Secondary Condition Claim · VASRD 5243
A condition caused or aggravated by an already service-connected disability can be granted its own service connection as a secondary condition under 38 CFR § 3.310. Here's how that works for Intervertebral Disc Syndrome (IVDS) when it develops after Muscle Group IV - Shoulder Stabilizer Muscles (Supraspinatus, Subscapularis).
Chronic muscle imbalance may cause nerve compression.
Primary condition · VASRD 5304
Muscle Group IV - Shoulder Stabilizer Muscles (Supraspinatus, Subscapularis)
Injury to the muscles that hold the head of the upper arm bone in the shoulder socket and rotate the arm — the supraspinatus, infraspinatus, teres minor and subscapularis.
Secondary condition · VASRD 5243
Intervertebral Disc Syndrome (IVDS)
Intervertebral disc syndrome involves damage to the cushioning discs between spinal vertebrae, which can bulge or herniate and press on nearby nerves, causing back pain, stiffness, and sometimes pain radiating into the arms or legs. Unlike most spine ratings based on range of motion, this code can alternatively be rated by counting incapacitating episodes requiring physician-prescribed bed rest.
The VA rates Intervertebral Disc Syndrome (IVDS) the same way whether it's claimed directly or as secondary to Muscle Group IV - Shoulder Stabilizer Muscles (Supraspinatus, Subscapularis) — severity of Intervertebral Disc Syndrome (IVDS) itself determines the percentage.
| Rating | Criteria |
|---|---|
| 100% | The entire spine — neck and back together — is fused rigid in a poor position. This level is reached only through the range-of-motion formula, not through incapacitating episodes. |
| 60% | At least 6 weeks of physician-prescribed bed rest for disc flare-ups in the past 12 months. This level is reached only through incapacitating episodes, not through the range-of-motion formula. |
| 50% | The whole mid and lower back is fused rigid in a poor position, though the neck still moves. This level is reached only through the range-of-motion formula, not through incapacitating episodes. |
| 40% | Range-of-motion route: the whole neck is fused rigid in a poor position, the lower back bends forward only 30 degrees or less, or the whole mid and lower back is fused in a neutral position. Bed-rest route: at least 4 but less than 6 weeks of physician-prescribed bed rest in the past 12 months. Meeting either one is enough — VA applies whichever of the two methods pays more. |
| 30% | The neck bends forward only 15 degrees or less, or the whole neck is fused in a neutral position. This level is reached only through the range-of-motion formula, not through incapacitating episodes. |
| 20% | Range-of-motion route: moderate loss of back or neck motion, or muscle spasm or guarding bad enough to change how you walk or hold your spine. Bed-rest route: at least 2 but less than 4 weeks of physician-prescribed bed rest in the past 12 months. Meeting either one is enough — VA applies whichever of the two methods pays more. |
| 10% | Range-of-motion route: mild loss of back or neck motion; or muscle spasm, guarding, or localized tenderness that does not change gait or posture; or a vertebral body that lost half its height or more in a fracture. Bed-rest route: at least 1 but less than 2 weeks of physician-prescribed bed rest in the past 12 months. Meeting either one is enough — VA applies whichever of the two methods pays more. |
Example combined rating
20% Muscle Group IV - Shoulder Stabilizer Muscles (Supraspinatus, Subscapularis) + 20% Intervertebral Disc Syndrome (IVDS) = 36%
The VA combines ratings with Table I of 38 CFR 4.25, not simple addition — 20% and 20% combine to 36%, not 40%. These figures are illustrative; your actual rating for each condition depends on your own evaluation.
Get the rating criteria for Intervertebral Disc Syndrome (IVDS), the evidence a secondary claim needs, and why it is linked to Muscle Group IV - Shoulder Stabilizer Muscles (Supraspinatus, Subscapularis) — delivered to your inbox.
Primary condition
Full Muscle Group IV - Shoulder Stabilizer Muscles (Supraspinatus, Subscapularis) guide
Secondary condition
Full Intervertebral Disc Syndrome (IVDS) guide
See how Muscle Group IV - Shoulder Stabilizer Muscles (Supraspinatus, Subscapularis) and Intervertebral Disc Syndrome (IVDS) combine with the rest of your service-connected conditions using the official VA combined-ratings formula.
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