Shoulder injuries in the military commonly lead to veterans receiving VA disability compensation. Rotator cuffs, dislocations, and poorly healed bones all contribute to long-term disabilities in veterans.
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In this article about VA disability for arm and shoulder pain:
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Basic shoulder anatomy
Before we dive into all of the VA disability rating codes for shoulder injuries, let’s go over some basic anatomy of the shoulder, beginning with your bones. The bone in your upper arm is called your humerus, and your collarbone is called your clavicle. Those two bones form a right angle at your shoulder and are connected by your scapula, also known as your shoulder blade.
There are also several different muscle groups that help you move your shoulders. Your trapezius muscles extend from your neck down to your clavicle, and your serratus magnus muscles run along the upper part of your ribs into your armpit. Your pectoral muscle extends across your chest, and your rhomboids, teres major, latissimus dorsi, infraspinatus, and coracobrachialis muscles connect to your scapula.
Your deltoid muscles extend down from your scapula and clavicle to the upper part of your humerus. And your biceps connect from the front upper part of your humerus to the inside of your elbow, while your triceps connect the back upper part of your humerus to the outside of your elbow.
VA disability benefits for shoulders and arms
The VA ratings for shoulders and arms are listed under the musculoskeletal section in the Schedule of Ratings. Each condition is assigned its own diagnostic code and disability ratings based on the severity of your injury and how seriously it limits your life.
You must also have evidence that you experienced some sort of event, injury, or illness during your service time that you can link to your injury or condition (called a service connection).
If you have more than one condition, you might receive a disability rating for each condition. The VA uses a complicated formula to determine a combined rating.
It is also important to note that you cannot receive two different ratings for effects stemming from the same root cause. This is called pyramiding.
Shoulder replacement
If you injure the bones in your shoulder badly enough, you may need to have a shoulder replacement. Like with any other joint replacement, a surgeon will go in and take out the upper part of your humerus and a part of your scapula. These will be replaced with prosthetic components that will act in place of the damaged structures.
If you have to have a shoulder replacement, the VA will place you on 100% disability for the first year after the surgery and you will get a code of 5051. After the first year, you’ll receive a permanent disability rating based on your level of function once you’re fully healed. The minimum permanent rating for a shoulder replacement is 30% for a dominant arm and 20% for a non-dominant arm, but you could get a rating as high as 50% or 60%, depending on your condition.
Frozen shoulder VA disability
In some cases, you may still have your arm and shoulder, but you may not be able to move them. If your shoulder is completely frozen, how it’s rated will depend on where it’s frozen. For instance, if you can still shrug your shoulder but not move your arm, you’ll get a different rating than if you could not move your shoulder at all.
If your arm cannot move 25 degrees away from your side, you’ll get a disability rating of 50% for a dominant arm or 40% for a non-dominant arm. Further movement beyond that is coded differently and will receive ratings based on how severe the limitation is.
Limitation of motion
Some shoulder injuries may leave you with a limited range of motion in your arm. This limitation can make it difficult to do even simple daily tasks, such as reaching for something in an upper cabinet or washing your hair. Your VA disability rating for this type of injury will receive a code of 5201 and will be based on whether your dominant or non-dominant arm is injured and how severe your limitation is.
If you can’t raise your arm to the front or side more than 25 degrees, you’ll get a disability rating of 40% for a dominant arm and 30% for a non-dominant arm. At 45 degrees, those ratings will be set at 30% and 20%. And if you can raise your arm to 90 degrees, or level with your shoulder, you’ll get a disability rating of 20%, no matter which arm the injury is on.
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Shoulder separation
In some cases, your shoulder dislocation may not involve your humerus bone popping out of the scapula joint. Your clavicle can also dislocate from your scapula at your acromioclavicular joint. This is called shoulder separation, and it can cause serious damage to the ligaments surrounding the joint, too.
Shoulder separations (diagnostic code 5203) are rated at 20% for either arm and regardless of severity.
Shoulder dislocation
The top of your humerus ends in a ball, which slides into a socket joint formed by your scapula. But some injuries cause that ball to pop out of its socket joint. Once you’ve had this injury, you may find that you’re prone to dislocating that joint over and over again.
If your shoulder frequently dislocates after your injury, it will be given a rating of 30% for a dominant arm and 20% for a non-dominant arm. If it only dislocates occasionally, it will be rated 20% for either arm. These injuries are rated using diagnostic code 5202.
If you had your shoulder dislocated anytime during your active duty, make a note of it and tell us when you call. A dislocated shoulder in service can cause long-term weakness in your shoulder and may lead to additional shoulder problems well after you were discharged.
Humerus bone injuries
Diagnostic code 5202 is a broad code that covers a wide range of injuries. In addition to shoulder dislocations, this code can also cover any injury to the humeral bone, including the humerus itself, the humeral head that sits inside your scapula, or the humeral neck that connects the two.
If you’ve lost your humeral head entirely, a condition known as flail shoulder, you’ll get a disability rating of 80% for a dominant arm or 70% for a non-dominant one. If you break your humeral neck and the bone doesn’t heal back together, you’ll receive a rating of either 60% or 50%.
If your shoulder is damaged in such a way that it’s held together by soft tissues instead of bones, you’ll get a rating of either 50% or 40%. And if your humeral bones are broken in such a way that you can see a deformity just by looking at your arm, you’ll receive a rating of either 30% or 20%, depending on the arm and the severity.
Clavicle and scapula bone injuries
You may also injure your clavicle or scapula in the line of duties. All of these injuries fall under code 5203, the same code as a shoulder separation. Ratings for these codes can range from 10 to 20%, depending on your injury.
If you break your clavicle or scapula and you have trouble controlling your arm afterward, you’ll receive a rating of 20%. If you don’t have trouble controlling your movement, but your bones didn’t heal back together, you’ll get a rating of 10%. You’ll also get 10% if your bones did heal back together, but not properly.
Other shoulder injuries
There are also a range of other diseases, injuries, and conditions that can impact your shoulder function. Degenerative arthritis and osteoporosis can both affect your shoulders. You may also get cancer or other tumors in your shoulder that are a result of your military service.
These other injuries, diseases, and conditions are rated depending on how severely they impact your life. If your shoulder aches from time to time when it rains, you’re likely to get 10% disability. However, if your arthritis is bad enough that you are completely bedridden, you’ll be eligible for a 100% disability rating.
Contacting Woods and Woods
If you received shoulder injuries in the military, you may be entitled to monthly compensation from the VA. Talk to your physician about your diagnosis and start the process of applying for VA disability payments. If you’d like help with a VA disability application or appeal reach out to us at Woods and Woods.
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FREQUENTLY ASKED QUESTIONS
The maximum rating for each arm is 80% for your secondary side and 90% for your primary side. We should look over your case to see if we can present your case in such a way to get 100% TDIU if you can’t work. Every case needs to be treated differently.
Yes. A missing arm counts as the highest level of injury, so any disability on your other arm would qualify for the extra 10% rating from the bilateral factor as long as that other arm’s injury can be service-connected.
Neil Woods
VA disability lawyer
Woods and Woods
VA Accreditation Number: 44739