How VA Rates Shoulder Conditions: Motion, Rotator Cuff, and Dominance

The primary diagnostic code for shoulder conditions, rotator cuff tears, and impingement syndrome is DC 5201. Ratings are based on limitation of arm motion in flexion (raising the arm forward) or abduction (raising the arm out to the side): 20% for limitation at shoulder level (90 degrees); 30% major / 20% minor for limitation midway between side and shoulder level (45 degrees); and 40% major / 30% minor for limitation to 25 degrees.

38 CFR 4.71a distinguishes between the major (dominant) arm and minor (nondominant) arm. Because impairment of the dominant arm causes greater functional limitation in daily occupational and personal activities, higher percentages are assigned to the dominant side across several shoulder rating levels.

Under 38 CFR 4.59 and 38 CFR 4.40, a veteran who experiences documented pain during shoulder movement is entitled to a minimum compensable rating of 10% (for either arm), even if the measured degrees of flexion and abduction exceed the 90-degree threshold.

Recurrent shoulder dislocation or subluxation is evaluated under DC 5202 based on the humerus. Frequent dislocations with guarding at all arm movements are rated at 30% major / 20% minor, while infrequent dislocations with guarding only at shoulder level receive 20% for either arm.

Impairments of the clavicle (collarbone) or scapula (shoulder blade) are evaluated under DC 5203: malunion or nonunion without loose movement is rated at 10%; nonunion with loose movement or dislocation receives 20%.

Chronic shoulder injuries frequently produce compensatory changes that affect adjacent anatomical structures. Common secondary claims include cervical spine strain, radiculopathy radiating down the arm, and opposite shoulder rotator cuff pathology due to compensatory overuse.