% | Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, the combined range of motion of the cervical spine not greater than 170 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. |
| 10% | Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, forward flexion of the cervical spine greater than 30 degrees but not greater than 40 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, combined range of motion of the cervical spine greater than 170 degrees but not greater than 335 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height. |
Evidence Needed
- MRI or CT scan showing spinal canal narrowing
- Medical records linking spinal stenosis to service or a service-connected condition
- Spinal range of motion measurements
- Neurological examination results documenting nerve involvement
- Documentation of how walking distance is limited by symptoms
C&P Exam Tips
- Describe how far you can walk before leg symptoms force you to stop or sit
- Report numbness, tingling, or weakness in your arms or legs
- Mention if bending forward relieves your symptoms, which is typical of stenosis
- Make sure all range of motion components are measured
- Describe your worst days and how flare-ups affect your motion
How to File
File under DC 5238 for spinal stenosis. The spine condition is rated based on range of motion, and any neurological deficits from the stenosis should be filed as separate secondary claims. Radiculopathy from spinal stenosis is one of the most common and valuable secondary claims.
Common Mistakes
Not filing separately for radiculopathy caused by the stenosis Not getting an MRI to document the severity of the narrowing Failing to describe the walking limitation pattern typical of stenosis Not reporting bladder or bowel symptoms if present
Frequently Asked Questions
Can spinal stenosis be service-connected?
Yes, either directly if it developed during service, or secondarily if it resulted from a service-connected disc condition or spinal injury. Degenerative stenosis that is an aggravation of a service-connected spine condition is also connectable.
What is neurogenic claudication?
Neurogenic claudication is leg pain, heaviness, and weakness that occurs with walking and is relieved by sitting or leaning forward. It is the hallmark symptom of lumbar spinal stenosis. Describe this pattern to your examiner because it demonstrates the functional impact of the condition.