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Scoliosis

An abnormal sideways curvature of the spine that can cause pain, limited motion, and difficulty with posture. 38 CFR 4.71a lists no diagnostic code for scoliosis — it names scoliosis only as an EXAMPLE of the abnormal spinal contour that supports a 20 percent rating. Scoliosis is therefore rated by analogy under 38 CFR 4.20, with the code built up under 4.27, on the General Rating Formula for Diseases and Injuries of the Spine. Do not accept DC 5241: that code is SPINAL FUSION, a different condition. It runs the same formula, which is exactly why the mismatch is easy to miss.

Code: 5299-5237
Criteria: 38 CFR 4.71a, General Rating Formula for Diseases and Injuries of the Spine; 38 CFR 4.20 and 4.27
Exam length: ~30-45 minutes
Form: Back (Thoracolumbar Spine) DBQ

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 measure your thoracolumbar spine range of motion in all planes: forward flexion, extension, lateral flexion (left and right), and rotation (left and right) using a goniometer or inclinometer.
You will be asked to perform repetitive use testing (at least three repetitions of forward bending) to evaluate whether pain, weakness, fatigue, or incoordination causes additional functional loss.
The examiner will perform a neurological evaluation testing sensation, reflexes, and muscle strength in your lower extremities to check for nerve involvement.
Your posture will be assessed standing and bending forward (Adams forward bend test) to evaluate the degree and location of the spinal curve.
You will be asked about flare-ups, muscle spasms, pain radiation, and how scoliosis affects sitting, standing, walking, lifting, and sleeping.

What the examiner is actually filling in

01Range of motion in all planes measured in degrees — forward flexion is the primary determinant, with combined range of motion as a secondary measure.
02Whether muscle spasm or guarding is severe enough to result in abnormal gait or abnormal spinal contour such as reversed lordosis or abnormal kyphosis.
03Additional functional loss after repetitive use and during flare-ups, estimated in degrees of lost motion per DeLuca criteria.
04Neurological findings in the lower extremities including any radiculopathy, which is rated separately under the peripheral nerve codes.
05Whether there is vertebral body fracture with loss of 50% or more of height, which triggers a higher rating under the spine formula.

Rated under 38 CFR 4.71a, General Rating Formula for Diseases and Injuries of the Spine; 38 CFR 4.20 and 4.27. The examiner records findings on the DBQ; a rating specialist makes the decision.

A complete answer sounds like

During forward flexion testing, bend as far as you naturally can and stop at the point where pain or tightness prevents further motion — do not force yourself past that point.
If you have morning stiffness, try to schedule the exam for morning when your back is at its stiffest rather than later in the day when you have loosened up.
Describe flare-ups in concrete terms: "During a flare I can only bend forward about 30 degrees instead of my usual 60" helps the examiner estimate functional loss.
If scoliosis causes you to lean to one side or have an uneven gait, point this out and ask the examiner to observe you walking.
Mention any secondary conditions that have developed because of the abnormal spinal mechanics, such as hip pain, sciatica, or disc degeneration.

What costs veterans points

Assuming that a large Cobb angle automatically means a high rating — VA rates scoliosis on functional impairment and range of motion, not curve degree alone.
Not reporting muscle spasms, guarding, or an abnormal gait — these findings can qualify you for a higher rating tier under the General Rating Formula for the spine.
Failing to mention neurological symptoms like radiating pain, numbness, or tingling in the legs, which can warrant separate radiculopathy ratings.
Pushing through pain during range of motion testing instead of stopping where pain naturally limits your motion.
Not describing how scoliosis has worsened since military service — progressive curvature or increasing symptoms over time are important for your claim.

The rating criteria, in plain language

Rating levels for Scoliosis under 38 CFR 4.71a, General Rating Formula for Diseases and Injuries of the Spine; 38 CFR 4.20 and 4.27
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 scoliosis 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.	Your forward flexion of the thoracolumbar spine is greater than 60 degrees but not greater than 85 degrees, or your combined range of motion is greater than 120 degrees but not greater than 235 degrees, or you have muscle spasm or guarding not causing an abnormal gait.
10%	What supports this level Forward flexion of thoracolumbar spine 61-85 degrees Combined range of motion 121-235 degrees Muscle spasm or guarding documented Scoliosis confirmed on spinal imaging
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 Combined range of motion 120 degrees or less Muscle spasm causing abnormal gait or spinal contour Scoliosis curvature documented on imaging
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. Your scoliosis severely limits your ability to bend forward.
40%	What supports this level Forward flexion of thoracolumbar spine 30 degrees or less Favorable ankylosis of entire thoracolumbar spine Severe limitation in bending and twisting Significant scoliosis curvature on imaging
50%	Unfavorable ankylosis of the entire thoracolumbar spine.	You have unfavorable ankylosis of the entire thoracolumbar spine. Your spine is fixed in an abnormal position and you cannot bend your trunk.
50%	What supports this level Unfavorable ankylosis of entire thoracolumbar spine Spine fixed in abnormal position Total inability to bend the trunk Severe scoliosis with spinal fusion or rigidity
100%	Unfavorable ankylosis of the entire spine.	You have unfavorable ankylosis of your entire spine. Both your cervical (neck) and thoracolumbar (mid and lower back) spine are fixed in an abnormal position.
100%	What supports this level Unfavorable ankylosis of entire spine Entire spine fixed in abnormal position Total inability to move the spine in any direction Severe impact on all daily activities and self-care

The middle column is our transcription of the criteria at 38 CFR 4.71a, General Rating Formula for Diseases and Injuries of the Spine; 38 CFR 4.20 and 4.27, 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 getting full spinal X-rays that show the degree of curvature — the Cobb angle measurement on imaging helps document the severity of your scoliosis and supports your claim.

Not reporting pain and limitations on your worst days — DeLuca factors (pain, weakness, fatigability, flare-ups) can support a higher rating even if your range of motion is borderline between two levels.

Not understanding that scoliosis is rated the same way as other spine conditions — the General Rating Formula focuses on range of motion, not the degree of curvature. Your functional limitations matter most.

Not asking the examiner to record abnormal spinal contour. The 20 percent row of the General Rating Formula is met by "muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis" — a route to 20 percent that does not depend on your forward flexion figure at all. It is often the strongest ground in a scoliosis claim and it is often left unrecorded.

Not filing for radiculopathy separately — if your scoliosis causes nerve compression leading to pain, numbness, or tingling in your legs or arms, this warrants a separate neurological rating.

Not connecting scoliosis to service — even if scoliosis was noted before service, military duties may have aggravated it beyond its natural progression. Document any worsening during service.

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

Scoliosis

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

Scoliosis

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