---
title: "DC 5235 - Vertebral fracture or dislocation"
diagnostic_code: "5235"
body_system: "Musculoskeletal System"
cfr_section: "§ 4.71a"
canonical: "https://veteranai.co/va-rating-schedule/musculoskeletal/5235-vertebral-fracture-or-dislocation"
source: "https://www.ecfr.gov/current/title-38/section-4.71a"
updated: "2026-07-21T19:54:45.767003Z"
---

# DC 5235 - Vertebral fracture or dislocation

Rated under § 4.71a. Body system: Musculoskeletal System.

General Rating Formula for Diseases and Injuries of the Spine

## 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 |
| 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 |
| 60% | With incapacitating episodes having a total duration of at least 6 weeks during the past 12 months |
| 40% | With incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months |
| 20% | With incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months |
| 10% | With incapacitating episodes having a total duration of at least one week but less than 2 weeks during the past 12 months |

## Notes

- Note (1): Evaluate any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, separately, under an appropriate diagnostic code.
- Note (2): (See also Plate V.) For VA compensation purposes, normal forward flexion of the cervical spine is zero to 45 degrees, extension is zero to 45 degrees, left and right lateral flexion are zero to 45 degrees, and left and right lateral rotation are zero to 80 degrees. Normal forward flexion of the thoracolumbar spine is zero to 90 degrees, extension is zero to 30 degrees, left and right lateral flexion are zero to 30 degrees, and left and right lateral rotation are zero to 30 degrees. The combined range of motion refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. The normal combined range of motion of the cervical spine is 340 degrees and of the thoracolumbar spine is 240 degrees. The normal ranges of motion for each component of spinal motion provided in this note are the maximum that can be used for calculation of the combined range of motion.
- Note (3): In exceptional cases, an examiner may state that because of age, body habitus, neurologic disease, or other factors not the result of disease or injury of the spine, the range of motion of the spine in a particular individual should be considered normal for that individual, even though it does not conform to the normal range of motion stated in Note (2). Provided that the examiner supplies an explanation, the examiner's assessment that the range of motion is normal for that individual will be accepted.
- Note (4): Round each range of motion measurement to the nearest five degrees.
- Note (5): For VA compensation purposes, unfavorable ankylosis is a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching. Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis.
- Note (6): Separately evaluate disability of the thoracolumbar and cervical spine segments, except when there is unfavorable ankylosis of both segments, which will be rated as a single disability.

# Vertebral Fracture or Dislocation — VA Disability Rating (Diagnostic Code 5235)

**Body System:** Musculoskeletal System
**Regulation:** 38 CFR § 4.71a
**Rated Under:** General Rating Formula for Diseases and Injuries of the Spine

---

## What This Condition Is

A vertebral fracture or dislocation involves a break or displacement affecting one or more of the bones (vertebrae) that make up your spine. Because the spine is central to movement, posture, and nerve function, injuries here can affect how far you can bend, how you stand and walk, and — in some cases — other body systems connected to the spinal nerves.

The VA evaluates this condition under the **General Rating Formula for Diseases and Injuries of the Spine**. Ratings are based largely on how much motion you retain in the affected part of your spine (the cervical/neck segment and the thoracolumbar/mid-and-lower-back segment), on whether the spine has become fixed in place (ankylosis), and on related factors like muscle spasm, guarding, or fracture severity. There is also a separate pathway for rating based on incapacitating episodes.

---

## Available Rating Levels

### Ratings Based on Motion, Ankylosis, and Related Findings

| Rating | What It Reflects |
|--------|------------------|
| **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 |
| **20%** | Forward flexion of the thoracolumbar spine greater than 30 but not greater than 60 degrees; **or** forward flexion of the cervical spine greater than 15 but not greater than 30 degrees; **or** combined range of motion of the thoracolumbar spine not greater than 120 degrees; **or** combined range of motion of the cervical spine not greater than 170 degrees; **or** muscle spasm or guarding severe enough to cause 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 but not greater than 85 degrees; **or** forward flexion of the cervical spine greater than 30 but not greater than 40 degrees; **or** combined range of motion of the thoracolumbar spine greater than 120 but not greater than 235 degrees; **or** combined range of motion of the cervical spine greater than 170 but not greater than 335 degrees; **or** muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or contour; **or** a vertebral body fracture with loss of 50 percent or more of the height |

### Ratings Based on Incapacitating Episodes (Over the Past 12 Months)

| Rating | Total Duration of Incapacitating Episodes |
|--------|-------------------------------------------|
| **60%** | At least 6 weeks |
| **40%** | At least 4 weeks but less than 6 weeks |
| **20%** | At least 2 weeks but less than 4 weeks |
| **10%** | At least 1 week but less than 2 weeks |

---

## What the VA Looks For

- **Range of motion measurements.** For VA purposes, normal forward flexion of the cervical spine is 0 to 45 degrees, and normal forward flexion of the thoracolumbar spine is 0 to 90 degrees. The VA also measures extension, left and right lateral flexion, and left and right lateral rotation, then adds them together for a "combined range of motion." Normal combined range of motion is 340 degrees for the cervical spine and 240 degrees for the thoracolumbar spine. Each measurement is rounded to the nearest five degrees.

- **Ankylosis (fixation of the spine).** *Favorable* ankylosis means a spinal segment is fixed, including in a neutral (zero-degree) position. *Unfavorable* ankylosis means the entire cervical spine, entire thoracolumbar spine, or entire spine is fixed in flexion or extension and results in specific problems — such as difficulty walking due to a limited line of vision, restricted mouth opening and chewing, breathing limited to diaphragmatic respiration, gastrointestinal symptoms from pressure of the costal margin on the abdomen, dyspnea or dysphagia, atlantoaxial or cervical subluxation or dislocation, or neurologic symptoms from nerve root stretching.

- **Muscle spasm, guarding, and spinal contour.** The examiner notes whether muscle spasm, guarding, or localized tenderness is present, and whether it is severe enough to cause an abnormal gait or an abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis.

- **Fracture severity.** A vertebral body fracture with loss of 50 percent or more of its height is specifically recognized in the rating criteria.

- **Separate segments, separate evaluations.** The thoracolumbar and cervical spine segments are evaluated separately — except when there is unfavorable ankylosis of both segments, which is rated as a single disability.

- **Associated neurologic problems.** Any objective neurologic abnormalities linked to the spine injury — including, but not limited to, bowel or bladder impairment — are evaluated separately under an appropriate diagnostic code.

- **Individual considerations.** In exceptional cases, an examiner may determine that a person's range of motion should be considered normal for that individual — due to factors such as age, body habitus, or neurologic disease not caused by a spine disease or injury — as long as the examiner provides an explanation.

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*This information summarizes the VA rating criteria for Diagnostic Code 5235 under 38 CFR § 4.71a. It is provided for general educational purposes and describes how the VA structures ratings for this condition.*

Source: https://www.ecfr.gov/current/title-38/section-4.71a