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Sacroiliac Joint Dysfunction

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.

Code: 5236
Criteria: 38 CFR 4.71a, DC 5236
Exam length: ~30-45 minutes
Form: Spine DBQ (Sacroiliac)

Rating steps

0%
10%
20%
40%
50%
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 perform specific sacroiliac provocation tests: FABER (Patrick's test), Gaenslen's test, compression test, distraction test, and thigh thrust — a positive result on 3 or more tests is considered diagnostic.
Your lumbar spine range of motion will also be measured because SI joint dysfunction is evaluated under the spine rating criteria (VASRD diagnostic codes 5236-5243).
The examiner will ask about pain location — SI dysfunction typically causes pain over the posterior pelvis, buttock, and sometimes radiating into the back of the thigh, which is different from lumbar radiculopathy.
You will be asked about activities that aggravate SI joint pain: prolonged sitting, transitioning from sitting to standing, climbing stairs, single-leg activities, and rolling over in bed.
The examiner will assess gait and functional limitations — SI joint dysfunction often causes a visible pelvic shift or antalgic gait pattern.

What the examiner is actually filling in

01Results of at least 3 sacroiliac provocation tests (positive or negative for each).
02Lumbar spine range of motion in degrees, since SI dysfunction is rated under the spine General Rating Formula.
03Pain with weight-bearing activities and transitional movements.
04Additional functional loss after repetitive use and during flare-ups.
05Whether the condition affects gait, posture, or the ability to sit, stand, or walk for sustained periods.

Rated under 38 CFR 4.71a, DC 5236. The examiner records findings on the DBQ; a rating specialist makes the decision.

A complete answer sounds like

When the examiner performs provocation tests, describe the location and quality of pain they reproduce: "That recreates the exact pain I feel over my right SI joint and into my buttock."
Mention if your SI joint pain causes compensatory lumbar or hip problems — the body shifts mechanics to protect the SI joint, often causing secondary issues.
If you have had radiofrequency ablation (nerve burning) and it provided temporary relief that wore off, explain the timeline — it demonstrates that the SI joint is the pain source and the condition is chronic.
Report your sitting tolerance precisely: "I have to stand up and shift my weight every 20 minutes or the pain becomes a 7 out of 10" — this affects occupational capacity.
If your SI dysfunction started from a specific injury (parachute landing, heavy rucksack marching, vehicle blast), connect that mechanism of injury to the condition explicitly.

What costs veterans points

Not distinguishing SI joint pain from lumbar spine pain. The examiner needs to understand that your primary pain generator is the SI joint, not the lumbar discs.
Forgetting to mention pain with transitional movements — getting up from a chair, rolling over in bed, getting out of a car — which are hallmark SI dysfunction symptoms.
Not reporting that the pain alternates sides or is bilateral, which can indicate inflammatory sacroiliitis rather than mechanical dysfunction.
Pushing through provocation tests without reporting the pain they reproduce — these tests are designed to stress the SI joint and your pain response is the diagnostic finding.
Not mentioning that prolonged sitting aggravates symptoms — many veterans report SI pain worsening after 20-30 minutes of sitting.

The rating criteria, in plain language

Rating levels for Sacroiliac Joint Dysfunction under 38 CFR 4.71a, DC 5236
Rating	Rating criteria	What that means for you
0%	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 sacroiliac dysfunction is service-connected but the measurements stay above the formula lowest step — forward flexion of the thoracolumbar spine is greater than 85 degrees, the combined range of motion is greater than 235 degrees, and the examination records no muscle spasm, guarding or localized tenderness. The General Rating Formula for Diseases and Injuries of the Spine starts at 10 percent and prints no 0 percent rung; 38 CFR 4.31 supplies it: no monthly payment, but the condition is on record and a later increase runs from this date. The lowest compensable level under this code is 10 percent.
0%	What supports this level Forward flexion of the thoracolumbar spine measured greater than 85 degrees Combined range of motion of the thoracolumbar spine measured greater than 235 degrees No muscle spasm, guarding or localized tenderness recorded on examination A dated record of the condition so that a later increase claim has a starting point
10%	Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour.	You have painful motion with noncompensable limitation, or your forward flexion of the thoracolumbar spine is greater than 60 degrees but not greater than 85 degrees, or you have muscle spasm or guarding not resulting in an abnormal gait.
10%	What supports this level Painful motion on examination Forward flexion of thoracolumbar spine 61-85 degrees SI joint tenderness documented Positive provocative SI joint tests (FABER, compression, distraction)
20%	Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 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 of the thoracolumbar spine is greater than 30 degrees but not greater than 60 degrees, or you have muscle spasm severe enough to cause an abnormal gait or abnormal spinal contour.
20%	What supports this level Forward flexion of thoracolumbar spine 31-60 degrees Muscle spasm causing abnormal gait SI joint dysfunction confirmed by imaging or injection Significant pain affecting daily activities
40%	Forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine.	Your forward flexion of the thoracolumbar spine is 30 degrees or less, or you have favorable ankylosis of the entire thoracolumbar spine.
40%	What supports this level 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
50%	Unfavorable ankylosis of the entire thoracolumbar spine	Your entire thoracolumbar spine is fixed in an unfavorable position. Ankylosis means the spine is frozen — this level is not reached by limited motion alone, however severe.
50%	What supports this level Imaging and examination establishing ankylosis (fixation), not merely limited motion, of the entire thoracolumbar spine A finding that the fixed position is unfavorable as § 4.71a Note (5) defines it
100%	Unfavorable ankylosis of the entire spine	Your entire spine — cervical and thoracolumbar — is fixed in an unfavorable position. This is the maximum schedular evaluation under the General Rating Formula for the spine.
100%	What supports this level Imaging and examination establishing ankylosis of the ENTIRE spine, cervical through thoracolumbar A finding that the fixed position is unfavorable as § 4.71a Note (5) defines it

The middle column is our transcription of the criteria at 38 CFR 4.71a, DC 5236, 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

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.

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.

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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.

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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

Sacroiliac Joint Dysfunction

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

Sacroiliac Joint Dysfunction

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