Crisis?Call 988, press 1Text 838255Chat with the Veterans Crisis Line (opens in a new window)

Skip to content
Helping The Brave, because no brave fights alone
← All exam guidesClaim Navigator

Get ready for your exam

Neck

Neck (cervical spine)

What it is

Your neck is the top seven bones of your spine; VA rates it mostly by how far you can tip your chin to your chest and by the total of all your neck motions.

Normal movement (what VA counts as normal)

  • Forward flexion (chin to chest)0 to 45°
  • Extension (look up)0 to 45°
  • Left lateral flexion (ear to shoulder)0 to 45°
  • Right lateral flexion0 to 45°
  • Left lateral rotation (turn head)0 to 80°
  • Right lateral rotation0 to 80°
  • Combined (all six added)340°

VA's code numbers for this: 5235, 5237, 5238, 5239, 5240, 5241, 5242, 5243

What the examiner will do

  • The examiner asks how and when the problem started, what treatment you have had, and how it affects work and daily life.
  • They ask about flare-ups: how often, how long, what sets them off, and what you cannot do during one.
  • They measure how far you can move the joint yourself (active motion) with a goniometer. They should note where pain begins.
  • They move the joint for you (passive motion). They test it with weight on it and without weight on it. They compare it to your other side if that side is healthy. (Correia v. McDonald, 2016; 38 CFR 4.59.)
  • They have you repeat each motion at least 3 times, then measure again (repetitive-use testing).
  • They check strength, muscle loss (atrophy), tenderness, and whether the joint is stuck (ankylosis).
  • They look at X-rays or other imaging, or order them.
  • They ask about braces, canes, or other devices and how often you use them.
  • Nerve checks in the arms: reflexes, feeling, grip and arm strength.
  • Questions about headaches, disc problems, and doctor-prescribed bed rest.

The examiner fills out a form called a DBQ. You can read it ahead of time: Neck (Cervical Spine) Conditions DBQ (updated 2024-08-22) (opens VA's site).

The rating levels, in plain words

VA rates most joints by how far they move. The less you can move, the higher the level.

Forward flexion

  • Up to 40°

    10%

    Can you tip your chin down more than 30 but not more than 40 degrees (close to normal)? That is 10%.

    Rule: 38 CFR 4.71a, General Rating Formula

  • Up to 30°

    20%

    Chin down more than 15 but not more than 30 degrees: 20%.

    Rule: 38 CFR 4.71a, General Rating Formula

  • Up to 15°

    30%

    Chin down only 15 degrees or less (a small nod): 30%. Also 30% if the whole neck is fused in a good position.

    Rule: 38 CFR 4.71a, General Rating Formula

Combined range of motion

  • Total of 335° or less

    10%

    All six neck motions added are more than 170 but not more than 335 degrees: 10%.

    Rule: 38 CFR 4.71a, General Rating Formula

  • Total of 170° or less

    20%

    All six motions added are 170 degrees or less: 20%.

    Rule: 38 CFR 4.71a, General Rating Formula

Spasm or tenderness

  • 10%

    Spasm, guarding, or tender spots that do not change your posture or walk: 10%.

    Rule: 38 CFR 4.71a, General Rating Formula

Spasm that changes posture

  • 20%

    Spasm or guarding that causes an abnormal walk or spine shape: 20%.

    Rule: 38 CFR 4.71a, General Rating Formula

Ankylosis

  • 40%

    Whole neck fused in a bad (unfavorable) position: 40%.

    Rule: 38 CFR 4.71a, General Rating Formula

IVDS incapacitating episodes

  • 10%

    Disc problem (DC 5243) with doctor-prescribed bed rest AND doctor treatment totaling at least 1 week but less than 2 weeks in the past 12 months: 10%.

    Rule: 38 CFR 4.71a, IVDS Formula, Note (1)

  • 20%

    At least 2 but less than 4 weeks in 12 months: 20%.

    Rule: 38 CFR 4.71a, IVDS Formula

  • 40%

    At least 4 but less than 6 weeks in 12 months: 40%.

    Rule: 38 CFR 4.71a, IVDS Formula

  • 60%

    At least 6 weeks in 12 months: 60%.

    Rule: 38 CFR 4.71a, IVDS Formula

Measured at home? Check which level your number falls in.

Measure it at home

With a helper and a cheap tool. Your home numbers help you describe your bad days honestly at the exam.

The tool to get

  • Best: a clear plastic goniometer (say GO-nee-OM-eh-ter). It looks like a protractor with two long arms joined by a pin. A 12-inch, 360-degree one costs about $5 to $10 online or at a medical supply store. This is the same kind of tool most examiners use.

  • Free: a phone goniometer or inclinometer (angle-measuring) app. Many are free. Tape or hold the phone flat along the body part, set it to zero at the start, then move.

  • No money and no phone: print a paper protractor (half circle, 0 to 180 degrees) on stiff paper. Tape two straws or paper strips to the center with a brad so they swing. Lay it against the joint.

  • A pen and the log sheet below. A second person (spouse, adult child, friend) to hold the tool, because you cannot measure yourself well.

  • A phone inclinometer app resting on top of the head is the easiest home method for the neck.

No tool yet? Print our paper protractor below.

Step by step, with a helper

  1. 1. Forward flexion and extension

    How to stand or lie
    Sit tall in a hard chair, back against it, shoulders still. Tip chin to chest, then look up at the ceiling.
    Where the tool goes
    Goniometer from the side: pin over the ear hole. Fixed arm straight up and down. Moving arm points to the base of the nose. Phone: lay it on top of the head (sideways), zero it sitting straight, then tip.
    Who holds what
    Helper keeps your shoulders from moving and reads the number at 'pain' and at stop.

  2. 2. Side bend (ear to shoulder)

    How to stand or lie
    Sit tall. Bring ear toward shoulder without lifting the shoulder or turning the face.
    Where the tool goes
    Pin on the bump at the base of the neck (back). Fixed arm straight up and down along the spine. Moving arm points to the center of the back of the head.
    Who holds what
    Helper stands behind you and reads each side.

  3. 3. Turn (rotation)

    How to stand or lie
    Sit tall. Turn your head to look over your shoulder.
    Where the tool goes
    Helper stands above you. Pin over the top of the head. Fixed arm lines up across your shoulders. Moving arm points to your nose.
    Who holds what
    Helper reads each side.

  4. 4. Add it up

    How to stand or lie
    Add all six numbers.
    Where the tool goes
    Example: 30+30+30+30+50+50 = 220. That is more than 170 and not more than 335, so the combined-motion test gives 10%. But forward flexion of 30 alone gives 20%, and VA uses the higher one.
    Who holds what
    Helper does the math.

Stop at the first real pain. Never force a joint to get a number. Stand close for balance during back and hip tests.

Check your number

1. Which motion did you measure?

Type the number where you had to stop.

degrees

Type your number above to see where it falls.

This is only to help you understand. The VA examiner measures and the VA decides.

The levels for forward flexion:

  • 0° to 15°30%
  • 16° to 30°20%
  • 31° to 40°10%

If your number is close to the next level, VA may give the higher one (38 CFR 4.7).

Your log: what to write each time

  1. DateExample: 10/12
  2. TimeExample: 7 pm
  3. Good day or flare-up day?Example: Flare-up day
  4. Body part and side (R/L)Example: Neck
  5. MotionExample: Chin to chest
  6. Degrees where pain STARTSExample: 20
  7. Degrees where you had to STOPExample: 30
  8. After 3 tries: degrees where you stopExample: 25
  9. Pain 0-10Example: 7
  10. Medicine taken today (what and when)Example: Ibuprofen 8 am
  11. Who measuredExample: Spouse
  12. Notes (clicking, giving way, swelling)Example: Hurt more after the 3rd try

Write it down (one line per try):

Measure on a normal day and again on a bad day. Do it 2 or 3 times over a few weeks. Bring the sheet to the exam.

Tap Print this page to get a blank log sheet and your exam-day checklist on paper.

Printable paper protractor

01801516530150451356012075105909010575120601354515030165151800Center: push a brad through this dot
  • Print at 100% scale; check the 90° line with a square corner (like the corner of a sheet of paper).
  • Glue it to stiff paper or a cereal box. Push a brad through the center dot.
  • Tape two paper strips or straws to the brad so they swing. One stays on the body part that doesn't move. The other follows the moving part.
  • The top numbers count from the left. The small numbers count from the right. Use whichever side starts at 0.

This is only to help you understand. The VA examiner measures and the VA decides.

Exam-day checklist

Tick each one off. Nothing you tick is saved or sent anywhere.

Tell the examiner

Flare-ups

A flare-up is a time when your joint gets much worse for a while. The examiner must ask about your flare-ups and estimate, in degrees, how much motion you lose during them, even if your exam is on a good day (Sharp v. Shulkin, 2017). They can only skip this if they explain why after getting your information. Be ready to say: how often (for example, 2 times a week), how long each lasts (for example, 1 to 2 days), what triggers it, and exactly what you cannot do (for example, 'I can't lift my arm to comb my hair'). If you measured at home on a flare-up day, show that number.

Repeated use

The examiner will have you do each motion at least 3 times and then measure again. Tell them if pain, weakness, tiredness, or poor control gets worse with each try. The form also asks about repeated use over time, like at the end of a workday. Pain alone does not raise a rating; pain that actually limits how far, how strong, or how long you can move does (Mitchell v. Shinseki, 2011; DeLuca v. Brown, 1995; 38 CFR 4.40 and 4.45).

Honest exam rules

  • Move each joint until pain starts. Say 'pain starts here' out loud. Stop when pain or stiffness stops you. Do not push through sharp pain to look tough. Do not stop before pain or stiffness really stops you, either. The examiner writes down both points.
  • Give your real, full effort on strength tests. The goal is an exam that shows how you truly are.
  • Describe a typical day AND your worst days. Bad days count, but say they are bad days and how often they happen.
  • Take your medicine the way you normally do. Do not skip it, and do not take extra just for the exam. Tell the examiner what you took and when, and how you are when it wears off. (Court decisions Jones v. Shinseki (2012) and Ingram v. Collins (2025) say VA should not lower a joint rating because medicine helps, when the rating rules do not mention medicine. VA tried to change this by rule in February 2026 and took the change back on February 27, 2026.)
  • Wear or bring any brace, cane, crutches, or walker you normally use. Bring the prescription or a record showing a provider ordered it.
  • Bring a one-page list: your diagnoses, surgeries, treatments tried, medicines, how often you have flare-ups, your home measurement log, and what you can no longer do at work and at home.
  • If you do not know or do not remember, say so. Do not guess.
  • Fraud warning: knowingly giving VA false information is a federal crime (18 U.S.C. 1001) and can cost you all VA benefits (38 U.S.C. 6103). Honest, complete reporting is all you need.

Common mistakes

  • Pushing through pain so the examiner only writes down your end point. Painful motion is a key factor, and the exam should record where pain starts.

    Where this comes from: 38 CFR 4.59; Burton v. Shinseki, 25 Vet. App. 1 (2011); Mitchell v. Shinseki, 25 Vet. App. 32 (2011)

  • Saying 'I'm fine' or only describing a good day. Flare-ups that are not described cannot be estimated.

    Where this comes from: Sharp v. Shulkin, 29 Vet. App. 26 (2017); DBQ flare-up section

  • An exam that skipped passive motion, weight-bearing testing, or the opposite joint. That exam may be inadequate; you or your representative can point this out.

    Where this comes from: Correia v. McDonald, 28 Vet. App. 158 (2016)

  • Not asking for at least the minimum rating when the joint is actually painful, unstable, or out of line from an old injury.

    Where this comes from: 38 CFR 4.59; Petitti v. McDonald, 27 Vet. App. 415 (2015)

  • Not mentioning arm or hand numbness. Nerve problems from the neck are rated separately (usually under the radicular group codes 8510-8513, which pay more for the dominant arm).

    Where this comes from: 38 CFR 4.71a General Rating Formula, Note (1); 38 CFR 4.124a DCs 8510-8513

  • Moving the shoulders or body during neck tests, which adds fake motion.

    Where this comes from: Neck DBQ; 38 CFR 4.71a Plate V

  • Counting self-chosen bed rest for a disc problem. Only physician-prescribed bed rest counts.

    Where this comes from: 38 CFR 4.71a, IVDS Formula Note (1)

Questions to ask together

A spouse, grown child or friend can read these out loud. Talk about each one before the exam, so nothing gets left out.

  1. Can you turn your head far enough to back the car out safely?
  2. Can you look up at the ceiling or a high shelf?
  3. Do you get numbness or tingling in your arms or fingers? Which fingers?
  4. Do you get headaches that start in your neck?
  5. When your neck flares, how long does it last and what do you stop doing?

Sources

Checked against VA's rules on October 30, 2026.

Helping The Brave doesn't file or prepare claims. This guide is free education, not medical or legal advice. The VA examiner measures and VA decides your rating.