Neck Pain VA Rating

Neck pain has no rating of its own. VA rates the diagnosed neck condition, such as cervical strain, degenerative arthritis or a herniated disc, under the same General Rating Formula in 38 CFR § 4.71a that covers the low back. The neck gets its own angles because normal cervical forward flexion is 45 degrees, not 90, and its own ladder of 10, 20, 30, 40 and 100 percent. VA's fiscal year 2024 Annual Benefits Report counts 1,611,188 ratings for lumbosacral or cervical strain, the code that covers both neck and low back strain, which makes it the fourth most common service-connected disability.

The biggest difference from the low back is what sits downstream. A herniated disc in the neck can press on a nerve root, and nerve findings in the arms are rated separately under DC 8510 through DC 8513, one rating per arm. This page covers the cervical formula, flare-ups and repeated use, disc disease, the exam, the common denial reasons and that radiculopathy chain.

TL;DR

• 24,251 decided Board rulings on cervical spine claims from 2021 to 2026: 20.5% were granted, 26.2% denied and 53.3% remanded. Remand is the most common outcome.
• The neck is rated under the General Rating Formula for Diseases and Injuries of the Spine in 38 CFR § 4.71a, DC 5235 through DC 5243, the same codes as the low back.
• Forward flexion thresholds: 10% above 30 and up to 40 degrees, 20% above 15 and up to 30 degrees, 30% at 15 degrees or less. 40% requires unfavorable ankylosis of the entire cervical spine and 100% unfavorable ankylosis of the entire spine.
• Unlike the low back, the neck has a 30 percent level.
• The exam has to account for pain, repeated use and flare-ups (DeLuca, Correia and Sharp).
• A herniated disc pressing on a nerve root (DC 5243) can be rated on incapacitating episodes, which require bed rest prescribed by a physician.
• Arm radiculopathy is rated separately for each arm under DC 8510 through DC 8513, with a higher percentage for the dominant arm at most levels.

Neck pain VA rating criteria under 38 CFR 4.71a

VA rates the diagnosis, not the pain level. The General Rating Formula applies "with or without symptoms such as pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease." Here are the parts of the formula that cover the neck, quoted from the Electronic Code of Federal Regulations (eCFR) in October 2026, with the rating after each level; [...] marks low back wording I left out.

Unfavorable ankylosis of the entire spine: 100

Unfavorable ankylosis of the entire cervical spine; [...]: 40

Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine: 30

[...] 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: 20

[...] 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: 10

The notes under the formula that matter most for the neck read as follows.

Note (1): Evaluate any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, separately, under an appropriate diagnostic code.

Note (2): (See also Plate V.) For VA compensation purposes, normal forward flexion of the cervical spine is zero to 45 degrees, extension is zero to 45 degrees, left and right lateral flexion are zero to 45 degrees, and left and right lateral rotation are zero to 80 degrees. [...] The combined range of motion refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. The normal combined range of motion of the cervical spine is 340 degrees [...].

Note (4): Round each range of motion measurement to the nearest five degrees.

Note (5): For VA compensation purposes, unfavorable ankylosis is a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching. Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis.

Note (6): Separately evaluate disability of the thoracolumbar and cervical spine segments, except when there is unfavorable ankylosis of both segments, which will be rated as a single disability.

Note (3), not quoted here, lets an examiner treat a smaller range as normal for you because of age, body habitus, neurologic disease or other factors not caused by the spine, as long as the examiner explains why.

Which diagnostic code applies

Neck diagnoses use the same codes as the low back, and whatever the code, the percentage comes from the formula. Cervical strain is DC 5237, "lumbosacral or cervical strain." Cervical spinal stenosis is DC 5238. Degenerative arthritis of the neck, which imaging reports may call cervical spondylosis, and degenerative disc disease other than intervertebral disc syndrome are DC 5242. A herniated disc with nerve root compression or irritation is DC 5243. Cervicalgia is a medical word for neck pain, not a diagnostic code; the rating follows the underlying diagnosis.

VA rating chart for neck range of motion

Under Note (2), normal neck motion is 45 degrees of forward flexion, 45 of extension, 45 of lateral flexion each way and 80 of rotation each way, 340 degrees combined. Here is the ladder with the monthly payment for a veteran with no dependents at the rates effective December 1, 2025 (the 2026 rates).

• 10 percent ($180.42): forward flexion above 30 and up to 40 degrees, combined motion above 170 and up to 335 degrees, or the spasm, tenderness or fracture findings in the formula.
• 20 percent ($356.66): forward flexion above 15 and up to 30 degrees, combined motion of 170 degrees or less, or spasm or guarding that causes an abnormal gait or spinal contour.
• 30 percent ($552.47): forward flexion of 15 degrees or less, or favorable ankylosis of the entire cervical spine.
• 40 percent ($795.84): unfavorable ankylosis of the entire cervical spine.
• 100 percent ($3,938.58): unfavorable ankylosis of the entire spine.

10 percent: forward flexion 40 degrees or less

Rounding to the nearest five degrees means a reading of 42 counts as 40. Combined motion is the sum of all six motions, so lost rotation can reach the 10 percent level even when forward flexion looks fine: anything at or below 335 degrees, against a normal 340, qualifies. A healed compression fracture with loss of 50 percent or more of the vertebral height also rates 10 percent after motion returns, if the imaging is in your file.

20 percent: spasm, guarding or 30 degrees

The spasm trigger is something the examiner sees: spasm or guarding "severe enough to result in an abnormal gait or abnormal spinal contour," such as reversed lordosis. A reversed curve on an X-ray is not enough by itself, because the formula ties the contour to spasm or guarding. If your examiner finds both, ask that both be written down.

30 percent: forward flexion 15 degrees or less

Fifteen degrees is one third of the neck's 45-degree normal range: you can tip your chin toward your chest only a third of the way. Favorable ankylosis of the entire cervical spine also rates 30 percent, and a neck fixed in neutral position always counts as favorable.

40 and 100 percent: unfavorable ankylosis

Unfavorable ankylosis means the entire cervical spine is fixed in flexion or extension and causes at least one problem Note (5) lists. Several are neck-specific: restricted opening of the mouth and chewing, dyspnea or dysphagia (trouble breathing or swallowing), and atlantoaxial or cervical subluxation or dislocation. 100 percent requires unfavorable ankylosis of the entire spine. Both are rare.

Pain, flare-ups and repeated use

The first measurement is not the whole rating picture for the neck either. Three regulations and three decisions of the Court of Appeals for Veterans Claims set what the exam has to capture.

38 CFR § 4.40 says functional loss "may be due to pain, supported by adequate pathology and evidenced by the visible behavior of the claimant undertaking the motion."

38 CFR § 4.45 directs the rater to weakened movement, excess fatigability, incoordination and pain on movement, among other factors, and treats the cervical vertebrae as a group of minor joints.

38 CFR § 4.59 ends with a testing instruction: "The joints involved should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint."

DeLuca v. Brown, 8 Vet. App. 202 (1995). As the Court later summarized it, a joints exam that fails to consider the §§ 4.40 and 4.45 factors is inadequate, and the examiner's view on whether pain could significantly limit function should, if feasible, be stated as the added range-of-motion loss due to pain on use or during flare-ups.

Correia v. McDonald, 28 Vet. App. 158 (2016). In a knee case, the Court held that the last sentence of § 4.59 is a requirement: the exam must include that testing whenever it can be done, and medical professionals decide whether a given test can be performed. The Court read "if possible" as applying only to the opposite-joint comparison, presumably to account for joints that have no opposite. The neck has none.

Sharp v. Shulkin, 29 Vet. App. 26 (2017). When the exam does not happen during a flare, the examiner has to ask about your flares (how often, how long, how severe and what you lose during them) and estimate the added loss from all the evidence, including what you report, or explain why that cannot be done. The examiner and the Board do not have to accept flare reports that conflict with other reliable evidence.

Here is how that plays out. Suppose your first forward bend measures 35 degrees, the 10 percent range, and after repeated motion pain stops you at 28. Rounded to 30, that falls in the 20 percent range, and an exam that records it gives the rater a basis for 20 percent. An exam that writes "no additional limitation after repeated use" without showing the repeated testing, or declines a flare estimate without asking about your flares, leaves the gap these rules address.

Cervical disc disease and incapacitating episodes

DC 5243, intervertebral disc syndrome, is assigned "only when there is disc herniation with compression and/or irritation of the adjacent nerve root; assign diagnostic code 5242 for all other disc diagnoses." For that herniated disc, VA uses the General Rating Formula or the incapacitating episodes formula, "whichever method results in the higher evaluation when all disabilities are combined under § 4.25."

The incapacitating episodes formula pays 10 percent for a total of at least one week in the past 12 months, 20 percent for at least two weeks, 40 percent for at least four weeks and 60 percent for at least six weeks. Its Note (1) sets the definition: "an incapacitating episode is a period of acute signs and symptoms due to intervertebral disc syndrome that requires bed rest prescribed by a physician and treatment by a physician."

Days you rest on your own do not count, however bad the flare. If a flare does lead a physician to prescribe bed rest, make sure the note records the prescription, the treatment and the dates. If you have disc syndrome in both the neck and the low back with clearly distinct effects, that formula's Note (2) evaluates each segment on whichever method is higher for it. The low back page covers the full formula.

How to prove a neck condition is service connected

Direct service connection means the evidence shows your neck condition was incurred in service (38 CFR § 3.303). In practice that takes three things.

• A current diagnosis. A named diagnosis such as cervical strain, degenerative arthritis or a herniated disc, with the X-ray or MRI behind it, gives the examiner something concrete to rate and to link.
• An injury or event in service. Service treatment records for a vehicle accident, a training fall, a hard parachute landing or sick call visits for neck pain. When the records are thin, buddy statements and your own personal statement fill in what happened and how the pain has gone since.
• A medical link. An opinion that the neck condition is at least as likely as not related to the in-service injury, with reasons, including why aging or a later job is not the better explanation. Nexus letters covers what the opinion needs.

Arthritis is on VA's list of chronic diseases (38 CFR § 3.309(a)). If degenerative arthritis of the neck shows up to a degree of 10 percent or more within one year after separation, and you served 90 days or more of continuous active service (38 CFR § 3.307), VA presumes it is service connected. A neck condition caused or worsened by another service-connected condition, such as a fall caused by a service-connected knee, can be claimed as a secondary condition under 38 CFR § 3.310.

The neck C&P exam

The neck DBQ guide walks through the questionnaire. Ask the examiner to record these findings.

• All six motions (forward flexion, extension, both lateral flexions and both rotations), with the point where pain begins, not only where motion stops.
• Pain on active and passive motion, in weight-bearing and nonweight-bearing, as § 4.59 and Correia call for.
• Motion after repeated use, and whether pain, weakness, fatigability or incoordination reduced it.
• Your flares: how often, how long, what triggers them and what you cannot do during one, with an estimate of the added loss, as Sharp requires.
• Any spasm, guarding, abnormal gait or abnormal spinal contour.
• A nerve check of both arms (strength, reflexes and sensation), and which hand is dominant, since arm radiculopathy ratings depend on it.
• For a herniated disc, any physician-prescribed bed rest in the past 12 months, with dates.

Physical therapy notes with measured motion, imaging reports and a symptom tracker log of your flares give the examiner the pattern over time. C&P exam prep helps you describe your limits without minimizing or exaggerating.

Why VA denies neck claims

Neck claims fail, or get rated lower than the record supports, for a few repeat reasons. The Board section below shows how the Board ruled on these appeals.

No in-service injury on record. The neck condition is documented now, but nothing places its start in service. The fix: service treatment records, buddy statements and a personal statement on when the pain began.

The opinion blamed age or wear and tear. A bare "degenerative" conclusion leaves the in-service injury unaddressed. The fix: a private opinion that takes the in-service event, the symptom history and each competing explanation in turn.

The exam skipped repeated use or flares. The fix: ask for a new exam citing §§ 4.40, 4.45 and 4.59, DeLuca, Correia and Sharp.

Arm symptoms never rated. Numbness, tingling or weakness in an arm was noted but not evaluated. The fix: a nerve exam, nerve conduction or EMG testing if your doctor orders it, and a claim for radiculopathy in each affected arm.

Dominant hand not recorded. The arm codes pay more for the dominant arm. The fix: make sure the record states which hand you use for writing and eating.

Disc episodes not counted. The flares were real, but no physician prescribed bed rest. The fix: document future flares with the prescription, treatment and dates.

Cervical radiculopathy and other secondary claims

Note (1) to the spine formula says to rate objective nerve findings separately, and for the neck that usually means the arms. VA rates arm radiculopathy under the radicular group codes in 38 CFR § 4.124a, one rating per arm. Most levels carry two percentages: "major" for your dominant arm and "minor" for the other. Under 38 CFR § 4.69, handedness "will be determined by the evidence of record, or by testing on VA examination," and only one hand is considered dominant.

Here are the four radicular group codes as eCFR states them, written as major / minor.

• DC 8510, upper radicular group (fifth and sixth cervicals). Complete paralysis, "all shoulder and elbow movements lost or severely affected, hand and wrist movements not affected": 70 / 60. Incomplete: severe 50 / 40, moderate 40 / 30, mild 20 / 20.
• DC 8511, middle radicular group. Complete paralysis, "adduction, abduction and rotation of arm, flexion of elbow, and extension of wrist lost or severely affected": 70 / 60. Incomplete: severe 50 / 40, moderate 40 / 30, mild 20 / 20.
• DC 8512, lower radicular group. Complete paralysis, "all intrinsic muscles of hand, and some or all of flexors of wrist and fingers, paralyzed (substantial loss of use of hand)": 70 / 60. Incomplete: severe 50 / 40, moderate 40 / 30, mild 20 / 20.
• DC 8513, all radicular groups. Complete paralysis: 90 / 80. Incomplete: severe 70 / 60, moderate 40 / 30, mild 20 / 20.

Two rules in § 4.124a shape the grade. "When the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree," so numbness or tingling alone tops out at moderate and a higher grade needs findings beyond sensation, such as weakness. And the ratings are for one side; "when bilateral, combine with application of the bilateral factor" (38 CFR § 4.26).

Here is a worked example with the neck at 20 percent and mild radiculopathy in both arms at 20 percent each. The arms combine to 36; adding the 10 percent bilateral factor (3.6) gives 39.6, which counts as 40. Then 40 and 20 combine to 52 under 38 CFR § 4.25, which rounds to 50 percent. For a veteran with no dependents, that is $1,132.90 a month against $356.66 for the neck alone.

The neck and shoulder overlap. DC 8510 covers the fifth and sixth cervical nerve roots, and complete paralysis of that group affects "all shoulder and elbow movements," so shoulder weakness that comes from the neck is rated as radiculopathy rather than under the shoulder joint codes. Other conditions can be secondary to a service-connected neck under 38 CFR § 3.310, either caused by it or aggravated by it, meaning the condition would be less severe but for the neck (M21-1 V.ii.2.D). VA rates only the part above the baseline (the current level minus a baseline shown by medical evidence), so the opinion should describe the baseline; VA's current manual no longer subtracts natural progress in these claims, even though the text of § 3.310(b) still mentions it, and the worsening does not have to be permanent. An opinion that addresses only causation and not aggravation is inadequate (El-Amin v. Shinseki, 26 Vet. App. 136 (2013)). Radiculopathy covers the nerve exam and grades in full.

Questions veterans ask about neck pain

What is the VA rating for neck pain?

It depends on your measured motion and exam findings, not the pain itself: 10 percent at forward flexion of 40 degrees or less, 20 percent at 30 or less, and 30 percent at 15 or less. Arm radiculopathy from the neck is rated separately.

What is the VA rating for cervical radiculopathy?

Each affected arm is rated under DC 8510 through DC 8513. Mild incomplete paralysis is 20 percent for either arm, and the higher grades pay more for the dominant arm, up to 70 percent for complete paralysis of one radicular group.

What is the VA diagnostic code for cervical strain?

DC 5237, "lumbosacral or cervical strain." It is rated on the General Rating Formula like every other spine code.

Is cervical stenosis rated differently from other neck conditions?

No. Spinal stenosis is DC 5238 and uses the same formula and the same motion thresholds. Any nerve findings it causes, in the arms or elsewhere, are rated separately under Note (1).

Does reversal of the cervical lordosis raise my rating?

Only when the examiner ties it to muscle spasm or guarding. The 20 percent level covers spasm or guarding "severe enough to result in an abnormal gait or abnormal spinal contour," and reversed lordosis is one of the contours the formula names.

Are the neck and low back rated separately?

Yes. Note (6) says to evaluate the cervical and thoracolumbar segments separately unless both have unfavorable ankylosis, and the two ratings combine under 38 CFR § 4.25.

Bottom Line

The neck is rated under the same General Rating Formula as the low back, scaled to a 45-degree normal flexion: 10 percent at 40 degrees or less, 20 at 30 or less, 30 at 15 or less, and 40 for unfavorable ankylosis of the entire cervical spine. Pain, repeated use and flare-ups can move a measurement into a higher level when the exam records them, and DeLuca, Correia and Sharp set what a complete exam includes. A herniated disc pressing on a nerve root opens the incapacitating episodes path, but only with physician-prescribed bed rest. The largest gains usually come from arm radiculopathy under DC 8510 through DC 8513, rated for each arm, with a higher percentage for the dominant arm at most levels.

Methodology and Limitations

• Data source: Rating criteria are quoted from 38 CFR § 4.71a (the General Rating Formula for Diseases and Injuries of the Spine and the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes) and 38 CFR § 4.124a, DC 8510 through DC 8513, as published in eCFR, retrieved October 6, 2026. Functional loss rules are from 38 CFR §§ 4.40, 4.45 and 4.59, DeLuca v. Brown, 8 Vet. App. 202 (1995), Correia v. McDonald, 28 Vet. App. 158 (2016), and Sharp v. Shulkin, 29 Vet. App. 26 (2017). Dominance follows 38 CFR § 4.69; combined rating math follows 38 CFR §§ 4.25 and 4.26. Service connection rules are from 38 CFR §§ 3.303, 3.307, 3.309 and 3.310 and M21-1 V.ii.2.D (change date May 1, 2026). Disability counts are from VA's fiscal year 2024 Annual Benefits Report. Board figures come from Claim Raven's read of every Board decision from 2021 to 2026 that it holds: 511,036 decisions containing 1,378,030 rulings.
• Sample size: 26,223 Board rulings on cervical spine claims from 2021 to 2026. Of those, 24,251 were decided (granted, denied or remanded) and 1,972 were dismissed or withdrawn. The grant rate is granted rulings divided by decided rulings: 20.5 percent. Denial-reason splits and rating-tier distributions are not part of this read, so this page gives no figures for them.
• Limitations: The dataset captures BVA-level decisions. Cervical claims granted at the regional office without appeal are not in the sample. Application of the functional loss rules still varies with the examiner's documentation, and Correia was decided on knees; this page states its holding as the Court wrote it. The 1,611,188 count is for lumbosacral or cervical strain together and counts disabilities rather than veterans. Radiculopathy grades (mild, moderate, severe) involve clinical judgment that varies across examiners. These observations describe BVA patterns and are not predictions of individual outcomes. Claim Raven is data analysis, not legal, medical, or VA-accredited advice. If you need help with a cervical spine claim, work with an accredited representative.