Cervical Strain VA Rating Guide for Veterans with Neck Pain

Neck pain is one of the most common musculoskeletal issues among veterans, often caused by years of physical strain, heavy gear, and repetitive motion. A cervical strain (an injury to the muscles or soft tissue of the neck) can lead to chronic pain, stiffness, and limited range of motion that impacts daily life. 

If your cervical strain is connected to your military service, you may qualify for VA disability compensation. The cervical strain VA rating ranges from 10% to 100%, depending on the severity of your symptoms, range of motion, and evidence of ankylosis. 

In this guide, we’ll explain how the VA rates cervical strain, what factors influence your rating, and how high-quality medical evidence (like a DBQ or nexus letter) can strengthen your VA disability claim. 

Key Takeaways

• The cervical strain VA rating ranges from 10% to 100%, depending on factors such as range of motion, ankylosis, and other spine-specific criteria. 

• In addition to a physical exam, a cervical strain C&P exam may include imaging tests such as X-rays, an MRI, or a CAT scan.  

• Secondary conditions to cervical strain include chronic headaches and radiculopathy (pinched or compressed nerves); these secondary claims can increase your rating with the right medical evidence. 

What is a Cervical Strain?

A cervical strain is an injury to the neck muscles caused by being twisted or bent in an unnatural or abnormal way. 

According to the American Academy of Orthopaedic Surgeons, symptoms from a mild to severe neck injury may not manifest until hours after the injuring event, sometimes not until the next day.  

Symptoms

• Pain, especially in the back of the neck, that worsens with movement 

• Pain that peaks a day or so after the injury, instead of immediately 

• Muscle spasms and pain in the upper shoulder 

• Headache in the back of the head 

• Increased irritability, fatigue, difficulty sleeping, and difficulty concentrating 

• Numbness in the arm or hand 

• Neck stiffness or decreased range of motion (side to side, up and down, and/or circular) 

• Tingling or weakness in the arms 

How the VA Rates Cervical Strain

Cervical strain VA ratings range from 10% to 100%, depending on the factors such as range of motion, ankylosis, and other spine-specific criteria.   

As with cervicalgia VA ratings (general neck pain), cervical strains fall under § 4.71a Schedule of ratings—musculoskeletal system and the General Rating Formula for Diseases and Injuries of the Spine. Cervical strain specifically uses Diagnostic Code (DC) 5237, Lumbosacral or cervical strain, rated with or without symptoms such as pain (whether or not it radiates), stiffness, or aching. 

Ankylosis and Range of Motion Assessment

The VA assigns disability ratings based on various factors, but there are two important terms we want to highlight:  

• “Ankylosis” refers to the stiffness or immobility of a joint and is referred to in cervical strain ratings of 30% and higher. 

• A range of motion (ROM) assessment provides information on how movement is allowed or limited in your cervical spine. ROM can be assessed through various methods, but each evaluates the following movements: 

• Forward flexion: How far you can bend your neck forward.  

• Extension: How far you can bend your neck backward.  

• Lateral flexion: How far you can tilt your neck to the right or left. 

• Lateral rotation: How far you can turn your neck to the right or left. 

Cervical Strain VA Rating Criteria and Explanations

100%: Unfavorable ankylosis of the entire spine. 

• This means your whole spine is stuck in a fixed, harmful position and you can’t move it at all. 

50%: Unfavorable ankylosis of the entire thoracolumbar spine. 

• Your mid-to-lower back is frozen in place in a damaging way, making normal movement impossible. 

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. 

• Either your neck is frozen, or you can barely bend your back forward (30° or less). 

30%: Forward flexion of the cervical spine 15 degrees or less or favorable ankylosis of the entire cervical spine. 

• You can only bend your neck forward a tiny amount (15° or less), or your neck is locked in a fixed but not harmful position. 

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. 

• Moderate limits: your back or neck bends somewhat but not fully, or spasms/guarding throw off your posture and walking. 

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. 

• Mild limits: you can still bend your back/neck a fair amount, or you have tenderness/spasms that don’t drastically change how you walk or stand. 

Establishing Service Connection

To qualify for a VA disability rating for cervical strain, you need to prove that your neck injury is connected to your service. For primary service connection, you will need:  

1. A current medical diagnosis of cervical strain; and

2. An in-service event, injury, illness, or aggravation; and

3. A medical nexus (or link) between your condition and the incident (e.g., with a nexus letter or statement) 

The Role of a Nexus Letter in Your Claim

One of the most powerful tools for proving service connection is a medical nexus letter. A nexus letter is written by a licensed medical professional and directly explains how your cervical strain is linked to your time in service.  

While a Nexus Letter doesn’t guarantee a claim approval, it often strengthens a claim by providing the VA with clear medical evidence tying your condition to military duty. 

Telemedica specializes in providing veterans with high-quality nexus letters that use medical expertise and VA-specific language to make your case clear and compelling.

How a DBQ Can Strengthen Your Claim

Another critical piece of evidence is the Disability Benefits Questionnaire (DBQ). A DBQ is a standardized VA form that documents the full scope of your symptoms, range of motion limitations, and the impact of your cervical strain on daily life. 

When completed by a qualified medical provider, a DBQ ensures the VA has a detailed, structured record of your condition in a format they already use for decision-making.  

Telemedica provides complete DBQs that capture every detail of your cervical strain and secondary symptoms, helping you present the strongest possible case. 

VA Secondary Conditions to Cervical Strain

A secondary condition occurs when a service-connected disability has caused or aggravated a new or pre-existing condition, illness, or injury. 

If you’ve successfully service-connected your cervical strain and are experiencing symptoms of other conditions connected to the neck pain, such as radiculopathy (pinched nerve) or chronic headaches/migraines, you may be able to claim them as a secondary condition. 

Cervical Strain C&P Exam

During a compensation and pension (C&P) exam for cervical strain, you should bring with you any medical records, including any previous range of motion (ROM) assessments. 

If you haven’t had any imaging tests completed, be prepared for X-rays, magnetic resonance imaging (MRI), or a computed tomography (CT) scan.  

While X-rays highlight issues in the bones, an MRI can show problems with your spinal cord, nerves, bone marrow and soft tissue; a CT scan can be helpful in place of an MRI.

Conclusion

There’s a reason the saying “pain in the neck” is so widespread—because neck pain is persistent, irritating, and impairs the most basic daily functions, like simply turning your head. 

However, with a service connection and the proper medical evidence, you can be compensated by the VA for your cervical strain and neck pain.  

Medical Evidence Wins VA Claims

Did you know that a lack of medical evidence is the #1 reason VA disability claims are denied?   

For a condition like cervical strain, strong medical evidence may include a range of motion assessment, imaging tests such as X-rays, MRIs, or CT scans, and supporting documentation like a nexus letter and DBQ. 

Medical evidence is a crucial piece of the puzzle that VA raters consider when reviewing a disability claim. Telemedica provides solutions for veterans looking to bolster their claims through high-quality medical evidence (such as DBQs and nexus letters) that wins claims!   

Schedule your 20-minute consultation call and learn how to get the supporting medical evidence you need to strengthen your claim. 

FAQs | Frequently Asked Questions

What is the cervical strain VA rating?

Cervical strain VA ratings range from 10% to 100% depending on factors such as range of motion, ankylosis, and other spine-specific criteria. 

What is a secondary condition to cervical strain?

There are two common secondary conditions to cervical strain: radiculopathy (compressed or pinched nerve) and chronic headaches or migraines. 

How serious is a cervical strain?

Cervical strain ranges from mild to severe, depending on the cause of the strain and its symptoms. Since it can be caused by whiplash and is considered a whiplash-associated condition, this grading system may be helpful:  

• Grade 0: No injury. 

• Grade 1: Pain only. 

• Grade 2: Pain plus signs of injury. 

• Grade 3: Pain plus signs of injury and neurological effects. 

• Grade 4: Severe pain and signs of serious or dangerous neurological effects.  

What causes neck strain in the military?

Neck strain can be caused by a number of factors in the military, including carrying heavy gear and equipment, high-impact activities, falls, vehicle accidents, explosions and other combat exposures, and stress, to name a few. 

Is cervical strain the same as neck pain?

Cervical strain is a specific kind of neck pain that refers to an injury of the neck muscles, as opposed to the bones or tendons.  

However, the VA disability rating for neck and shoulder pain falls under the same VA rating for cervical strain—musculoskeletal system—and uses the General Rating Formula for Diseases and Injuries of the Spine to assign a rating. 

How much VA disability can you get for neck pain?

The cervical strain VA rating ranges from 10% to 100%, depending on factors such as range of motion, ankylosis, and other spine-specific criteria.