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Cervical Strain (Neck Pain)

Pain and limited motion in the neck. The VA rates cervical spine conditions using the General Rating Formula for Diseases and Injuries of the Spine, with different range-of-motion thresholds than the lumbar spine.

Code: 5237
Criteria: 38 CFR 4.71a, DC 5237 — General Rating Formula for Diseases and Injuries of the Spine
Exam length: ~30-45 minutes
Form: Spine DBQ (Cervical)

Rating steps

0%
10%
20%
30%
40%
100%

The percentages this diagnostic code can be rated at. Which one applies depends on the findings — no tool here can tell you in advance.

What happens at the appointment

The examiner will measure how far you can move your neck: forward, backward, side to side, and turning left and right.
You will be asked to repeat the movements to check for pain, weakness, and fatigue with repeated use.
The examiner will test your reflexes, sensation, and strength in your arms and hands to check for nerve problems.
You will be asked about flare-ups — times when your neck gets significantly worse.
The examiner may feel your neck for muscle spasm, tenderness, and guarding.

What the examiner is actually filling in

01Forward flexion range of motion in degrees (key measurement for cervical spine rating).
02Combined range of motion of the cervical spine.
03Pain, weakness, fatigue, and incoordination on repeated use (DeLuca factors).
04Muscle spasm, guarding, and impact on gait or spinal contour.
05Neurological testing of the upper extremities: reflexes, sensation, grip strength.
06Estimated additional range of motion loss during flare-ups.

Rated under 38 CFR 4.71a, DC 5237 — General Rating Formula for Diseases and Injuries of the Spine. The examiner records findings on the DBQ; a rating specialist makes the decision.

A complete answer sounds like

Stop moving when pain begins, not when you physically cannot go any further.
Mention if turning your head while driving is difficult or dangerous — this is a concrete functional impact.
If repeated movements make your neck worse, tell the examiner and make sure they document it.
Report any pain, numbness, or tingling going into your shoulders, arms, or hands.
If you get headaches from your neck condition, tell the examiner — cervicogenic headaches may support a secondary claim.

What costs veterans points

Taking extra pain medication before the exam.
Pushing through the pain during range of motion testing instead of stopping when it hurts.
Not mentioning pain, numbness, or tingling that goes into your arms and hands — this could be cervical radiculopathy rated separately.
Forgetting to describe flare-ups and how much more limited you are during them.
Not mentioning headaches caused by your neck condition — these may be rated separately.

The rating criteria, in plain language

Rating levels for Cervical Strain (Neck Pain) under 38 CFR 4.71a, DC 5237 — General Rating Formula for Diseases and Injuries of the Spine
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.	The cervical strain is diagnosed and service connected, but forward flexion and combined range of motion fall inside the normal ranges the General Rating Formula sets, and there is no muscle spasm, guarding, or localized tenderness. A zero percent rating pays nothing now, but it establishes service connection and fixes the effective date any later increase runs from.
0%	What supports this level Diagnosis of cervical strain in the treatment record Forward flexion and combined range of motion measured and recorded, even when normal Examination finding no muscle spasm, guarding, or localized tenderness Range of motion re-measured during a flare-up, which is when it is most likely to be compensable
10%	Forward flexion of the cervical spine greater than 30 degrees but not greater than 40 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; or, vertebral body fracture with loss of 50 percent or more of the height.	Your forward flexion is greater than 30 degrees but not greater than 40 degrees, or your combined range of motion is greater than 170 degrees but not greater than 335 degrees, or you have muscle spasm or guarding that does not result in abnormal gait or spinal contour.
10%	What supports this level Forward flexion 31-40 degrees Combined range of motion 171-335 degrees Muscle spasm or guarding without abnormal gait
20%	Forward flexion of the cervical spine greater than 15 degrees but not greater than 30 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 such as scoliosis, reversed lordosis, or abnormal kyphosis.	Your forward flexion is greater than 15 degrees but not greater than 30 degrees, or your combined range of motion is 170 degrees or less, or you have muscle spasm severe enough to cause abnormal gait or spinal contour.
20%	What supports this level Forward flexion 16-30 degrees Combined range of motion 170 degrees or less Muscle spasm causing abnormal gait or spinal contour
30%	Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine.	Your forward flexion is 15 degrees or less, or you have favorable ankylosis of your entire cervical spine.
30%	What supports this level Forward flexion 15 degrees or less Favorable ankylosis of entire cervical spine
40%	Unfavorable ankylosis of the entire cervical spine.	You have unfavorable ankylosis of your entire cervical spine.
40%	What supports this level Unfavorable ankylosis of entire cervical spine Neck fixed in flexion or extension
100%	Unfavorable ankylosis of the entire spine.	You have unfavorable ankylosis of your entire spine (cervical and thoracolumbar).
100%	What supports this level Unfavorable ankylosis of the entire spine

The middle column is our transcription of the criteria at 38 CFR 4.71a, DC 5237 — General Rating Formula for Diseases and Injuries of the Spine, 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.

Mistakes we see most often

Not reporting radiculopathy (pain, numbness, tingling into the arms/hands) — this is rated separately.

Failing to document flare-ups and their impact on daily activities.

Not mentioning headaches that originate from neck problems — these may qualify as a secondary condition.

Before & after your exam

These apply to every C&P exam, whatever the condition.

Do not miss the appointment: Missing your C&P exam without a good reason can cost you. Under 38 CFR § 3.655, a missed exam can cause a claim for an increased rating or a reopened claim to be denied, and can cause an original claim to be decided on the evidence already in your file. If you cannot make it, call the VA or the exam company right away to reschedule — a documented good reason (illness, work conflict, no transportation, a family emergency) protects your claim.
Your examiner may be a contractor: Many C&P exams are performed by VA-contracted companies — QTC, Optum Serve (LHI), VES, or MSLA — not at a VA hospital. They will call, text, or mail you to schedule. Do not ignore an unknown number or letter while your claim is pending, and confirm the exam location and time before you go.
The examiner does not decide your claim: The examiner's job is to record findings on the Disability Benefits Questionnaire (DBQ). A rating specialist at the Regional Office makes the actual decision, using the exam together with your full record — service records, medical records, and lay statements. One appointment does not settle everything.
Get a copy of your exam report: After the exam you can request the report (often called the DBQ or C&P exam results) through VA.gov, the Blue Button tool, or your accredited representative. Reading it lets you catch errors while you still have time to respond.
If the exam was inadequate, you have options: If the examiner rushed you, evaluated the wrong condition, or the report is inaccurate, you can submit a statement and new evidence, and — after a decision — request a review (a Supplemental Claim or Higher-Level Review). A single bad exam is not the end of your claim.

View condition guide →View evidence checklist →

Folder readiness

Tick these off as you gather them. Nothing here is required — the exam happens either way — but each one is something the examiner cannot record if it is not in front of them.

Saved in this browser only.

Take it with you

Print the whole guide — what the examiner records, the folder list with your ticks, the criteria table and the mistakes to avoid — and bring it to the appointment.

Frequently paired

Documented secondary or co-occurring conditions. Each is examined separately and has its own guide.

Free tool · 282 guides · DBQ-aligned

C&P Exam Preparation Guides

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.

Source forms
Coverage

Cervical Strain (Neck Pain)

Rating steps

What happens at the appointment

What the examiner is actually filling in

A complete answer sounds like

What costs veterans points

The rating criteria, in plain language

What supports this level

What supports this level

What supports this level

What supports this level

What supports this level

What supports this level

Mistakes we see most often

Before & after your exam

Cervical Strain (Neck Pain)

Rating steps

What happens at the appointment

What the examiner is actually filling in

A complete answer sounds like

What costs veterans points

The rating criteria, in plain language

What supports this level

What supports this level

What supports this level

What supports this level

What supports this level

What supports this level

Mistakes we see most often

Before & after your exam