Sacroiliac Joint Dysfunction

DC 5236Musculoskeletal38 CFR 4.71a, DC 5236

Pain and instability in the sacroiliac joint where the lower spine connects to the pelvis. The VA rates sacroiliac joint dysfunction using the General Rating Formula for Diseases of the Spine, based on how much your range of motion is limited.

Rating Levels

Your forward flexion of the thoracolumbar spine is 30 degrees or less, or you have favorable ankylosis of the entire thoracolumbar spine.

What the VA looks for

Forward flexion of thoracolumbar spine 30 degrees or less
Favorable ankylosis of entire thoracolumbar spine
Severe SI joint dysfunction documented
Major functional limitation in bending and twisting

Common Pitfalls

⚠SI joint dysfunction can be difficult to diagnose — ask for specific SI joint provocation tests (FABER, compression, distraction, thigh thrust) and consider a diagnostic SI joint injection to confirm the diagnosis.
⚠Not understanding that SI joint dysfunction is rated under the General Rating Formula for the Spine — the same range of motion criteria used for lumbar strain apply here.
⚠Not reporting pain and limitations on your worst days — DeLuca factors (pain, weakness, fatigability, flare-ups) can support a higher rating.
⚠Not filing for secondary conditions — SI joint problems commonly cause hip pain, leg pain, and altered gait that may lead to knee or opposite hip issues.
⚠Confusing SI joint dysfunction with lumbar spine conditions — if you have both, they should be clearly differentiated in your medical records.

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…

Rating Levels

Your forward flexion of the thoracolumbar spine is 30 degrees or less, or you have favorable ankylosis of the entire thoracolumbar spine.

What the VA looks for

Forward flexion of thoracolumbar spine 30 degrees or less
Favorable ankylosis of entire thoracolumbar spine
Severe SI joint dysfunction documented
Major functional limitation in bending and twisting

Common Pitfalls

⚠SI joint dysfunction can be difficult to diagnose — ask for specific SI joint provocation tests (FABER, compression, distraction, thigh thrust) and consider a diagnostic SI joint injection to confirm the diagnosis.

⚠Not understanding that SI joint dysfunction is rated under the General Rating Formula for the Spine — the same range of motion criteria used for lumbar strain apply here.

⚠Not reporting pain and limitations on your worst days — DeLuca factors (pain, weakness, fatigability, flare-ups) can support a higher rating.

⚠Not filing for secondary conditions — SI joint problems commonly cause hip pain, leg pain, and altered gait that may lead to knee or opposite hip issues.

⚠Confusing SI joint dysfunction with lumbar spine conditions — if you have both, they should be clearly differentiated in your medical records.