Musculoskeletal · 38 CFR 4.71a
Musculoskeletal Conditions and VA Disability
Back, neck, knee, shoulder, hip, and foot problems are the most claimed VA disabilities of all. Years of carrying gear, hard landings, and repetitive strain add up. The VA rates these conditions under 38 CFR 4.71a, mostly by how far the joint still moves.
Patriot Path writes the medical piece of these claims. Our physicians write nexus letters and independent medical opinions that connect your injury to your service, or to another condition. One flat fee of $1,500, and the first consultation is free.
Medically reviewed by the Patriot Path Medical Team
Licensed MD reviewers • Last updated: June 2026
Conditions in this system
These are the joints and areas veterans claim most. Each one has a full guide with a rating estimator, how the VA rates it, and the ways to connect it to your service.
- Lower back
Lumbosacral strain and most low-back conditions. The most claimed condition of all.
DC 5237
- Neck
Cervical strain and degenerative changes. Rated like the back, with different numbers.
DC 5237 / 5242
- Knee
Limited motion, instability, and arthritis. Often claimed in pairs.
DC 5256-5261
- Shoulder
Limited arm motion from rotator cuff and joint problems.
DC 5201
- Hip
Limited hip motion and arthritis.
DC 5252
- Ankle and foot
Limited motion, plantar fasciitis, and flat feet.
DC 5271 / 5276 / 5284
How the VA rates musculoskeletal conditions
Most joint conditions are rated on range of motion. A doctor measures how far the joint bends or turns, in degrees, and the VA matches that to a rating in 38 CFR 4.71a. Less motion means a higher rating.
Pain matters too. Under 38 CFR 4.59, painful motion earns at least the minimum rating, usually 10%, even if your motion looks near-normal. The VA is also supposed to account for weakness, fatigue, and flare-ups, not just one good measurement on one good day.
The spine and muscle injuries use their own scales. The back, for example, is rated by how far you can bend forward, or by flare-ups that require bed rest if you have disc disease.
Connecting a musculoskeletal condition to service
- Direct. An injury or repetitive strain in service caused it. Jumps, lifting, ruck marches, and vehicle accidents are common causes.
- Secondary. One joint problem caused another (38 CFR 3.310). A bad knee or foot changes how you walk, which strains your back, hips, or the other leg.
- Aggravation. You had the condition before service, and service made it permanently worse.
For most claims the VA needs a current diagnosis, an in-service cause, and a medical opinion linking them (38 CFR 3.303). That opinion has to clear the “at least as likely as not” standard, a 50% or better chance. That standard is the benefit-of-the-doubt rule under 38 U.S.C. 5107(b), carried out in 38 CFR 3.102. A nexus letter is that linking opinion.
Frequently asked questions
How does the VA rate musculoskeletal conditions?
Most are rated on range of motion: how far the joint bends or moves, measured in degrees under 38 CFR 4.71a. Less motion means a higher rating. The spine and muscle injuries have their own rules.
Can I get a rating if my motion is almost normal but it hurts?
Yes. Under 38 CFR 4.59, painful motion warrants at least the minimum compensable rating, usually 10%. The VA is also supposed to account for pain, weakness, fatigue, and flare-ups, not just a single measurement.
How is the back rated?
Two ways, and you get whichever is higher: by range of motion (mostly how far you can bend forward) under the General Rating Formula, or by incapacitating episodes if you have disc disease (IVDS). Nerve pain that radiates down a leg can be rated separately on top.
Can one joint problem cause another?
Yes, and this is common. A bad knee, ankle, or foot can change how you walk, which strains your back, hips, or the other side. That is a secondary condition under 38 CFR 3.310, and it can raise your combined rating.
Do I need a nexus letter?
Often, yes. If the injury was not well documented in service, or you are claiming one joint as secondary to another, a nexus letter is usually what links it and decides the claim.
Hurting from years of service?
Tell us where it hurts. The first consultation is free, and we will tell you straight whether a nexus letter can strengthen your claim.
Sources & regulatory references
- VA disability compensation (VA.gov) https://www.va.gov/disability/
- 38 CFR 4.71a, Schedule of ratings, musculoskeletal system (eCFR) https://www.ecfr.gov/current/title-38/section-4.71a
- 38 CFR 4.40, Functional loss (eCFR) https://www.ecfr.gov/current/title-38/section-4.40
- 38 CFR 4.59, Painful motion (eCFR) https://www.ecfr.gov/current/title-38/section-4.59
- 38 CFR 3.310, Secondary service connection (eCFR) https://www.ecfr.gov/current/title-38/section-3.310
- 38 U.S.C. 5107, Benefit of the doubt (Cornell LII) https://www.law.cornell.edu/uscode/text/38/5107