Acromioclavicular Joint Separation VA Disability Rating

From rotator cuffs and dislocations to poorly healed bones, shoulder and arm injuries are common among soldiers — and all these injuries can lead to long-term disabilities in veterans. Yet establishing a service connection for shoulder and arm injuries can still be a challenge. What’s more, getting a disability rating that’s enough to reflect the severity of arm and shoulder injuries is another hurdle. 

Keep reading to learn more about VA disability benefits for arm and shoulder conditions and how you can increase your disability rating.

What Is Acromioclavicular Joint Separation?

Acromioclavicular joint separation, also known as AC separation, occurs when the clavicle (collar bone) separates from the scapula (shoulder blade). This injury is typically caused by a fall directly on the shoulder “point” or a direct blow from contact.

AC separation injuries can make daily life extremely challenging. We use our arms and shoulders for many daily tasks, including getting dressed, driving, and bathing. An untreated AC injury can make daily, independent life a struggle. The pain, stiffness, and limited motion can become severe when left untreated, and it can cause the veteran to repeatedly miss work and social events while living in constant pain. 

What Is a VA Disability Rating?

The VA assigns disability ratings based on the severity of veterans’ service-connected conditions. The VASRD determines how much disability compensation veterans will receive each month in addition to their eligibility for other VA benefits. Examples for shoulder and arm injuries could include a VA disability rating for shoulder range of motion, VA disability rating for shoulder tendonitis, or VA disability rating for shoulder impingement.

Symptoms of Acromioclavicular Joint Separation

Symptoms and signs of AC shoulder separation include:

• Pain begins the moment the injury happens
• Limited movement due to pain, not weakness
• Swelling and bruising
• Deformity — the outer end of the collarbone might look out of place, or the top of the shoulder might have a bump on it
• Tenderness over the AC joint on top of the shoulder

VA Disability Applications for Acromioclavicular Joint Separation

Before you can apply for VA disability for AC joint separation, you need to gather evidence and supporting documents to file with your claim. This evidence includes:

• VA medical records and hospital records relating to your Acromioclavicular Joint Separation or that show it has gotten worse.
• Private medical records or hospital reports related to your AC separation that show the deteriorating condition.
• Supporting statements from family members, friends, clergy, law enforcement, or people you served with elaborating on your AC separation, when it happened, and how it has worsened.

Ensure you fill out your claim entirely and send all supporting documents — this helps process the claim quicker. Note that you are not required to submit evidence with your Acromioclavicular Joint Separation VA disability application, but you will find it helpful for your case. 

You can file your claim online, by mail, in person, or with the help of a trained and accredited representative like Woods and Woods, The Veteran’s Firm.

Should the VA deny your claim, this does not mean your case is over and you have zero chances of receiving benefits for your injuries. If the VA sends you a letter stating that they denied your claim, it’s important to contact a veterans’ rights lawyer to figure out your next steps. You have one year to appeal the claim from the date of the denial.

Establishing a Service Connection for VA Disabilities

To receive veterans benefits for your Acromioclavicular Joint Separation, you must prove a service connection for the condition. Here’s how:

• Direct Service Connection — This is perhaps the most common method of pursuing service connection and requires (1) An injury, event, or illness caused by service, (2) A current diagnosis of AC separation, and (3) A link (nexus) between the in-service event and AC separation diagnosis.
• Secondary Service Connection — Your claim can be service-connected for a condition that results from another service-connected condition. 
• Aggravation — Service connections by aggravation apply to conditions that got worse because of military service. For example, John had a bad shoulder from playing baseball in his youth. Then, carrying around his weapon on that same shoulder for 18 years in the service resulted in his shoulder bone and clavicle separating.
• 1151 Service Connection — 1151 claims refer to a group of claims that apply to disabilities or death caused by “hospital care, medical, or surgical treatment, or examination,” by a VA medical professional or facility, or by participation in a vocational rehab program.

VA Disability Rating for Acromioclavicular Joint Separation

Under § 4.71a, Diagnostic Code 5203, the VA assigns shoulder separations a 20% rating for either arm, regardless of severity.

• Range of motion — The less you can lift or bend your shoulder, the higher the disability rating you will likely receive. 
• Instability — The VA categorizes instability in three ways: slight (10%), moderate (20%), or severe (30%).
• VA C&P exam — The VA might request further examination at the Compensation and Pension (C&P) exam to examine your shoulder. The C&P exam is where the VA will collect all pertinent information to rate your shoulder disability and determine the appropriate compensation for your claim. Instead of treating your shoulder injury, the doctor at the C&P exam will review your claim file and Disability Benefits Questionnaire (DBQ) and ask questions based on it. During your exam, you will have the chance to describe your shoulder pain to your doctor and talk about how it affects your daily life. This is also a good time to talk about flareups and episodes — they can support a claim for an increased disability rating. The doctor will also get an official measurement of your range of motion with a tool known as a goniometer.

Secondary Conditions to Acromioclavicular Joint Separation

As we mentioned, shoulder injuries are extremely common among service members tasked with heavy lifting and training exercises that include overhead motions. Completing these tasks for an extended period while serving can lead to many other VA secondary conditions to shoulder injuries, including:

Amputations Resulting From Shoulder and Arm Conditions

Should a veteran’s shoulder condition lead to amputation, the rating will change. If the entire arm is amputated, it will change to a 90% rating whether it is your dominant arm or not. If you have to have your arm amputated up to the deltoid, which is midway above your elbow, you’ll get a rating of 80 percent. Veterans that have to have their arm amputated below the deltoid will receive a 70 percent rating. All of these falling under VASRD code 5200. The ratings are 10% lower if they are on your non-dominant side from the 70% rating level downward.

Shoulder Replacements

The VA evaluates shoulder replacements under Diagnostic Code 5051. If a prosthetic device replaces the entire shoulder joint, the condition is rated at 100% for the month following discharge from the hospital. Then, the condition receives a permanent rating after the conditional period is complete.

If you experience weakness and severe pain with motion, your injury is rated 60% for the dominant arm and 50% for the non-dominant arm.

For a veteran experiencing occasional periods of weakness, pain, or limited motion, the condition will be rated under Diagnostic Code 5002 (i.e., rheumatoid arthritis) or 5203 (i.e., impairment of the clavicle or scapula), depending on which most closely describes the symptoms.

Rotator Cuff Tear

You might also receive a VA disability rating for shoulder rotator cuff tear. Rotator cuff injuries are common among veterans who have experienced traumatic injuries while in service. Muscles and tendons that keep the head of the upper arm bone firmly within the shoulder socket make up the rotator cuff. When the muscles are overused or experience undue force, the tendons often tear from the stress. These tears can severely limit a veteran’s range of motion, which can qualify them for disability benefits based on their inability to work. 

Shoulder Arthritis

AC separation patients may also experience arthritis because the shoulder separation damages the ligaments surrounding the AC joint. When the bones no longer align properly, they may scrape on one another and cause inflammation and pain; this condition can also lead to rheumatoid arthritis.

VA Disability Ratings for Arthritis

Under the VA’s schedule of ratings, they can rate arthritis as degenerative arthritis or rheumatoid arthritis — several criteria affect that decision. Active cases of rheumatoid arthritis can receive up to a 100% VA disability rating for shoulder arthritis if the condition is debilitating. 

With all forms of arthritis, the patient’s range of motion and associated pain are key factors in evaluating the rating. Because these measurements are vital in the arthritis rating, a physician must record the exact range of motion measurements using a goniometer.

If you have arthritis or another secondary condition related to your AC separation, you may be eligible for further compensation under a combined rating. This combined rating takes effect if your other condition qualifies for a rating, such as VA disability rating for shoulder bursitis.

VA Disability for Shoulder Injuries

This article covers rotator cuffs, shoulder blades, and other general shoulder injuries that qualify for VA disability.

Read About All VA Rated Shoulder Injuries

How Long Will It Take to Get My Disability Rating Letter?

It takes about 125 days to get an answer to your initial claim. If you are filing an appeal, it can take up to 12-18 months for the VA to review and grant your appeal. That is an estimate, of course. The VA experienced delays during the Covid-19 pandemic like many other industries.

If you work with us, we’ll keep tabs on when the VA makes a decision. If you hear from the VA, give us a call to make sure we got the information too. If we hear from the VA, we’ll contact you as soon as we can to follow up with our next steps.

Treatment for AC Joint Separation

Nonsurgical treatments for AC separation include a sling, ice packs, and medications to manage the pain. Physical therapy can also help manage pain and restore some of the range of motion to the shoulder.

If pain persists or the deformity is severe, a surgeon may trim back the end of the collarbone to stop it from rubbing against the shoulder blade bone.

Your treatments may also vary depending on your other conditions. If a dislocated shoulder is a secondary-connection to tumors, deforming arthritis, or other disease, your treatment might look very different.

Obtaining TDIU for a Separated Shoulder

If you cannot get and/or keep gainful employment because of your shoulder condition, you may qualify for total disability based on individual unemployability (TDIU). Veterans granted TDIU receive payment at the 100% rate — the highest compensation for VA disability awards.

The VA doesn’t usually give 100% TDIU for just a single disability. They typically add up disabilities and veterans meet the criteria like this:

1. You have at least 1 service-connected disability rated at 60% or more disabling, or 2 or more service-connected disabilities—with at least 1 rated at 40% or more disabling and a combined rating of 70% or more—and
2. You can’t hold down a steady job that supports you financially (known as substantially gainful employment) because of your service-connected disability. Odd jobs (marginal employment), don’t count.

Taken from https://www.va.gov/disability/eligibility/special-claims/unemployability/

How Can You Increase Your Shoulder Injury VA Disability Rating?

If you believe there has been an error in your VA disability filing or that you are entitled to higher compensation, you can submit an appeal. You must do this within one year of the VA issuing the rating. You can file a Notice of Disagreement, take the higher review lane, or submit a supplemental claim. For a supplemental claim, you can show new evidence that wasn’t considered with your initial claim. If you are not receiving maximum compensation, you can file for an increase if your condition worsens. You can also submit a new claim for a secondary condition or increase your disability rating by combining multiple disabilities.

Working with an experienced attorney can also significantly boost your chances of receiving a higher disability rating. The process can be overwhelming and confusing — that’s where your attorney steps in. Woods and Woods is well-versed in the laws and know the best strategies to secure the most favorable outcomes for our clients.

If you have service-connected shoulder pain or injury, reach out to the VA disability lawyers at Woods and Woods, The Veteran’s Firm. We can help maximize your compensation and make sure you get the disability rating you’re entitled to the first time you file for disability. Contact us today, and let’s get started building your case. 

At Woods and Woods, the Veteran’s Firm, we’ve helped thousands of veterans with their VA disability applications and appeals. We’ve been adding staff and lawyers during the Covid pandemic to serve disabled veterans better in difficult times.

Call us today to discuss your VA disability appeal or your first application. The call is free and we won’t charge you a single fee until we win your case. We even pay for the postage for all of the documentation you send to our office. You can look for a VA disability attorney near you or call us and join the thousands of veterans living off of VA disability thanks to Woods and Woods.

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