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Spinal Stenosis

A narrowing of the spaces in your spine that puts pressure on the nerves, causing pain, numbness, or weakness. The VA rates spinal stenosis using the General Rating Formula for Diseases of the Spine, based on how much your range of motion is limited.

Code: 5238
Criteria: 38 CFR 4.71a, DC 5238
Exam length: ~30-45 minutes
Form: Spine DBQ

Rating steps

0%
10%
20%
30%
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 spine range of motion — forward flexion, extension, lateral flexion, and rotation — and note the degree at which pain begins.
A thorough neurological exam will be performed: reflexes, sensation, and motor strength in your legs (lumbar stenosis) or arms (cervical stenosis) to assess nerve compression.
The examiner will specifically ask about neurogenic claudication — pain, numbness, or weakness in your legs that worsens with standing and walking and improves when you sit or lean forward.
You will be asked about flare-ups, incapacitating episodes, and whether you have had epidural injections, nerve blocks, or surgical decompression.
Walking tolerance will be assessed — the examiner needs to know how far you can walk before neurological symptoms force you to stop.

What the examiner is actually filling in

01Spine range of motion with pain onset documented in degrees.
02Neurological findings: specific nerve root involvement, dermatomal sensory loss, motor weakness, reflex changes.
03Walking tolerance and presence of neurogenic claudication.
04Additional functional loss after repetitive use and during flare-ups (DeLuca factors).
05Whether stenosis has caused bowel or bladder dysfunction — this can warrant a separate rating or elevate the spine rating.

Rated under 38 CFR 4.71a, DC 5238. The examiner records findings on the DBQ; a rating specialist makes the decision.

A complete answer sounds like

If the examiner asks you to walk, walk until your symptoms start — do not push through. The point where symptoms force you to stop is the clinically relevant measurement.
Describe the difference between your spine pain and your neurological symptoms separately: "My back aches constantly, but the real problem is that my legs go numb after 5 minutes of walking."
Mention if you use a shopping cart, cane, or walker specifically because leaning forward relieves the stenosis symptoms — this is a classic sign the examiner should document.
If you have had surgery and symptoms have returned or worsened (failed back surgery syndrome), explain the timeline clearly — recurrence after decompression indicates ongoing disease.
Report any changes in balance or coordination. Cervical stenosis can cause myelopathy (spinal cord compression) which affects walking stability and fine motor skills in the hands.

What costs veterans points

Not explaining neurogenic claudication clearly. "My legs get heavy and numb after walking one block and I have to sit down for 5 minutes" is exactly what the examiner needs to hear.
Forgetting that radiculopathy from stenosis can be rated separately from the spine condition — make sure you describe leg or arm symptoms distinctly.
Not mentioning bladder or bowel changes (urgency, frequency, difficulty initiating) that can result from severe stenosis — these are important red-flag symptoms.
Sitting comfortably during the exam without mentioning that sitting is the only position that relieves your symptoms — this positional relief pattern is diagnostically significant.
Not reporting that you can no longer stand for prolonged periods at work or in daily life — functional standing tolerance directly affects occupational impairment.

The rating criteria, in plain language

Rating levels for Spinal Stenosis under 38 CFR 4.71a, DC 5238
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 spinal stenosis 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 the combined range of motion is greater than 120 degrees but not greater than 235 degrees, or you have muscle spasm or guarding not resulting in 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 MRI or CT showing spinal stenosis
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 the combined range of motion is not greater than 120 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 Imaging confirming spinal stenosis
30%	Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine.	Your forward flexion of the cervical spine is 15 degrees or less, or you have favorable ankylosis of the entire cervical spine. This rating applies to cervical spinal stenosis.
30%	What supports this level Forward flexion of cervical spine 15 degrees or less Favorable ankylosis of entire cervical spine Severe cervical stenosis on imaging Significant nerve compression documented
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 stenosis with significant nerve compression Major functional limitation documented
50%	Unfavorable ankylosis of the entire thoracolumbar spine.	You have unfavorable ankylosis of the entire thoracolumbar spine. Your thoracolumbar spine is fixed in an abnormal position.
50%	What supports this level Unfavorable ankylosis of entire thoracolumbar spine Spine fixed in abnormal position Severe functional impairment Inability to bend or twist the trunk
100%	Unfavorable ankylosis of the entire spine.	You have unfavorable ankylosis of the entire spine. Both your cervical and thoracolumbar 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 Severe impact on all daily activities

The middle column is our transcription of the criteria at 38 CFR 4.71a, DC 5238, 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 filing for radiculopathy (nerve pain in the arms or legs) separately — spinal stenosis often compresses nerves, and radiculopathy is rated under separate neurological codes in addition to the spine rating.

Not getting an MRI to document the stenosis — MRI or CT imaging showing the narrowing and nerve compression is critical evidence.

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

Not understanding that spinal stenosis can affect either the cervical or thoracolumbar spine — if both are affected, they should be rated separately.

Not filing for secondary conditions — stenosis commonly causes bladder problems, bowel issues, and sexual dysfunction that may warrant separate ratings.

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.

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

Spinal Stenosis

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

What supports this level

Mistakes we see most often

Before & after your exam

Spinal Stenosis

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

What supports this level

Mistakes we see most often

Before & after your exam