Vertebra Fracture Residuals (Legacy DC 5285) — VA Rating
Diagnostic Code 5285 · 38 CFR §4.71a
What Is It?
DC 5285 no longer exists. VA replaced the entire pre-2003 spine schedule effective September 26, 2003 with the General Rating Formula for Diseases and Injuries of the Spine at DCs 5235 through 5243. Appendix A to 38 CFR part 4, which records every amendment to the rating schedule since 1946, states it plainly: DC 5235 "Replaces 5285-5295 September 26, 2003." The current formula is measured in degrees of range of motion, with a separate route through DC 5243 for intervertebral disc syndrome based on incapacitating episodes, and it evaluates any associated objective neurologic abnormality separately under the appropriate neurological code. 38 CFR § 3.951(a) is the provision that answers it: a readjustment to the rating schedule "shall not be grounds for reduction of a disability rating in effect on the date of the readjustment unless medical evidence establishes that the disability to be evaluated has actually improved." Under § 3.951(b), an evaluation continuously held at or above its level for 20 years or more cannot be reduced at all except on a showing of fraud, with the 20 years counted from the effective date of the evaluation. Under § 3.957, service connection in effect for 10 years or more cannot be severed except for fraud or a showing from military records that the person did not have the requisite service or character of discharge. And any reduction at all has to run through § 3.105(e): a written proposal setting out all material facts and reasons, 60 days to submit evidence, and — under § 3.105(i) — 30 days from the notice to request a predetermination hearing. The criteria below are the legacy ones — the criteria your evaluation was actually made under. They are reproduced because that is what a veteran holding this rating needs to be able to read, not because they govern a claim filed today. The most consequential difference between the two schedules sits in this code. Legacy DC 5285 added 10 percent for demonstrable deformity of a vertebral body on top of the rating for the residual limitation of motion or muscle spasm. The current General Rating Formula has no such add-on: vertebral fracture residuals are rated at DC 5235, "Vertebral fracture or dislocation," on the same degrees-of-motion criteria as every other spine condition, with residuals of cord involvement evaluated under the neurological codes and special monthly compensation considered under 38 CFR § 3.350 where there is loss of use. A veteran holding the legacy 10 percent add-on keeps it; a claim filed today does not generate one.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Vertebra fracture with cord involvement — bedridden, OR requiring long leg braces or a wheelchair, OR with paralysis of substantial functional extent. Special Monthly Compensation under 38 USC 1114 applies in addition based on the specific functional losses. |
| 60% | Vertebra fracture residuals without cord involvement but with abnormal mobility requiring neck brace (jury mast), OR fracture residuals with neurological symptoms — radiculopathy, sensory loss, motor weakness — short of cord injury. |
| 10% | Vertebra fracture residuals with demonstrable deformity of the vertebra body — a 10% rating is added to the rating assigned for the residual limitation of motion or muscle spasm under the applicable spine code. |
Evidence Needed
The original rating decision letter establishing the DC 5285 evaluation is the anchor — it locks in the protected status. Spine X-rays or CT showing the residual vertebral deformity document the demonstrable-deformity 10% increment. MRI of the spine documents any cord, nerve root, or disc involvement. Neurological examination findings (sensory and motor function below the fracture level, reflexes, gait) characterize the residuals. Service medical records establishing the in-service fracture event — combat trauma, MVA, parachute landing, training injury — support the protected service connection. If the veteran has been notified of a proposed re-evaluation under the current general spine formula, that proposal letter and basis should be reviewed before agreeing to anything because the protection rules favor keeping the legacy rating.
C&P Exam Tips
For an increase claim under DC 5285, focus on the specific findings in the rating criteria: vertebral body deformity on imaging (the 10% add-on), abnormal mobility requiring bracing, neurological symptoms below the fracture level, and any cord involvement. The legacy criteria measure different things from the modern general spine formula, so if the examiner only performs goniometric range-of-motion measurements, ask explicitly whether the legacy criteria are being evaluated. Bring imaging, neurological history, brace prescriptions, and any specialist consultation reports. Do not consent to re-evaluation under the current general spine formula without confirming it produces a higher rating; the protected status under 38 CFR §3.951 favors keeping the legacy rating in most cases.
How to File
If you hold this rating, the code being retired is not a reason to file anything. For an increase, file VA Form 21-526EZ for the spine segment involved and expect DC 5235 and the current formula: forward flexion in degrees, combined range of motion, abnormal gait or spinal contour from muscle spasm or guarding, and ankylosis. Claim every associated neurologic abnormality separately — radiculopathy, bowel or bladder impairment, sensory loss — because the General Rating Formula directs that they be evaluated separately under the appropriate code. Where there is loss of use of an extremity or of bowel or bladder control, raise special monthly compensation under § 3.350 expressly. Bring imaging that documents the deformity and current goniometer measurements.
Common Mistakes
Agreeing to re-evaluation under the current general spine formula without checking whether it produces a higher rating Letting the demonstrable-deformity 10% add-on go unclaimed when imaging clearly shows residual vertebral body distortion Missing the SMC evaluation when cord involvement justifies it Not pursuing radiculopathy and bowel/bladder dysfunction as separate secondary claims
Frequently Asked Questions
Why does the VA still use DC 5285 if it was replaced in 2003?
The 2003 amendment to the spine schedule did not retroactively re-rate existing claims. Veterans rated under the pre-2003 spine codes — DC 5285 through 5295 — kept those ratings under the principle that an existing favorable rating cannot be reduced by a regulatory change. New claims and reopened claims use the current general spine formula, but the legacy ratings remain in force for tens of thousands of veterans.
What is the "demonstrable deformity" 10% add-on?
Under DC 5285, a 10% rating is added to the underlying rating when imaging shows persistent deformity of the fractured vertebra body — a wedged vertebra, a compressed body, or other structural distortion that persists after healing. The add-on is on top of whatever rating the residual limitation of motion or muscle spasm earns under the applicable spine code. It is a specific finding that should be documented explicitly in the rating decision; if it was not, that may be a basis for filing for increase.
What happens if my cord involvement worsens over time?
Worsening neurological function below the fracture level supports a rating increase under the 100% tier and triggers evaluation for Special Monthly Compensation. SMC is paid in addition to the schedular rating for veterans with loss of use of limbs, bowel/bladder dysfunction, or the need for aid and attendance. As cord-level functional losses progress, the SMC tier should be re-evaluated annually or whenever a change is documented.