Lumbosacral Strain / Lower Back
ROM-based. Goniometer required. 10-40% typical.
Common symptoms
- Back pain
- Stiffness
- Limited range of motion
- Muscle spasm
- Pain radiating to leg
VA rating criteria
| Rating | Criteria |
|---|---|
| 100% | Unfavorable ankylosis of the entire spine |
| 50% | Unfavorable ankylosis of the entire thoracolumbar spine |
| 40% | 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 |
| 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 |
| 0% | Greater range of motion than 10% criteria |
Rating notes
- Goniometer measurement required.
- Painful Motion principle (§4.59): pain on motion = at least 10%.
- Mitchell v. Shinseki: examiner must consider flare-ups.
- Correia v. McDonald: ROM tested active/passive and weight-bearing/non-weight-bearing.
Common secondaries from this condition
If Lumbosacral Strain / Lower Back is service-connected, these are conditions worth investigating as secondaries (caused or aggravated by it).
Sciatic Nerve Radiculopathy (Sciatica)
Lower extremity nerve pain from lumbar spine impairment. Each leg rated separately.
Major Depressive Disorder
Persistent depressed mood, loss of interest, and associated symptoms. Common secondary to chronic pain.
Insomnia Disorder
Difficulty falling/staying asleep. Often filed as secondary to PTSD, anxiety, depression, or chronic pain.
Filing this claim
This is typically filed as a direct service connection claim. You need a current diagnosis, evidence of in-service event or exposure, and a nexus letter linking them. Use the letter generators to draft your nexus letter and Statement in Support of Claim.
Step by step
- File an Intent to File (Form 21-0966) to lock your effective date.
- Confirm you have a current medical diagnosis in a medical record.
- Get a nexus letter — magic phrase: "at least as likely as not."
- Write a Statement in Support of Claim (21-4138).
- If applicable, gather buddy statements (21-10210).
- File the formal 21-526EZ.
Source: 38 CFR §4.71a. For exact regulatory language, consult eCFR Title 38. This is general education — for your specific case, consult a VA-accredited representative.