Spondylolisthesis or segmental instability
38 CFR § 4.71a — Musculoskeletal system
Rated under the General Rating Formula for the spine (codes 5235–5243) unless IVDS is separately evaluated under the episode method.
Diagnostic code
5239
DC 5239 applies to spondylolisthesis or segmental instability. As with other spine diagnostic codes in this range, the VA typically applies the General Rating Formula to place the disability on the percentage scale.
Imaging showing slippage or motion on flexion/extension films may support the diagnosis, but the rating still depends on measured range of motion, functional loss, and other schedule criteria—plus any separate nerve evaluations when documented.
Official VA rating criteria — General Rating Formula for Diseases and Injuries of the Spine
Live 38 CFR § 4.71a General Rating Formula (current as of 8/27/2026). There is no 30% evaluation for thoracolumbar flexion. The 30% row in this formula is cervical-only: forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine. Unfavorable ankylosis of the entire thoracolumbar spine is 50%, not 40%. This formula has no 0% row.
| Rating | VA criteria (eCFR text) | Segment |
|---|---|---|
| 100% | Unfavorable ankylosis of the entire spine. | Entire spine. |
| 50% | Unfavorable ankylosis of the entire thoracolumbar spine. | Thoracolumbar. |
| 40% | 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. | Thoracolumbar flexion ≤30° or favorable entire-thoracolumbar ankylosis. Unfavorable entire-thoracolumbar ankylosis is 50%. |
| 30% | Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine. | Cervical-only. Not a thoracolumbar flexion band. |
| 20% | 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. | Thoracolumbar flexion >30° not >60° is 20%, not 30%. |
| 10% | 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. | Thoracolumbar flexion >60° not >85° is 10%. |
Source: 38 CFR § 4.71a — https://www.ecfr.gov/current/title-38/chapter-I/part-4/subpart-B/subject-group-ECFRd3005f7d828ea7b/section-4.71a (current as of 8/27/2026).
Service connection — common paths
Direct service connection
An in-service injury or illness (lifting, falls, MVAs, blast, etc.) with evidence of a current chronic spine disability may support direct service connection when the record ties them under VA’s standard of proof.
Secondary service connection
A service-connected condition elsewhere (for example knee, ankle, or foot) can theoretically contribute to or aggravate a spine condition when competent medical evidence supports that relationship.
Secondary conditions sometimes pursued with Spondylolisthesis or segmental instability
The list below describes common secondary claim theories discussed with accredited representatives—not automatic benefits. Whether a secondary is granted depends on evidence, including medical nexus opinions where needed.
Often argued when imaging or exams suggest nerve-root involvement with leg symptoms; requires medical evidence linking radicular signs to the spine.
May be raised when providers document neurologic or medication-related links; highly fact-specific.
Chronic pain can factor into mental-health claims; mental disorders are rated on their own criteria under § 4.130.
Some veterans connect pain, weight change, or sleep fragmentation; apnea needs its own medical theory of causation.
Altered gait or compensation is sometimes argued as contributing to lower-extremity conditions; opinions and records matter.
“Commonly discussed,” “Sometimes discussed,” and “Less often discussed” describe how often these theories appear in educational materials. They are not a prediction of approval. Use accredited help for your specific file.
Already service-connected for something else?
If you are already service-connected for a lower-body condition, a spine disability may be claimed as secondary when competent medical evidence supports aggravation or causation (not automatic).
Altered gait from knee disability is a common secondary theory for back symptoms.
Biomechanical alignment issues may be argued as aggravating lumbar strain.
Hip pathology can change posture and loading on the spine when medically supported.
Limping or instability may be tied to compensatory back stress in some records.
Catalog source snapshot:
Rating criteria (38 CFR Part 4)
Diagnostic code 5239 — Spondylolisthesis or segmental instability — is listed under 38 CFR § 4.71a in 38 CFR Part 4. The paragraphs below summarize how this code is used; the official schedule text controls exact percentages, formulas, and notes.
Schedule summary (educational, not a substitute for the regulation): Rated under the General Rating Formula for the spine; neurologic impairment may be rated separately under appropriate nerve codes.
Exact rating criteria: Open Part 4 in the eCFR (link under “Official source” below). Locate your diagnostic code number (5239) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “5239”. Copy the verbatim rating table, including any parenthetical notes, exceptions, and cross-references, for the version of Part 4 that applies to your effective date.
Effective dates & which schedule version applies
Which diagnostic code, percentage, and effective date apply depends on the facts of your claim and the version of the rating schedule in force for the period being decided. Generally, VA applies the schedule in effect at the specified time under 38 U.S.C. § 5110 and implementing rules, subject to exceptions (e.g., protected ratings, liberalizing law changes—see regulation and VA manual policy as applicable).
For older claims, the **current** eCFR may not match the text that applied years ago. If your decision references a prior percentage or code, compare against the Part 4 text **as of** your claim’s relevant dates; historical Federal Register / CFR snapshots may be needed for precise comparison.
The “Last verified” date on this page is when we last checked this educational summary against the electronic CFR—not the date of any VA policy or your personal claim decision.
Notes for your claim
Evidence: Show that your diagnosis and severity match the factors the schedule names for DC 5239 (e.g., measurements, frequency, treatment, functional loss), with medical and lay evidence as appropriate.
C&P exams: Results should reflect the schedule’s requirements (correct joints measured, correct formulas). If the exam omits required findings, consider submitting records or requesting clarification.
If you disagree with the DC, percentage, or effective date, review the Part 4 text for your period and consider a supplemental claim or appeal with a VA-accredited representative.
This site does not provide legal advice.
Official source
38 CFR Part 4 (eCFR) — locate diagnostic code 5239 in the subpart for your body system (use Find in Page if needed).
Discuss how your evidence fits DC 5239 with a VA-accredited representative. Quick search: DC code lookup.
⚠️ Important Disclaimer
This page provides general educational information based on public VA regulations and VA.gov resources. It is not legal or medical advice, and My Claim Packet is not a VA-accredited representative. Any worksheets or draft documents produced by the tools must be reviewed for accuracy and are not filed with VA for you. Ratings and service connection are decided case-by-case from the individual record. Consult a VA-accredited VSO, claims agent, attorney, or qualified clinician for help with your situation, and verify current rules using the linked official source.