38 CFR Part 4 — 38 CFR § 4.71a
Degenerative Arthritis Degenerative Disc Disease Other Than Intervertebral Disc Syndrome Also See Either Dc 5003 Or 5010
dc-5242-degenerative-arthritis-degenerative-disc-disease-other-than-intervertebral-disc-syndrome-also-see-either-dc-5003-or-5010
Musculoskeletal
Diagnostic code
5242
Why your DC matters: DC 5242 is the exact code the VA uses to rate this condition. It determines which symptoms unlock which percentage, what evidence the rater looks for, and which secondaries are most likely to be approved.
Last verified against 38 CFR (eCFR Part 4):
Rating criteria (38 CFR Part 4)
Diagnostic code 5242 — Degenerative Arthritis Degenerative Disc Disease Other Than Intervertebral Disc Syndrome Also See Either Dc 5003 Or 5010 — 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): Schedule assigns other disc diagnoses here vs DC 5243 for IVDS with nerve-root compression/irritation; notes may also reference DC 5003 or 5010—see regulation text.
Exact rating criteria: Open Part 4 in the eCFR (link under “Official source” below). Locate your diagnostic code number (5242) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “5242”. 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 5242 (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 5242 in the subpart for your body system (use Find in Page if needed).
DC 5242 covers degenerative changes of the spine that DON'T meet IVDS criteria (no nerve root impingement). It's rated under the General Rating Formula for Diseases and Injuries of the Spine — the same formula as DC 5237 lumbosacral strain, scored on forward flexion of the thoracolumbar spine and combined range of motion. Veterans miss higher tiers because the C&P measures ROM in isolation, ignoring pain, muscle spasm, and the DeLuca factors.
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 100% | Unfavorable ankylosis of the ENTIRE spine (cervical + thoracolumbar fused in non-neutral position). | Imaging confirming full spinal ankylosis; surgical fusion records spanning multiple levels. |
| 50% | Unfavorable ankylosis of the entire thoracolumbar spine. | Imaging showing thoracolumbar fusion in fixed flexion or extension; surgical hardware throughout the segment. |
| 40% | Forward flexion of the thoracolumbar spine 30° or less; OR favorable ankylosis of the entire thoracolumbar spine. | Goniometer reading ≤30° forward flexion (after repetitive use); or imaging confirming thoracolumbar fusion in neutral position. |
| 20% | Forward flexion >30° but ≤60°; OR combined ROM of thoracolumbar spine ≤120°; OR muscle spasm or guarding severe enough to result in abnormal gait or abnormal spinal contour (reversed lordosis or abnormal kyphosis). | Goniometer + functional exam documenting spasm/guarding altering gait or posture. |
| 10% | Forward flexion >60° but ≤85°; OR combined ROM of thoracolumbar spine >120° but ≤235°; OR muscle spasm/guarding/localized tenderness not resulting in abnormal gait; OR vertebral body fracture with loss of ≥50% body height. | Goniometer reading in this range; or palpable spasm/tenderness in the chart; or imaging confirming vertebral compression fracture. |
What Qualifies as 'Degenerative Arthritis of the Spine' Under DC 5242?
Imaging-confirmed degenerative changes without active IVDS
X-ray or MRI showing osteophytes, disc desiccation, facet arthropathy, or other degenerative findings WITHOUT nerve root impingement requiring incapacitating-episodes rating.
Rated under the General Rating Formula for Diseases and Injuries of the Spine
Mechanical degree thresholds for forward flexion + combined ROM + spasm/guarding alternates:
- • 10% — flexion 60–85°, combined ROM 120–235°, or spasm not affecting gait
- • 20% — flexion 30–60°, combined ROM ≤ 120°, or spasm affecting gait/contour
- • 40% — flexion ≤ 30°, or favorable ankylosis
- • 50% — unfavorable ankylosis of entire thoracolumbar spine
- • 100% — unfavorable ankylosis of entire spine
Language Your Rater Needs to See
These are the exact (or near-exact) regulatory phrases that unlock specific tiers. If your DBQ or C&P report doesn't use this vocabulary, the rater may default to a lower percentage even when symptoms qualify.
“Muscle spasm or guarding severe enough to result in abnormal gait or abnormal spinal contour”
This is the alternate path to 20% even if your ROM is normal. If the examiner documents palpable spasm + altered gait or reversed lordosis, you qualify regardless of degrees.
“Forward flexion of the thoracolumbar spine 30 degrees or less”
The 40% threshold is mechanical — but it must be measured AFTER repetitive use per § 4.40/4.45. A single 'flexion to 35°' reading isn't enough; the examiner must record post-repetition and flare-up estimates.
“Neurologic abnormalities associated with the spine condition”
Per Note 1 to the General Spine Formula, associated objective neurologic abnormalities (radiculopathy, bowel/bladder impairment) are rated SEPARATELY. Always claim these on top of the spine rating.
Evidence Checklist — Specific to This Condition
Spine DBQ with full goniometric ROM (forward flexion, extension, lateral flexion bilateral, rotation bilateral)
CRITICALAll six measurements after three repetitions, plus a flare-up estimate per Sharp v. Shulkin. Combined ROM = sum of all six.
MRI or X-ray showing degenerative changes
CRITICALImaging anchors the diagnosis. Note whether there's nerve root impingement — if yes, DC 5243 (IVDS) may yield a higher rating.
Treatment records — PT, injections, medications, surgery
IMPORTANTLong failed treatment trail supports severity ratings.
Functional impact statement
IMPORTANTTasks you can't perform: bending, lifting, prolonged sitting/standing, sleeping. Supports DeLuca application.
Neuro exam for radiculopathy
CRITICALStrength, sensation, reflexes in upper and lower extremities. Each affected limb = separate rating under § 4.124a.
C&P Exam Tips
Demand post-repetitive ROM measurements
Three reps of each motion, then re-measure. If the DBQ doesn't show the post-rep numbers, the exam is incomplete.
Describe flare-ups in detail
Per Sharp v. Shulkin, the examiner must estimate ROM during flare-ups. 'Two days a week I can barely get out of bed' gives them something to work with.
Don't tough out the exam
If pain stops you at 50°, stop. Pushing through gives the examiner a number that doesn't reflect your true functional limit.
Common Mistakes That Cost Veterans Points
Not claiming radiculopathy separately
Per Note 1, neurologic manifestations are SEPARATE ratings. Each affected leg/arm under 8520 (sciatic) or 8510-series (upper) is its own rating on top of the spine rating.
Confusing 5242 with 5243
5243 (IVDS) requires nerve root involvement. If your MRI shows disc disease but no impingement, you're under 5242. With impingement and incapacitating episodes, switch to 5243 — sometimes higher.
Missing the 10% floor under DC 5003
Even with normal ROM, painful motion + imaging-confirmed arthritis = 10% minimum. If the rater applies 0%, file HLR.
Tactical Plays
⚡ Stack radiculopathy on top of the back rating
A 20% back rating + bilateral 20% sciatic radiculopathy + bilateral factor = combined ~55%. Most veterans with rated backs have at least mild radiculopathy that's never been separately rated. Audit your last decision.
⚡ 5242 vs 5243 — pick the higher
If your MRI shows nerve root impingement and you have documented bed-rest-prescribing episodes, run the math under DC 5243 incapacitating-episodes formula. Six weeks of physician-prescribed bed rest in 12 months = 60% under 5243 — potentially higher than the General Spine Formula yields.
⚡ Get a 30-day flare log
Per Sharp v. Shulkin, the examiner must estimate flare-up ROM. Walk in with a log: 'Day 3: couldn't bend past 25°. Day 7: needed help to get out of bed. Day 12: flare lasted 3 days.' That data drives the rating.
Secondary Conditions to File With This One
Sciatic radiculopathy (lower extremities)
STRONGDC 8520
Most common spine secondary. Each leg rated separately. Combined ratings often double the back rating.
Cervical radiculopathy (upper extremities)
STRONGDC 8510
Cervical 5242 → upper-extremity radiculopathy. Each arm separately ratable.
IVDS (if nerve impingement on imaging)
MODERATEDC 5243
If MRI shows disc herniation with nerve root contact, DC 5243 may yield a higher rating via incapacitating episodes.
Sleep impairment / insomnia
MODERATEChronic back pain disrupts sleep. Supports mental health secondaries (MDD, anxiety).
Depression / anxiety (chronic pain)
MODERATEDC 9434
Chronic pain → mood disorder is well-accepted. Secondary path to mental health rating.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
10% — single, no dependents
Base rating
$180.42
TOTAL
$180.42/mo
Flexion 60–85° OR mild spasm/tenderness.
20% — single, no dependents
Base rating
$356.66
TOTAL
$356.66/mo
Flexion 30–60° OR combined ROM ≤ 120° OR spasm affecting gait.
40% — single, no dependents
Base rating
$795.84
TOTAL
$795.84/mo
Flexion ≤ 30° OR favorable ankylosis.
50% — single, no dependents
Base rating
$1,132.90
TOTAL
$1,132.90/mo
Unfavorable ankylosis of entire thoracolumbar spine.
100% — single, no dependents
Base rating
$3,938.58
TOTAL
$3,938.58/mo
Unfavorable ankylosis of entire spine.
20% spine + bilateral 20% radiculopathy + bilateral factor
TOTAL
$1,132.90/mo
Combined ~49% with § 4.26 bilateral factor → rounds to 50% = $1,132.90/mo alone. Most veterans with rated backs have unclaimed radiculopathy.
Note: Amounts are approximations rounded to nearest dollar. Actual comp varies with effective date, dependents (spouse, children, parents — each adds), Aid & Attendance, and additional disabilities. Combined ratings use VA Math (§ 4.25), not simple addition.
Key Definitions
🔗What is 'Ankylosis'?
Complete fusion of joints — bone-to-bone, no movement possible. 'Favorable' = fused in neutral position. 'Unfavorable' = fused in fixed flexion or extension. Required for 40%+ ratings under DC 5242.
📐What is 'Combined ROM'?
Sum of all six thoracolumbar measurements: forward flexion + extension + lateral flexion (L+R) + rotation (L+R). Normal = ~240°. Combined ROM ≤ 120° qualifies for 20% even with relatively preserved forward flexion.
💢What is 'Muscle Spasm/Guarding'?
Palpable muscular contraction protecting against painful movement. The 20% alternate path even with normal ROM — requires examiner to document spasm/guarding + altered gait or reversed lordosis.
⚡Why is radiculopathy rated separately?
Per Note 1 to the General Spine Formula, objective neurologic abnormalities (radiculopathy, bowel/bladder impairment) associated with the spine condition are rated SEPARATELY — not absorbed into the spine rating.
How to File Your Claim
Get a spine DBQ with FULL goniometric ROM
All six motions: forward flexion, extension, left + right lateral flexion, left + right rotation. Each measured BEFORE and AFTER three repetitions, with pain-onset degrees.
Submit imaging (MRI preferred) showing degenerative changes
Look for nerve root impingement — if present, DC 5243 (IVDS) may yield a higher rating via incapacitating episodes. Without impingement, DC 5242 applies.
File radiculopathy claims separately for EACH affected limb
Per Note 1, radiculopathy is rated separately under § 4.124a. Each leg (or arm for cervical spine) is its own rating.
Bring a 30-day flare-up log to C&P
Per Sharp v. Shulkin, examiner must estimate flare-up ROM. Log: 'Day 3: couldn't bend past 25°. Day 7: needed help out of bed.'
Audit existing rating for missing pieces
If you have a rated back but no radiculopathy ratings, file the secondary claims now. Combined rating math often jumps 20–30 points.
Typical Claim Timeline
File initial claim
Day 0–7: Submit VA Form 21-526EZ with all medical evidence on file
VA acknowledges claim
Week 1–2: Receive confirmation letter and claim tracking number
C&P examination scheduled
Month 1–3: VA contracts an exam vendor and sends you appointment notice
Attend C&P exam
Bring your full evidence package; describe symptoms on your worst days, not your best
Decision & rating notice
Month 3–6: Decision letter with rating percentage and effective date
First payment & retro back pay
Within 15 days of decision; retroactive to claim date (or effective date if earlier)
Timeline varies by case complexity and VA regional office workload. Some claims resolve faster; others take longer.
Important Considerations
If you have a back rating, you probably have unclaimed radiculopathy
Note 1 makes radiculopathy a separate rating. Pull your records — any STR mention of radiating leg pain, numbness, or positive straight-leg raise + current symptoms = file. Each leg can add 10–40%.
DC 5242 vs DC 5243 — run the math both ways
If MRI shows nerve root impingement and you have physician-prescribed bed-rest episodes, DC 5243's incapacitating-episode formula may exceed the General Spine Formula. Apply whichever yields the higher rating.
Muscle spasm route bypasses ROM
20% is available if the examiner documents muscle spasm/guarding + altered gait/contour, even with normal flexion. Don't let the rater dismiss spasm — it's a separate path.
Painful motion floor under DC 5003
Imaging-confirmed arthritis + painful motion = 10% minimum per major joint group, even with full ROM. If the rater applies 0% with documented arthritis, file HLR.
Related Tools & Resources
Frequently Asked Questions
What's the difference between DC 5242 and DC 5237 (lumbosacral strain)?
Both are rated under the same General Rating Formula — same percentage thresholds. DC 5237 is for strain without arthritis; DC 5242 requires imaging-confirmed degenerative changes. The rating is identical; the diagnosis label may matter for severity perception.
Can I switch from DC 5242 to DC 5243 if my MRI shows new impingement?
Yes — file for an increase, attach the MRI, and request rating under DC 5243 with incapacitating-episode evidence. The rater must compare both formulas and apply the higher.
Does posture or scoliosis affect my rating?
Reversed lordosis or abnormal kyphosis from muscle spasm/guarding can support 20% under the alternate path. Underlying postural abnormality must be linked to the spine condition.
What's 'unfavorable ankylosis' vs 'favorable'?
Favorable = entire thoracolumbar fused in neutral position (40% under DC 5242). Unfavorable = fused in fixed flexion or extension (50% if thoracolumbar only, 100% if entire spine).
How do flare-ups factor in if I have a good exam day?
Per Sharp v. Shulkin, the examiner MUST estimate ROM during flare-ups based on your history. If they don't address flare-ups, the exam is inadequate — grounds for HLR or supplemental claim.
Official Regulatory Source
Degenerative arthritis of the spine is rated under 38 CFR § 4.71a, Diagnostic Code 5242.
38 CFR § 4.71a — Musculoskeletal System (eCFR) →Scroll to the General Rating Formula for Diseases and Injuries of the Spine (covering DCs 5235–5243).
⚠️ Verify with a VSO
General Rating Formula for Diseases and Injuries of the Spine applies to DCs 5235–5243 (except IVDS rated separately under 5243's incapacitating-episode formula). Flare-up estimation per Sharp v. Shulkin is mandatory. Verify your effective date against the most recent rule version with a VSO.
Next Steps
If your rating decision lists DC 5242, compare your current symptoms and documentation against the criteria above. Consider:
- Requesting a copy of your rating decision and C&P exam report from the VA
- Gathering all relevant medical records (VA and private providers)
- Documenting functional limitations and how they impact work and daily activities
- Obtaining a nexus letter if needed to establish or strengthen service connection
- Filing for secondary conditions that may be related to this primary condition
- Contacting a VA-accredited VSO, claims agent, or attorney to review your file
This is general educational information only — not legal or medical advice.
Also: DC code lookup (tools) lists the same index in a compact layout.
Source: 38 CFR Part 4, Diagnostic Code 5242 • va.gov
⚠️ 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.