VA Disability for Cervical Spine (Neck): Ratings, Evidence & Secondary Conditions

How the VA rates Cervical Spine (Neck)

Cervical Spine (Neck) is rated under 38 CFR 4.71a, Diagnostic Code 5237 (ratings of 10%–100%). Each criterion below is transcribed verbatim from the VA rating schedule and verified against the regulation (eCFR / Cornell LII) — never paraphrased.

• 10%

  Forward flexion of the thoracolumbar spine >60° but ≤85°; or forward flexion of the cervical spine >30° but ≤40°; or combined range of motion of the thoracolumbar spine >120° but ≤235°; or combined range of motion of the cervical spine >170° but ≤335°; or muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or vertebral body fracture with loss of 50% or more of the height.

• 20%

  Forward flexion of the thoracolumbar spine >30° but ≤60°; or forward flexion of the cervical spine >15° but ≤30°; or combined range of motion of the thoracolumbar spine ≤120°; or combined range of motion of the cervical spine ≤170°; or muscle spasm or guarding severe enough to result in abnormal gait or abnormal spinal contour.

• 30%

  Forward flexion of the cervical spine ≤15°; or favorable ankylosis of the entire cervical spine.

• 40%

  Forward flexion of the thoracolumbar spine ≤30°; or favorable ankylosis of the entire thoracolumbar spine; or unfavorable ankylosis of the entire cervical spine.

• 50%

  Unfavorable ankylosis of the entire thoracolumbar spine.

• 100%

  Unfavorable ankylosis of the entire spine.

Common conditions secondary to Cervical Spine (Neck)

Veterans routinely under-claim because they don't know a secondary condition exists. These are commonly claimed as secondary to service-connected Cervical Spine (Neck) — each is a candidate to raise with your provider, not an automatic grant, and each needs a medical nexus opinion.

• Cervical radiculopathy (upper extremities)

  Cervical (neck) spine conditions frequently cause radiating nerve pain into the arms/hands, separately ratable as secondary.

• Migraine / tension headaches

  Migraines/tension headaches are one of the most commonly claimed secondaries to a service-connected mental-health condition, tinnitus, or a cervical-spine condition. Often ratable at 30-50%.

Evidence the VA looks for

A strong Cervical Spine (Neck) claim ties a current diagnosis to your service with a medical nexus. The records that move a Cervical Spine (Neck) claim, in priority order:

• A current diagnosis (cervical strain, degenerative disc disease) with imaging where available
• A range-of-motion measurement of the cervical spine (forward flexion is the key figure)
• Documentation of muscle spasm, guarding, abnormal gait, or abnormal spinal contour
• Evidence of radiating nerve pain into the arms/hands (cervical radiculopathy) — separately ratable
• A nexus tying the neck condition to an in-service injury or repetitive strain

The C&P exam & the nexus

For most Cervical Spine (Neck) claims the VA schedules a Compensation & Pension (C&P) exam. The examiner measures the things the rating schedule turns on and gives a medical opinion on whether your Cervical Spine (Neck) is at least as likely as not connected to your service (the “nexus”). Knowing what the examiner will assess — and bringing the evidence above — is the single biggest thing you control. Prepare for the exam and check that your records support a nexus before you file.

Cervical Spine (Neck) VA disability: frequently asked questions

How does the VA rate neck (cervical spine) conditions?

The cervical spine is rated under the same General Rating Formula for the Spine (38 CFR 4.71a) as the back, but with its own range-of-motion thresholds: for example, forward flexion greater than 15 but not greater than 30 degrees rates 20%, and 15 degrees or less rates 30%.

Can I get a separate rating for cervical radiculopathy?

Yes. Radiating nerve pain into the arms or hands (cervical radiculopathy) is rated separately under the nerve codes, in addition to the cervical-spine rating — which can raise your combined rating.

What is the maximum rating for a neck condition?

Under the spine formula, the cervical spine maxes at 30% for favorable ankylosis (and 40% for unfavorable ankylosis of the entire cervical spine), with 100% reserved for unfavorable ankylosis of the entire spine. Most cases fall in the 10–30% range, plus any separate radiculopathy rating.

Are neck and headache claims related?

Often. Cervical-spine conditions are a recognized contributor to secondary migraine / tension headaches, which are separately ratable (frequently at 30–50%) with a nexus opinion linking them to the neck condition.