38 CFR Part 4 — 38 CFR § 4.71a (pre-September 26, 2003)
Lumbosacral strain (legacy — pre-9/26/2003 schedule)
dc-5295-lumbosacral-strain-legacy
Musculoskeletal
Diagnostic code
5295
Why your DC matters: DC 5295 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 5295 — Lumbosacral strain (legacy — pre-9/26/2003 schedule) — is listed under 38 CFR § 4.71a (pre-September 26, 2003) 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Schedule summary (educational, not a substitute for the regulation): Superseded by DC 5237 under General Spine Formula effective 9/26/2003. Legacy criteria still apply for pre-2003 effective dates or straddling rating periods per Karnas v. Derwinski / VAOPGCPREC 7-2003.
Exact rating criteria: Open Part 4 in the eCFR (link under “Official source” below). Locate your diagnostic code number (5295) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “5295”. 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 5295 (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 5295 in the subpart for your body system (use Find in Page if needed).
DC 5295 (lumbosacral strain) was the primary lumbosacral strain code in the pre-September 26, 2003 spine schedule. It was SUPERSEDED by the General Rating Formula for Diseases and Injuries of the Spine — specifically DC 5237 (lumbosacral strain) — effective September 26, 2003. Modern claims rate under DC 5237 / the General Spine Formula (ROM-based). DC 5295 remains relevant only for: (1) protected ratings from pre-2003 effective dates, (2) supplemental claims invoking the more favorable of the two schedules when effective date crosses the rule change, and (3) legacy appeals still using the old criteria. The pre-2003 schedule used a different framework: 0/10/20/40% based on pain, muscle spasm, lateral spine motion loss, and 'listing of whole spine to opposite side with positive Goldthwaite's sign.' Critically: VAOPGCPREC 7-2003 and Karnas v. Derwinski require the rater to apply WHICHEVER VERSION OF THE SCHEDULE IS MORE FAVORABLE when effective dates straddle a rule change. Don't let modern raters dismiss DC 5295 reflexively — for some veterans, the legacy criteria yield a higher rating.
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 40% | (Pre-2003) Severe — listing of whole spine to opposite side, positive Goldthwaite's sign, marked limitation of forward bending in standing position, loss of lateral motion with osteoarthritic changes, or narrowing or irregularity of joint space, or some of the above with abnormal mobility on forced motion. | Orthopedic exam documenting Goldthwaite's sign + lateral listing + ROM limitations + imaging (osteoarthritis, joint space narrowing). |
| 20% | (Pre-2003) Moderate — muscle spasm on extreme forward bending, loss of lateral spine motion unilateral in standing position. | Orthopedic exam documenting muscle spasm + unilateral lateral motion loss. |
| 10% | (Pre-2003) With characteristic pain on motion. | Chart documenting pain on motion of lumbosacral spine. |
| 0% | (Pre-2003) Slight subjective symptoms only. | Subjective complaints without objective findings. |
What Qualifies Under DC 5295 (Legacy)?
Pre-September 26, 2003 effective date
DC 5295 was superseded by DC 5237 (under General Spine Formula) effective 9/26/2003. Modern claims rate under DC 5237. DC 5295 remains relevant only for pre-2003 effective dates or straddling rating periods.
Pre-2003 physical exam findings
Goldthwaite's sign, listing of whole spine to opposite side, muscle spasm on extreme forward bending, unilateral loss of lateral spine motion, characteristic pain on motion. Specific findings the modern schedule doesn't use.
Karnas / VAOPGCPREC 7-2003 — more favorable version applies
When effective dates straddle the 9/26/2003 rule change, the rater MUST apply whichever schedule version yields the higher rating. Both legacy and modern criteria must be considered.
Legacy lumbosacral strain
DC 5295 specifically — distinct from DC 5292 (limitation of motion, legacy) and DC 5293 (IVDS, legacy). Modern equivalent for the lumbosacral strain pathway is DC 5237.
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.
“Listing of whole spine + positive Goldthwaite's sign + marked limitation of forward bending”
Pre-2003 40% gate. The 'listing' is a postural lean of the entire spine to the opposite side from the injured side — visible on physical exam. Goldthwaite's sign tests for sacroiliac dysfunction. Joint space narrowing on imaging supports.
“Muscle spasm on extreme forward bending + loss of lateral spine motion unilateral”
Pre-2003 20% gate. Both elements (spasm + unilateral lateral motion loss) required. Modern raters may overlook these findings if not explicit in the chart.
“Apply whichever schedule version is more favorable to the veteran”
Per Karnas v. Derwinski (1991) and VAOPGCPREC 7-2003, when effective dates straddle the September 26, 2003 schedule change, the rater MUST apply whichever version yields the higher rating. Don't accept reflexive application of only the modern DC 5237 if DC 5295 yields more.
Evidence Checklist — Specific to This Condition
Effective date documentation — pre-2003 vs. post-2003
CRITICALCritical: if effective date is before September 26, 2003 (or any portion of the rating period falls before), the pre-2003 schedule MUST be considered alongside the modern schedule.
Orthopedic / spine exam documenting Goldthwaite's sign, lateral listing
CRITICALPre-2003 40% elements. Specific physical exam findings that modern DBQs often omit. Demand explicit documentation if applying legacy schedule.
Lumbosacral imaging (X-ray, MRI)
IMPORTANTOsteoarthritis, joint space narrowing, irregularity. Supports legacy 40% tier (and modern DC 5237 secondary considerations).
ROM documentation under BOTH legacy and modern formulas
IMPORTANTLegacy: forward bending, lateral spine motion. Modern: forward flexion, combined ROM, muscle spasm + abnormal gait/spinal contour. Calculate both ways.
Service-period documentation of in-service injury
IMPORTANTSTR documenting lumbosacral strain incurred in service. Standard SC requirement.
Pain on motion chart notation
SUPPORTINGPre-2003 10% gate is 'characteristic pain on motion.' Demand explicit chart note.
C&P Exam Tips
Ask examiner to perform Goldthwaite's test and document lateral listing
Modern DBQs typically don't include these findings. If applying legacy schedule, demand explicit documentation.
Bring effective date documentation
If effective date crosses 9/26/2003, the rater must consider BOTH schedules. Bring decision letter and original 526 filing date.
Demand ROM measurements under both formulas
Legacy: forward bending + lateral motion. Modern: forward flexion, combined thoracolumbar ROM. Both matter if straddling effective dates.
Don't let rater dismiss legacy schedule reflexively
Karnas/VAOPGCPREC 7-2003 requires more-favorable-version analysis when effective date straddles the rule change. Explicit citation in appeals.
Common Mistakes That Cost Veterans Points
Accepting only modern DC 5237 rating when effective date straddles 9/26/2003
Karnas v. Derwinski and VAOPGCPREC 7-2003 require both schedule versions to be considered when effective date crosses the rule change. The MORE FAVORABLE version applies. If your effective date is pre-2003, file supplemental invoking both schedules.
Filing under DC 5295 for post-2003 effective dates
DC 5295 was superseded effective 9/26/2003. Modern claims with post-2003 effective dates rate under DC 5237 (lumbosacral strain) under the General Spine Formula. Don't file under the legacy code unless the effective date is genuinely pre-2003.
Missing the Goldthwaite's sign / lateral listing physical findings
These pre-2003 specific physical exam findings are critical for the legacy 40% tier. Modern DBQs typically don't include them. Demand explicit documentation if applying legacy schedule.
Not pursuing intervertebral disc syndrome (DC 5293 / 5243) parallel rating
DC 5293 (IVDS) was also revised in 2003. Pre-2003 used incapacitating-episodes formula; post-2003 is the same but under DC 5243. If you have IVDS pathology, the IVDS formula may yield higher than either DC 5295 OR DC 5237. Calculate all paths.
Tactical Plays
⚡ Invoke BOTH schedules when effective date straddles 9/26/2003
Per Karnas v. Derwinski (1991) and VAOPGCPREC 7-2003, when effective dates cross a schedule change, the rater MUST apply whichever version yields the HIGHER rating. If your effective date is pre-2003 (or any portion of the rating period falls before), file supplemental explicitly invoking both DC 5295 (legacy) and DC 5237 (modern). Calculate both; rate under the higher.
⚡ Demand Goldthwaite's sign + lateral listing documentation for legacy 40% tier
Pre-2003 40% requires specific physical exam findings — Goldthwaite's sign (sacroiliac compression test), listing of whole spine to opposite side, marked forward-bending limitation. Modern DBQs typically don't include these. If applying legacy schedule, demand explicit physical exam documentation. Without it, the legacy 40% tier is contested.
⚡ Run the IVDS parallel rating — DC 5243 (modern) / 5293 (legacy)
Lumbosacral strain (DC 5295 / 5237) and IVDS (DC 5293 / 5243) are different DCs with different rating formulas. If MRI shows disc herniation with nerve root impingement AND you have ≥ 2 weeks of physician-prescribed bed rest in 12 months, the IVDS incapacitating-episodes formula may yield higher than the strain rating. Calculate all three paths (legacy strain, modern strain, IVDS) for straddling effective dates.
⚡ Stack neurological abnormalities separately (sciatica, etc.)
Both pre- and post-2003 schedules allow separate rating of neurological abnormalities arising from spine pathology — sciatic radiculopathy under DC 8520 / 8620, cauda equina syndrome, bladder/bowel dysfunction. These rate separately from the orthopedic spine rating. Don't let the rater fold sciatica into the back rating.
Secondary Conditions to File With This One
Sciatic radiculopathy (separate nerve rating)
STRONGDC 8520 / 8620
Per VAOPGCPREC 36-97 and modern note (1) to General Spine Formula, neurological abnormalities are evaluated separately under appropriate nerve DCs. Same principle pre- and post-2003.
Intervertebral disc syndrome (IVDS)
STRONGDC 5243 (modern) / 5293 (legacy)
If IVDS pathology exists, the incapacitating-episodes formula may yield higher than lumbosacral strain rating. Calculate both paths.
Lumbar spine arthritis
MODERATEDC 5242 / 5003
Degenerative arthritis of lumbar spine on imaging can rate under DC 5242 (modern) or as DC 5003 floor when ROM is noncompensable.
Hip / knee secondary from altered gait
MODERATEChronic low back pain causes altered gait → contralateral hip, knee, ankle complaints. Each can rate separately if independently established.
Depression secondary to chronic pain
MODERATEDC 9434
Chronic back pain has well-documented depression comorbidity.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
0% — single, no dependents
TOTAL
$0.00/mo
Pre-2003 slight subjective symptoms only.
10% — single, no dependents
Base rating
$180.42
TOTAL
$180.42/mo
Pre-2003 characteristic pain on motion.
20% — single, no dependents
Base rating
$356.66
TOTAL
$356.66/mo
Pre-2003 muscle spasm + unilateral lateral motion loss.
40% — single, no dependents
Base rating
$795.84
TOTAL
$795.84/mo
Pre-2003 listing + Goldthwaite's + marked forward bending limitation.
40% DC 5295 (legacy) + 20% DC 8520 sciatica + 10% DC 5003 arthritis
Base rating
$1,435.02
TOTAL
$1,435.02/mo
Legacy schedule maximum + neurologic + arthritis floor — combined ~57% rounds to 60%.
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 Goldthwaite's Sign?
Physical exam test for sacroiliac joint dysfunction. Patient supine; examiner places one hand under lumbar spine, raises straight leg with other hand. If pain occurs before lumbar spine moves = SI joint pathology (positive Goldthwaite's). Used in pre-2003 DC 5295 40% tier criteria. Modern DBQs typically don't include this test.
📐What is 'Listing of Whole Spine'?
Postural lean of the entire spine to one side, visible on physical exam. In lumbosacral strain, listing typically away from the painful side (compensatory). Pre-2003 40% tier element. Documented by observation + photo if possible.
⚖️Karnas v. Derwinski / VAOPGCPREC 7-2003 Rule
When effective dates of a claim straddle a schedule rule change (such as the 9/26/2003 spine schedule revision), the rater MUST apply whichever version of the schedule yields the higher rating for the veteran. Both legacy and modern criteria must be calculated; the more favorable applies. Don't accept reflexive application of only the modern schedule.
🔁Why is DC 5295 superseded?
The September 26, 2003 spine schedule revision replaced multiple legacy spine codes (DC 5292 limitation of motion, DC 5293 IVDS, DC 5295 lumbosacral strain, DC 5294 sacroiliac injury) with the General Rating Formula for Diseases and Injuries of the Spine — applied uniformly via DC 5235-5243. Goal was to standardize spine rating based on objective ROM and ankylosis rather than mixed pain/spasm/postural criteria.
How to File Your Claim
Confirm effective date — pre- or post-9/26/2003
Pull original decision letter and 526 filing date. If pre-2003, both schedules must be considered.
Document pre-2003 physical findings if applying legacy schedule
Goldthwaite's sign, lateral listing, muscle spasm, lateral motion loss — explicit chart documentation.
Calculate ratings under BOTH legacy and modern schedules
DC 5295 (legacy) AND DC 5237 (modern General Spine Formula). Compare which is higher.
File supplemental invoking Karnas / VAOPGCPREC 7-2003 if straddling effective dates
Explicit citation in claim narrative. Modern rater must apply more favorable version.
Stack sciatica + arthritis + IVDS pathways separately
Both schedules allow separate rating of neurological abnormalities and IVDS where applicable.
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
Superseded effective 9/26/2003 — but still applies for pre-2003 effective dates
Modern claims rate under DC 5237 (General Spine Formula). DC 5295 remains relevant only for pre-2003 effective dates or straddling rating periods.
Karnas / VAOPGCPREC 7-2003 — more favorable version applies
When effective date straddles 9/26/2003, the rater MUST apply whichever schedule yields the higher rating. Don't accept reflexive modern-only application.
Demand specific legacy physical findings for 40% tier
Goldthwaite's sign + listing + marked forward-bending limitation. Modern DBQs typically don't include these. Explicit documentation required.
Stack with sciatica, arthritis, IVDS pathways
Both legacy and modern schedules allow separate rating of neurological abnormalities and IVDS. Don't let the rater fold them into the spine rating.
Related Tools & Resources
Frequently Asked Questions
Is DC 5295 still a valid rating code?
DC 5295 was superseded by DC 5237 under the General Rating Formula for Diseases and Injuries of the Spine effective September 26, 2003. Modern claims with post-2003 effective dates rate under DC 5237. DC 5295 remains valid only for: (1) pre-2003 effective date claims, (2) supplemental/appeal claims where the effective date crosses the rule change, and (3) protected ratings from pre-2003 awards.
What if my effective date is before September 2003?
Per Karnas v. Derwinski (1991) and VAOPGCPREC 7-2003, when the effective date straddles a schedule change, the rater MUST apply whichever schedule version yields the higher rating. Calculate both DC 5295 (legacy) and DC 5237 (modern) — the more favorable version applies. File supplemental explicitly invoking both schedules if you have a pre-2003 effective date.
Does DC 5295 cover post-2003 lumbosacral strain claims?
No — post-2003 effective date claims rate under DC 5237 (lumbosacral strain) under the General Spine Formula, not under legacy DC 5295. The modern schedule uses ROM measurements + ankylosis criteria; the legacy schedule used pain/spasm/postural findings.
What's Goldthwaite's sign?
Physical exam test for sacroiliac dysfunction — patient supine, examiner places hand under lumbar spine, raises straight leg with other hand. If pain occurs before lumbar spine moves = positive (SI joint pathology). Pre-2003 40% tier element under DC 5295. Modern DBQs typically don't include this test; demand explicit examination if applying legacy schedule.
Can I still get IVDS rating under DC 5293 (legacy)?
DC 5293 (legacy IVDS) was also superseded effective 9/26/2003 by DC 5243 (modern IVDS under General Spine Formula). The Karnas / VAOPGCPREC 7-2003 rule applies — more favorable version applies when effective dates straddle. The incapacitating-episodes formula carried over largely intact, so the practical difference is often small.
Official Regulatory Source
DC 5295 (legacy lumbosacral strain) was superseded by DC 5237 effective September 26, 2003. Legacy schedule applies only for pre-2003 effective dates or straddling rating periods under Karnas v. Derwinski / VAOPGCPREC 7-2003.
38 CFR § 4.71a — Musculoskeletal System (eCFR — current modern schedule) →Modern schedule: scroll to DC 5237 and the General Rating Formula for Diseases and Injuries of the Spine. Legacy schedule: archived pre-9/26/2003 § 4.71a available via Federal Register historical lookup.
⚠️ Verify with a VSO
DC 5295 is a legacy code superseded effective 9/26/2003. Modern claims rate under DC 5237. DC 5295 entry retained for pre-2003 effective date analysis and Karnas / VAOPGCPREC 7-2003 more-favorable-version rule. Confirm effective date before relying on legacy criteria.
Next Steps
If your rating decision lists DC 5295, 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 5295 • 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.