Neck Impairments: What Qualifies?

The physically demanding work associated with many positions in the U.S. Armed Forces puts veterans at increased risk for developing musculoskeletal issues in the neck and cervical spine. If you are experiencing any issues with your neck or cervical spine that you believe may be due to your military service, it is important to contact your doctor right away so he or she can record your symptoms and assign you the proper diagnosis for your condition. Orthopedic conditions affecting the neck are compensated differently depending on the degree of disability and the location of the injury, so seeking treatment with an orthopedic specialist may also be an effective plan of action to ensure that you are getting the most accurate information possible in your medical record. In addition, obtaining the proper diagnosis for your pain is important to ensure that you are receiving the best possible treatment. 

While many veterans with neck conditions also have lower spine issues, for the purposes of calculating a veteran’s total disability rating, back and neck impairments are treated as separated disabilities. The only exception to this rule is a diagnosis of unfavorable ankylosis of both segments, which is treated as a single condition. If you do not have unfavorable ankylosis of both segments, there are a number of other neck conditions which are subject to compensation under the VA’s disability rating system:

-Mechanical cervical pain syndrome

-Cervical sprain/strain

-Cervical spondylosis (degenerative joint disease of cervical spine, also called neck arthritis)

-Degenerative disc disease

-Foraminal stenosis/central stenosis

-Intervertebral disc syndrome

-Radiculopathy (often occurs as a secondary condition to another impairment)

-Ankylosis of the cervical spine

-Myelopathy

-Ankylosing spondylitis of the cervical spine (neck)

-Vertebral fracture (vertebrae of the neck)

Other neck conditions may also be subject to compensation, which is why it is important that you talk to both your treating physician and your VA examiner extensively about your symptoms, service history, and medical history. The more information you provide, the more likely it is that you will receive the correct diagnosis and VA disability rating. 

Getting Service Connected for Neck Impairments: What Evidence is Necessary

If your neck pain began in service or was made worse by your military service, you may be eligible for service connection and VA disability benefits. To prove service connection for your neck condition, you will need to start by gathering information to submit to the VA. This information should include your service medical records, military personnel files (especially anything that may mention an in-service accident, diagnosis, or change of duty due to neck issues), private medical records, and any other documents that could help establish a correlation between your military service and your neck condition. Sworn declarations from those familiar with your neck condition are also helpful, including those from family members, friends, and fellow servicemembers.

As is evident from the rating schedules below, the highest possible schedular rating for any single neck impairment is 60 percent for veterans with severe intervertebral disc syndrome (IVDS). Other neck conditions have maximum schedular ratings of 40 percent or lower. However, the pain and mobility limitations caused by severe neck conditions prevent many veterans from performing even sedentary or light work. This is especially true for veterans who may have other service-connected disabilities that are related to their neck condition(s), such as cervicogenic headaches or mental health conditions. 

If you are unable to work due to your neck condition, getting the maximum monthly benefit will usually require seeking a total disability based on unemployability rating (TDIU rating). In order to obtain a TDIU rating, you will need other evidence in addition to the medical records and service records described above. Most likely, you will also need statements from vocational experts, information from your previous employers, and other documentation clarifying the effects of your neck condition on your occupational functioning. 

How the VA Rates Neck Impairments

Neck muscle injuries

Under 38 CFR § 4.73, injuries to neck muscles are compensated differently depending on the severity of the impairment and the muscles affected.

  • Diagnostic Code 5320, Muscle Group XX

Function: Postural support of body; extension and lateral movements of spine. Spinal muscles: Sacrospinalis (erector spinae and its prolongations in thoracic and cervical regions). Cervical and thoracic region:

  • Severe: 40%
  • Moderately Severe: 20%
  • Moderate: 10%
  • Slight: 0%
  • Diagnostic Code 5322, Muscle Group XXII

Function: Rotary and forward movements of the head; respiration; deglutition (swallowing). Muscles of the front of the neck: (Lateral, supra-, and infrahyoid group.) (1) Trapezius I (clavicular insertion); (2) sternocleidomastoid; (3) the “hyoid” muscles; (4) sternothyroid; (5) digastric.

  • Severe: 30%
  • Moderately Severe: 20%
  • Moderate: 10%
  • Slight: 0%
  • Diagnostic Code 5323, Muscle Group XXIII

Function: Movements of the head; fixation of shoulder movements.

Muscles of the side and back of the neck: Suboccipital; lateral vertebral and anterior vertebral muscles.

  • Severe: 30%
  • Moderately Severe: 20%
  • Moderate: 10%
  • Slight: 0%
Musculoskeletal Neck Conditions

Under 38 CFR § 4.71a, conditions affecting the cervical spine such as fractures, cervical strain, spinal stenosis, ankylosing spondylitis, and spinal fusion are usually evaluated using the General Rating Formula for Diseases and Injuries of the Spine: 

  • Diagnostic Codes 5235 to 5243
  • Unfavorable ankylosis of the entire spine: 100%
  • Unfavorable ankylosis of the entire thoracolumbar spine: 50%
  • Unfavorable ankylosis of the entire cervical spine; or, forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar 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 thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 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 thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, forward flexion of the cervical spine greater than 30 degrees but not greater than 40 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 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 exception to the above rating schedule is intervertebral disc syndrome (IVDS). IVDS can be evaluated using either the General Rating Formula for Diseases and Injuries of the Spine or the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes (see below). For rating purposes, the VA is required to use whichever scale yields the highest combined rating for the veteran when their disabilities are evaluated together.

Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes
  • Diagnostic Code 5423
  • With incapacitating episodes having a total duration of at least 6 weeks during the past 12 months: 60%
  • With incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months: 40%
  • With incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months: 20%
  • With incapacitating episodes having a total duration of at least one week but less than 2 weeks during the past 12 months: 10%

Making Your Claim as Strong As Possible

The most important information you can include in your claim for service connection of your neck condition are medical records. Ideally, these records will include documents (1) diagnosing you with a neck condition that began in service or was made worse during your military service and (2) specifying the severity of the condition. These documents are important because you will likely be sent to a Compensation and Pension (C&P) examination by the VA to assess the severity of your neck condition, and having favorable medical records already in your file increases the likelihood that the C&P examiner will simply agree with the findings of your treating doctor and issue a favorable report. However, sometimes the C&P exam may not contain supportive findings, in which case having favorable medical records in your file is still helpful because they could cast doubt on the results of the C&P exam.

When attending a C&P exam, you want to be aware that the doctors conducting the assessment are contracted by the VA. This means that these doctors are being underpaid and overworked and are thus incentivized to rush you through the exam. Because of this, when the doctor asks you a question, you want to answer honestly and quickly and make sure that they heard what you said. If you do not think the doctor was paying attention when you were describing the severity of your neck mobility issues, tell him or her again. In these situations, you want to be your own advocate and make sure that the doctor has as much information as possible when writing his or her report. That being said, make sure you do not understate or exaggerate the severity of your condition. The more frank you are about your symptoms, the more likely it is that you will get an accurate schedular rating for your neck impairment. 

Contact the Veterans Law Office About Your Neck Impairments Claim

If you are looking to obtain service connection for your neck impairment or are hoping to increase your schedular rating for your existing service-connected neck condition, please do not hesitate to contact our office at the phone number or Free Case Evaluation link above. Our veterans attorneys have ample experience obtaining service connection for veterans with neck impairments.