Vertebral fracture or dislocation
38 CFR § 4.71a — Musculoskeletal system
Listed in 38 CFR § 4.71a under The Spine — diagnostic codes 5235 through 5243 use the General Rating Formula unless IVDS is rated under the incapacitating-episode formula (DC 5243 only).
Diagnostic code
5235
DC 5235 is the schedule code for vertebral fracture or dislocation residuals. In most cases the VA rates this disability under the General Rating Formula for Diseases and Injuries of the Spine (range of motion, combined motion, muscle spasm with gait or contour changes, ankylosis, and related criteria)—not on X-ray wording alone.
The regulation also contemplates a 10% pathway tied to vertebral body fracture with loss of 50% or more of height when that finding is documented. Your exam and imaging must align with the language the rater applies.
For thoracolumbar versus cervical thresholds, self-check ideas, and exam pitfalls, start with our back & spine overview.
Official VA rating criteria — General Rating Formula (thoracolumbar spine, forward flexion)
The table highlights forward-flexion measurements for the thoracolumbar spine. Each percentage in 38 CFR § 4.71a also lists alternate ways to meet the same evaluation (combined ROM, ankylosis, muscle spasm, etc.). Cervical spine uses different thresholds—do not mix segments.
| Rating | VA criteria (thoracolumbar spine) | Key evidence at this level |
|---|---|---|
| 40% | Forward flexion of the thoracolumbar spine to 30 degrees or less; or unfavorable ankylosis of the entire thoracolumbar spine; or other criteria at 40% in the regulation. | Goniometer measurement showing severe restriction in bending forward; imaging/exam supporting ankylosis when applicable. |
| 30% | Forward flexion greater than 30 degrees but not greater than 60 degrees; or other criteria at 30% in the regulation. | C&P ROM sheet in this flexion band; treatment records consistent with limitation. |
| 20% | Forward flexion greater than 60 degrees but not greater than 85 degrees; or favorable ankylosis of the entire thoracolumbar spine; or severe muscle spasm with abnormal gait or spinal contour as described in the schedule. | Documented ROM restriction; examiner notes on gait, contour, or ankylosis matching the regulatory language. |
| 10% | Forward flexion greater than 85 degrees but not greater than 90 degrees; or other 10% criteria (e.g., muscle spasm, localized tenderness) per the schedule. | X-rays, MRI, ROM testing showing mild restriction and/or localized findings described in § 4.71a. |
| 0% | Criteria for a compensable evaluation under this formula are not met (asymptomatic or below schedular thresholds). | Service connection may still be established at the noncompensable level. |
Source: 38 CFR § 4.71a — General Rating Formula for Diseases and Injuries of the Spine (verify wording for your effective date).
Service connection — common paths
Direct service connection
An in-service injury or illness (lifting, falls, MVAs, blast, etc.) with evidence of a current chronic spine disability may support direct service connection when the record ties them under VA’s standard of proof.
Secondary service connection
A service-connected condition elsewhere (for example knee, ankle, or foot) can theoretically contribute to or aggravate a spine condition when competent medical evidence supports that relationship.
Secondary conditions sometimes pursued with Vertebral fracture or dislocation
The list below describes common secondary claim theories discussed with accredited representatives—not automatic benefits. Whether a secondary is granted depends on evidence, including medical nexus opinions where needed.
Often argued when imaging or exams suggest nerve-root involvement with leg symptoms; requires medical evidence linking radicular signs to the spine.
May be raised when providers document neurologic or medication-related links; highly fact-specific.
Chronic pain can factor into mental-health claims; mental disorders are rated on their own criteria under § 4.130.
Some veterans connect pain, weight change, or sleep fragmentation; apnea needs its own medical theory of causation.
Altered gait or compensation is sometimes argued as contributing to lower-extremity conditions; opinions and records matter.
“Strong” / “Moderate” / “Developing” reflect how often these theories appear in educational materials—not a prediction of approval. Use accredited help for your specific file.
Already service-connected for something else?
If you are already service-connected for a lower-body condition, a spine disability may be claimed as secondary when competent medical evidence supports aggravation or causation (not automatic).
Altered gait from knee disability is a common secondary theory for back symptoms.
Biomechanical alignment issues may be argued as aggravating lumbar strain.
Hip pathology can change posture and loading on the spine when medically supported.
Limping or instability may be tied to compensatory back stress in some records.
Last verified against 38 CFR (eCFR Part 4):
Rating criteria (38 CFR Part 4)
Diagnostic code 5235 — Vertebral fracture or dislocation — is listed under 38 CFR § 4.71a in 38 CFR Part 4. The paragraphs below summarize how this code is used; the official schedule text controls exact percentages, formulas, and notes.
Schedule summary (educational, not a substitute for the regulation): Spine segment code; usually rated under the General Rating Formula for Diseases and Injuries of the Spine (ROM/ankylosis criteria). See site overview under Musculoskeletal.
Exact rating criteria: Open Part 4 in the eCFR (link under “Official source” below). Locate your diagnostic code number (5235) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “5235”. Copy the verbatim rating table, including any parenthetical notes, exceptions, and cross-references, for the version of Part 4 that applies to your effective date.
Effective dates & which schedule version applies
Which diagnostic code, percentage, and effective date apply depends on the facts of your claim and the version of the rating schedule in force for the period being decided. Generally, VA applies the schedule in effect at the specified time under 38 U.S.C. § 5110 and implementing rules, subject to exceptions (e.g., protected ratings, liberalizing law changes—see regulation and VA manual policy as applicable).
For older claims, the **current** eCFR may not match the text that applied years ago. If your decision references a prior percentage or code, compare against the Part 4 text **as of** your claim’s relevant dates; historical Federal Register / CFR snapshots may be needed for precise comparison.
The “Last verified” date on this page is when we last checked this educational summary against the electronic CFR—not the date of any VA policy or your personal claim decision.
Notes for your claim
Evidence: Show that your diagnosis and severity match the factors the schedule names for DC 5235 (e.g., measurements, frequency, treatment, functional loss), with medical and lay evidence as appropriate.
C&P exams: Results should reflect the schedule’s requirements (correct joints measured, correct formulas). If the exam omits required findings, consider submitting records or requesting clarification.
If you disagree with the DC, percentage, or effective date, review the Part 4 text for your period and consider a supplemental claim or appeal with a VA-accredited representative.
This site does not provide legal advice.
Official source
38 CFR Part 4 (eCFR) — locate diagnostic code 5235 in the subpart for your body system (use Find in Page if needed).
Discuss how your evidence fits DC 5235 with a VA-accredited representative. Quick search: DC code lookup.
⚠️ Important Disclaimer
This page provides general educational information only based on public VA regulations (38 CFR) and va.gov resources. It is not legal, medical, or claims assistance. Ratings and service connections are decided case-by-case by the VA based on the individual veteran’s evidence. We do not prepare claims, generate documents, or provide personalized advice. Always consult a VA-accredited Veterans Service Organization (VSO), attorney, or your physician for help with your specific situation. Verify the latest rules on va.gov.