Sacral Fracture Residuals

DC 5236Musculoskeletal38 CFR 4.71a, DC 5236

Lasting symptoms from a fracture of the sacrum, the triangular bone at the base of the spine. Residuals can include chronic low back pain, difficulty sitting, nerve damage causing numbness or weakness in the legs, and loss of bowel or bladder control. The VA rates sacral fracture residuals based on pain, range of motion limitation, and neurological symptoms.

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 5236

Rating range

10% – 40%

Rating levels

Rating criteria are defined in 38 CFR 4.71a, DC 5236. 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 sacral fracture residuals cause severe pain and major limitation of motion. You may have neurological deficits such as numbness, weakness, or bladder or bowel problems from nerve damage at the fracture site.

What the VA looks for

Forward flexion 30 degrees or less
Neurological deficits (numbness, weakness, radiculopathy) documented
Bladder or bowel dysfunction from sacral nerve involvement
EMG/nerve conduction studies showing nerve damage
Significant occupational impairment from pain and neurological symptoms

Common Pitfalls

⚠Not getting imaging that specifically shows the sacral fracture — a CT scan or MRI of the sacrum is more sensitive than a plain X-ray. Some sacral fractures are missed on initial X-rays and only found on CT.
⚠Not claiming neurological symptoms separately — the VA rates nerve damage (numbness, weakness, bladder/bowel problems) from sacral fractures under separate neurological codes in addition to the orthopedic rating. This can significantly increase your combined rating.
⚠Not documenting painful flare-ups and functional limitation during flares — the DeLuca factors require the C&P examiner to estimate additional range of motion loss during flare-ups, which can push you to a higher rating level.
⚠Failing to document how sitting is affected — sacral fractures make sitting painful, which directly impacts most occupations. Document how long you can sit before needing to stand or lie down.
⚠Not connecting the fracture to a specific in-service event — document the fall, vehicle accident, parachute landing, or other trauma that caused the fracture.

Related DBQ Forms

DBQ Back (Thoracolumbar Spine) Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

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

Sacral Fracture Residuals

How the VA rates this condition

Diagnostic code

DC 5236

Rating range

10% – 40%

Rating levels

Rating Levels

What the VA looks for

Forward flexion 30 degrees or less
Neurological deficits (numbness, weakness, radiculopathy) documented
Bladder or bowel dysfunction from sacral nerve involvement
EMG/nerve conduction studies showing nerve damage
Significant occupational impairment from pain and neurological symptoms

Common Pitfalls

⚠Not getting imaging that specifically shows the sacral fracture — a CT scan or MRI of the sacrum is more sensitive than a plain X-ray. Some sacral fractures are missed on initial X-rays and only found on CT.

⚠Not claiming neurological symptoms separately — the VA rates nerve damage (numbness, weakness, bladder/bowel problems) from sacral fractures under separate neurological codes in addition to the orthopedic rating. This can significantly increase your combined rating.

⚠Not documenting painful flare-ups and functional limitation during flares — the DeLuca factors require the C&P examiner to estimate additional range of motion loss during flare-ups, which can push you to a higher rating level.

⚠Failing to document how sitting is affected — sacral fractures make sitting painful, which directly impacts most occupations. Document how long you can sit before needing to stand or lie down.

⚠Not connecting the fracture to a specific in-service event — document the fall, vehicle accident, parachute landing, or other trauma that caused the fracture.