Muscle Group XX — Spinal Muscles (Erector Spinae)

DC 5320Musculoskeletal38 CFR 4.73, DC 5320

Muscle Group XX includes the spinal muscles: the sacrospinalis (erector spinae group including the iliocostalis, longissimus, and spinalis), the multifidi, and the semispinalis. These muscles control extension of the spine (bending backward), lateral flexion, rotation of the vertebral column, and postural support of the trunk. In military service, injuries commonly occur from heavy rucksack marches causing chronic strain, lifting and carrying heavy equipment (artillery rounds, crew-served weapons), blast injuries to the back, penetrating wounds from shrapnel to the paraspinal region, and motor vehicle accidents and helicopter crashes during deployment. The VA rates Muscle Group XX injuries under 38 CFR 4.73.

How the VA rates this condition

The VA rates this condition based on how much it affects your ability to work and carry out daily activities. The examiner will focus on the functional limitations your condition causes, not just the diagnosis itself.

Diagnostic code

DC 5320

Rating range

0% – 40%

Rating levels

Rating criteria are defined in 38 CFR 4.73, DC 5320. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

Your Muscle Group XX injury is severe. There is extensive scarring with severe loss of erector spinae muscle substance and visible paraspinal atrophy. Spinal extension and postural support are profoundly impaired, resulting in difficulty standing upright, chronic severe back pain, and significant limitations in all activities requiring trunk strength and stability.

What the VA looks for

Ragged, depressed, or adherent scars along spine
Severe paraspinal substance loss with visible atrophy
Muscle swelling and hardening abnormally in contraction
X-ray evidence of retained foreign bodies or bony changes
Profound impairment of spinal extension and postural support
Kyphotic or compensatory postural deformity

Common Pitfalls

⚠Not documenting your MOS and specific duties that caused the injury — paraspinal injuries should be linked to military rucksack marches, heavy lifting, combat operations, blast exposure, or specific penetrating trauma to the back.
⚠Failing to describe the cardinal signs of muscle disability per 38 CFR 4.56 — loss of power, weakness, lowered threshold of fatigue, fatigue-pain, impairment of coordination, and uncertainty of movement must each be addressed.
⚠Not distinguishing between muscle injury and intervertebral disc or spine joint disease — if your back condition is primarily muscular, it should be claimed under DC 5320 rather than the spinal codes (DC 5235-5243) to avoid pyramiding, but the higher-rated code should be selected.
⚠Not documenting postural changes — paraspinal muscle atrophy can cause visible postural changes including increased kyphosis or lateral shift, which provide objective evidence of muscle substance loss.

Related DBQ Forms

DBQ Muscle Injuries

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

Muscle Group XX — Spinal Muscles (Erector Spinae)

How the VA rates this condition

Diagnostic code

DC 5320

Rating range

0% – 40%

Rating levels

Rating Levels

What the VA looks for

Ragged, depressed, or adherent scars along spine
Severe paraspinal substance loss with visible atrophy
Muscle swelling and hardening abnormally in contraction
X-ray evidence of retained foreign bodies or bony changes
Profound impairment of spinal extension and postural support
Kyphotic or compensatory postural deformity

Common Pitfalls

⚠Not documenting your MOS and specific duties that caused the injury — paraspinal injuries should be linked to military rucksack marches, heavy lifting, combat operations, blast exposure, or specific penetrating trauma to the back.

⚠Failing to describe the cardinal signs of muscle disability per 38 CFR 4.56 — loss of power, weakness, lowered threshold of fatigue, fatigue-pain, impairment of coordination, and uncertainty of movement must each be addressed.

⚠Not distinguishing between muscle injury and intervertebral disc or spine joint disease — if your back condition is primarily muscular, it should be claimed under DC 5320 rather than the spinal codes (DC 5235-5243) to avoid pyramiding, but the higher-rated code should be selected.

⚠Not documenting postural changes — paraspinal muscle atrophy can cause visible postural changes including increased kyphosis or lateral shift, which provide objective evidence of muscle substance loss.