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The VA orders this exam to verify your diagnosis and measure how severe it is right now. It can shape your rating and your monthly compensation — but it does not decide your claim. A rating specialist weighs it against your full record, and if the exam does not reflect your condition, you can say so and ask the VA to correct it.
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A type of inflammatory arthritis that mainly affects your spine, causing the vertebrae to fuse together over time. This can make your back stiff and hunched. The VA rates ankylosing spondylitis as an active process or based on residual limitation of motion.
The percentages this diagnostic code can be rated at. Which one applies depends on the findings — no tool here can tell you in advance.
Rated under 38 CFR 4.71a, DC 5009. The examiner records findings on the DBQ; a rating specialist makes the decision.
| Rating | Rating criteria | What that means for you |
|---|---|---|
| 0% | § 4.31 Zero percent evaluations. In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. | Your ankylosing spondylitis is service connected and documented, but at the time of examination it is neither in an active exacerbation nor leaving limitation of motion that any joint or spine code compensates. The lowest compensable rung on this ladder is 10 percent. A zero percent rating pays nothing now, but it establishes service connection and fixes the effective date any later increase runs from. |
What supports this level
| ||
| 10% | Note (2): With the types of arthritis, diagnostic codes 5004 through 5009, rate the acute phase under diagnostic code 5002; rate any chronic residuals under diagnostic code 5003. Degenerative arthritis established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved (DC 5200 etc.). When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 pct is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. | Your ankylosing spondylitis is not in an active flare, but it has left chronic residuals — limitation of motion of an affected joint or spine segment that is objectively confirmed by swelling, muscle spasm, or painful motion, yet is not severe enough to be compensable under the diagnostic code for that joint. DC 5009 Note (2) sends chronic residuals to DC 5003, which pays 10 percent for each such major joint or group of minor joints. |
What supports this level
| ||
| 20% | One or two exacerbations a year in a well-established diagnosis. 20 percent. Note (3): The ratings for the active process will not be combined with the residual ratings for limitation of motion, ankylosis, or diagnostic code 5003. Instead, assign the higher evaluation. | You have one or two flare-ups of your ankylosing spondylitis per year during an active disease process, in a well-established diagnosis. DC 5009 Note (2) rates the active phase under DC 5002; chronic residuals are rated separately under DC 5003 or under the code for the specific joint or spine segment involved. |
What supports this level
| ||
| 40% | With symptom combinations productive of definite impairment of health objectively supported by examination findings or incapacitating exacerbations occurring 3 or more times a year. 40 percent. | You have symptom combinations that are productive of definite impairment of health, objectively supported by examination findings or incapacitating exacerbations occurring three or more times per year. |
What supports this level
| ||
| 60% | Less than criteria for 100 percent, but with weight loss and anemia productive of severe impairment of health or severely incapacitating exacerbations occurring 4 or more times a year or a lesser number over prolonged periods. 60 percent. | Your ankylosing spondylitis symptoms are less than the criteria for 100 percent but with weight loss and anemia that are productive of severe impairment of health, or severely incapacitating exacerbations occurring four or more times per year or a lesser number over prolonged periods. |
What supports this level
| ||
| 100% | With constitutional manifestations associated with active joint involvement, totally incapacitating. 100 percent. | Your ankylosing spondylitis causes constitutional manifestations associated with active joint involvement that are totally incapacitating. |
What supports this level
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The middle column is our transcription of the criteria at 38 CFR 4.71a, DC 5009, condensed for reading. Read the section itself on eCFR before relying on the exact wording. The items under each level are the kinds of evidence that document it — not a VA checklist, and not a prediction of which level applies to you.
Not getting tested for the HLA-B27 gene marker — this is a key diagnostic tool for ankylosing spondylitis and helps establish the diagnosis for VA purposes.
Not documenting flare-ups with medical visits — the rating levels depend on the number and severity of exacerbations per year, so each flare-up needs to be recorded in your medical records.
Failing to document extra-articular manifestations — ankylosing spondylitis can affect your eyes (uveitis), heart, and lungs, and each may support additional secondary service-connected claims.
Not requesting imaging of the sacroiliac joints — early sacroiliitis is often the first radiographic sign and is essential for diagnosis.
These apply to every C&P exam, whatever the condition.