Musculoskeletal

Cervical Spine (Neck) C&P Exam Guide

Associated DBQ Form: DBQ Neck (Cervical Spine)

What to Expect During Your Exam

The neck C&P exam is similar to the back exam, lasting about 30-45 minutes with both interview and physical components.

The exam includes:
1. Medical history review
2. Discussion of injury and current symptoms
3. Range of motion testing (flexion, extension, rotation)
4. Neurological assessment if upper extremity symptoms exist
5. Palpation for muscle spasm or tenderness

Questions the Examiner May Ask

  • 1 How did you injure your neck?
  • 2 When did this occur during service?
  • 3 Where is the pain located?
  • 4 Does pain radiate into your arms or hands?
  • 5 Do you have numbness or tingling in your arms?
  • 6 Do you have headaches related to your neck condition?
  • 7 What activities aggravate your neck pain?
  • 8 Do you experience flare-ups?
  • 9 What treatments have you received?

Documentation to Bring

  • Service treatment records showing neck injury or treatment
  • Current imaging (X-rays, MRI of cervical spine)
  • Treatment records documenting ongoing care
  • Physical therapy records
  • Buddy statements about the injury
  • Personal statement describing injury and limitations

How to Prepare

Before your exam:

1. **Document your injury** - Know exactly when and how it happened

2. **Track your symptoms** - Pain levels, flare-ups, radiating symptoms

3. **List functional limitations** - Difficulty driving, looking up/down, computer work

4. **Note associated symptoms** - Headaches, arm pain/numbness, hand weakness

5. **Don't overmedicate before the exam** - Show your typical condition

Helpful Tips

- Stop range of motion testing when pain begins
- Mention if movement causes pain to radiate into arms
- Describe how neck pain affects work, driving, sleeping
- Report headaches if they're related to your neck condition
- Mention numbness/tingling in arms or hands (radiculopathy)
- Describe flare-ups and what triggers them
- Bring imaging results showing degenerative changes

Common Mistakes to Avoid

- Full range of motion but claiming severe pain
- No in-service documentation of neck problems
- Inconsistency between claimed severity and behavior
- Not mentioning neurological symptoms that are in your records

How VA Rates This Condition

Cervical spine conditions are rated under the General Rating Formula for Diseases and Injuries of the Spine:

**10%** - Forward flexion greater than 30° but not greater than 40°, OR combined ROM greater than 170° but not greater than 335°

**20%** - Forward flexion greater than 15° but not greater than 30°, OR combined ROM not greater than 170°, OR muscle spasm/guarding causing abnormal gait or contour

**30%** - Forward flexion 15° or less, OR favorable ankylosis

**40%** - Unfavorable ankylosis of the entire cervical spine

**100%** - Unfavorable ankylosis of the entire spine

**Note:** Upper extremity radiculopathy is rated separately.