The VA rates ankylosing spondylitis under diagnostic code 5240, using the General Rating Formula for Diseases and Injuries of the Spine. Ratings range from 10% to 100%, based on how far you can bend your neck and lower back, whether any part of your spine has fused into a fixed position (ankylosis), and whether you have muscle spasms or an abnormal gait. In 2026, a 100% rating pays $3,938.58 a month for a single veteran with no dependents. Most veterans with ankylosing spondylitis are rated between 20% and 50%, since fully fused, unfavorable ankylosis of the whole spine is required for the top rating.
Ankylosing spondylitis is a chronic inflammatory arthritis that attacks the spine and sacroiliac joints, gradually stiffening the vertebrae until they can fuse together. It is not on the VA's list of presumptive conditions, so you need medical evidence connecting it to your military service, either directly or as a secondary condition to something already service connected. Here is how the rating actually works and what to expect from your claim.
How the VA Rates Ankylosing Spondylitis
Ankylosing spondylitis falls under 38 CFR 4.71a, the spine section of the VA's Schedule for Rating Disabilities. The rating depends on three things: range of motion (forward flexion), the presence and type of ankylosis (favorable versus unfavorable spinal fusion), and functional symptoms like muscle spasm, guarding, and abnormal posture or gait.
The VA measures forward flexion of the thoracolumbar spine (mid and lower back) and the cervical spine (neck) separately during a Compensation and Pension (C&P) exam, then applies whichever criterion produces the highest rating.
2026 Rating Chart for Diagnostic Code 5240
| Rating | Criteria |
|---|
| 100% | Unfavorable ankylosis of the entire spine |
| 50% | Unfavorable ankylosis of the entire thoracolumbar spine |
| 40% | Forward flexion of the thoracolumbar spine 30 degrees or less; OR favorable ankylosis of the entire thoracolumbar spine; OR unfavorable ankylosis of the entire cervical spine |
| 30% | Forward flexion of the cervical spine 15 degrees or less; OR favorable ankylosis of the entire cervical spine |
| 20% | Forward flexion of the thoracolumbar spine greater than 30 but not greater than 60 degrees; OR forward flexion of the cervical spine greater than 15 but not greater than 30 degrees; OR combined range of motion of the thoracolumbar spine not greater than 120 degrees; OR muscle spasm, guarding, or localized tenderness severe enough to cause an abnormal gait or abnormal spinal contour |
| 10% | Forward flexion of the thoracolumbar spine greater than 60 but not greater than 85 degrees; OR forward flexion of the cervical spine greater than 30 but not greater than 40 degrees; OR combined range of motion of the thoracolumbar spine greater than 120 but not greater than 235 degrees; OR muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or spinal contour |
A few points that trip up a lot of veterans filing this claim:
- "Ankylosis" means the vertebrae have actually fused into a fixed position, not just that motion is limited by pain or stiffness. Favorable ankylosis means the spine is fused in a neutral position; unfavorable means it's fused in flexion, extension, or with abnormal curvature.
- You do not need ankylosis to get a rating. Most veterans with ankylosing spondylitis are rated on range of motion alone (the 10%, 20%, or 40% tiers), since full spinal fusion tends to happen only in advanced, long-standing disease.
- The VA rates the cervical spine and thoracolumbar spine separately. If both are affected, you may get two separate ratings that are then combined, not added, using VA math.
- Pain that limits motion counts. Under the DeLuca factors, if pain, weakness, fatigue, or incoordination further limits your range of motion beyond what was measured, the examiner is supposed to account for that when assigning the rating.
Alternative Rating Path: Incapacitating Episodes
If your ankylosing spondylitis causes intervertebral disc syndrome (IVDS) with flare-ups requiring bed rest prescribed by a physician, the VA can rate you under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes instead, if that produces a higher number. This formula rates based on the total duration of incapacitating episodes over the past 12 months, from 10% (at least one week but less than two weeks total) up to 60% (at least six weeks total). Your claims examiner should apply whichever formula results in the higher rating.
Service Connection: Direct and Secondary
Ankylosing spondylitis is not automatically presumed service connected. You need one of the following:
Direct service connection. Medical records showing symptom onset or diagnosis during active duty, or a doctor's opinion (nexus letter) linking your current diagnosis to an in-service event, injury, or the gradual onset of symptoms that began in service.
Secondary service connection. If you already have a service-connected back or neck condition, or a service-connected condition like reactive arthritis or inflammatory bowel disease that is medically linked to ankylosing spondylitis, you can file a secondary claim arguing your ankylosing spondylitis developed as a result of or was aggravated by the already-connected condition.
Because ankylosing spondylitis often overlaps with other musculoskeletal and autoimmune issues, many successful claims are built on the secondary pathway, especially for veterans whose back pain was originally rated as a mechanical or degenerative condition before ankylosing spondylitis was formally diagnosed.
Common Secondary Conditions to Claim Alongside Ankylosing Spondylitis
| Secondary Condition | Why It's Connected |
|---|
| Radiculopathy (arm or leg) | Nerve compression from spinal inflammation or fusion |
| Degenerative disc disease | Accelerated wear from chronic spinal stiffness |
| Sacroiliitis | Inflammation of the sacroiliac joints, common in early ankylosing spondylitis |
| Sleep apnea | Restricted chest expansion from spinal rigidity can affect breathing |
| Depression or anxiety | Chronic pain and reduced mobility linked to mental health conditions |
| Uveitis (eye inflammation) | Common autoimmune complication of ankylosing spondylitis |
Each secondary condition rated separately adds to your combined VA rating using the VA's combined ratings table, which is not simple addition.
Filing Your Claim
- Gather medical evidence. Current diagnosis, imaging (X-rays or MRI showing sacroiliitis or spinal fusion), and treatment records from a rheumatologist if possible.
- Get a nexus letter if filing direct or secondary. A statement from a treating physician connecting the condition to service or to an already service-connected condition significantly strengthens the claim.
- File the claim. Submit VA Form 21-526EZ through VA.gov, by mail, or with help from a Veterans Service Officer (VSO) at no cost.
- Attend the C&P exam. The examiner will measure your range of motion with a goniometer, check for ankylosis, and ask about flare-ups, incapacitating episodes, and how the condition affects daily function and work.
- Wait for the rating decision. Current average processing time runs several months. You'll receive a decision letter explaining your rating and effective date.
- Appeal if needed. If you disagree with the rating, you can file a Supplemental Claim with new evidence, request Higher-Level Review, or appeal to the Board of Veterans' Appeals.
2026 VA Disability Pay Rates
VA compensation increased by 2.8% for 2026 to match the Social Security cost-of-living adjustment. These are the monthly rates for a veteran with no dependents.
| Rating | Monthly Payment (2026) |
|---|
| 10% | $180.42 |
| 20% | $356.66 |
| 30% | $552.47 |
| 40% | $795.84 |
| 50% | $1,132.90 |
| 60% | $1,435.02 |
| 70% | $1,808.45 |
| 80% | $2,102.15 |
| 90% | $2,362.30 |
| 100% | $3,938.58 |
Ratings of 30% or higher qualify for additional compensation if you have a dependent spouse, child, or parent. Check the current dependent rates at VA.gov before estimating your total payment.
TDIU: Getting Paid at the 100% Rate Without a 100% Rating
If ankylosing spondylitis and its secondary conditions prevent you from holding down substantially gainful employment, you may qualify for Total Disability based on Individual Unemployability (TDIU), which pays at the same rate as a 100% schedular rating even if your combined rating is lower. To qualify, you generally need:
- One service-connected condition rated at 60% or higher, OR
- Two or more service-connected conditions with a combined rating of 70% or higher, with at least one condition rated at 40% or higher
TDIU is common for veterans whose ankylosing spondylitis has progressed enough to limit standing, lifting, sitting for long periods, or driving, even when the schedular spine rating alone falls short of 100%.
Frequently Asked Questions
What diagnostic code does the VA use for ankylosing spondylitis?
The VA rates ankylosing spondylitis under diagnostic code 5240, applying the General Rating Formula for Diseases and Injuries of the Spine found in 38 CFR 4.71a. If IVDS with incapacitating episodes applies and produces a higher rating, the VA uses that formula instead.
Can I get a 100% VA rating for ankylosing spondylitis?
Yes, but only with unfavorable ankylosis of the entire spine, meaning both the cervical and thoracolumbar spine are fused in an unfavorable position. This level of fusion typically reflects advanced, long-standing disease. Most veterans with ankylosing spondylitis are rated below 100% based on limited range of motion rather than full ankylosis.
Is ankylosing spondylitis a VA presumptive condition?
No. Ankylosing spondylitis is not on the VA's presumptive conditions list. You need medical evidence directly connecting the condition to your military service, or a secondary service connection to an already-rated condition.
Can I claim ankylosing spondylitis as secondary to another condition?
Yes. Many veterans file ankylosing spondylitis as secondary to a service-connected back or neck condition, reactive arthritis, inflammatory bowel disease, or other conditions with a documented medical link, supported by a nexus letter from a treating physician.
Do the cervical spine and thoracolumbar spine get rated separately?
Yes. The VA evaluates the neck (cervical spine) and the mid and lower back (thoracolumbar spine) independently. If ankylosing spondylitis affects both, you can receive two separate ratings that are then combined using the VA's combined ratings table, not simple addition.
What if my ankylosing spondylitis makes it impossible to work?
You may qualify for TDIU (Total Disability based on Individual Unemployability), which pays at the 100% rate even if your schedular rating is lower, provided you meet the minimum rating thresholds and can show the condition prevents substantially gainful employment.
