Shoulder injuries in the military are a common source of VA disability compensation. Rotator cuffs, dislocations, and poorly healed bones all contribute to long-term disabilities in veterans.
If you’ve served in the military, the VA offers you a variety of aid programs and benefits. But one of the biggest sources of aid for many veterans is the VA disability program. This benefit gives injured veterans monthly compensation to make up for the limits their injury places on their life.
In This Article About VA Disability for Arm and Shoulder Pain:
- Basic Shoulder Anatomy
- How VA Disability Benefits Work
- VA Rating Schedules
- Shoulder Replacement
- Arm and Shoulder Amputations
- Frozen Shoulder VA Disability
- Limitation of Motion
- Shoulder Dislocation
- Shoulder Separation
- Humerus Bone Injuries
- Clavicle and Scapula Bone Injuries
- Other Shoulder Injuries
- VA Shoulder Pain Ratings and Grip Increases
- Separate Ratings vs. Pyramiding
- Qualifying for VA Disability Payments
- Learn More About Shoulder Injuries in the Military
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.
How VA Disability Benefits Work
If you qualify for a VA disability benefit, you’ll receive a tax-free monthly payment. The amount you receive will be based on what kind of injury or condition you have and how seriously it impacts your life. Conditions and injuries are organized into rating schedules, which get translated into percentages that represent what percent of your ability to work you’ve lost.
If you have a disability rating of 10 percent, you’ll receive $152.64 a month, and with a rating of 20 percent, you’ll get $301.74. Payments for ratings of 30 percent and above depend on whether you have a dependent spouse and/or children. If you have a disability rating of 100 percent, one child, a dependent spouse, and two parents relying on you, you could receive more than $3,332.06 every month.
VA Rating Schedules
In order for the VA to determine your disability rating, they have to assess both the nature and severity of your injury or condition. If you lost a pinky finger in the military, it may impact your ability to live a normal life a bit. But if you lost a whole arm, your impact will obviously be much more drastic.
The VA has created a schedule for classifying and evaluating different conditions and injuries called the VASRD (Veteran Affairs Schedule for Rating Disabilities). Each condition gets its own code and is eligible for a certain level of disability rating. The VA has also generated a system to allow you to combine multiple injuries or conditions into one overall disability rating.
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 percent 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 percent for a dominant arm and 20 percent for a non-dominant arm, but you could get a rating as high as 50 or 60 percent, depending on your condition.
Arm and Shoulder Amputations
In the most severe cases of injury, you may have to have your whole arm amputated up to the shoulder. In these cases, you’ll receive the maximum rating for loss of use of that arm. However, it is important to note that if you have multiple injuries in your arm, those cannot be combined for a higher rating than the rating you’d get for amputation of the limb.
If you have to have your entire arm and shoulder amputated, you’ll receive a 90 percent disability rating, no matter which arm it is. If you have to have your arm amputated up to the deltoid, you’ll get a rating of 80 percent. If you have to have your arm amputated below the deltoid, you’ll receive a 70 percent rating, with all of these falling under code 5200.
Learn More About VA Ratings for Losing an Arm or Fingers
Veterans who lost an arm, hand, or finger during military service are eligible for VA disability benefits and other compensation.
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 percent for a dominant arm or 40 percent for a non-dominant arm. Further movement beyond that is coded differently and will receive ratings based on how severe the limitation is.
Here is our video explaining VA math for combined VA disabilities.
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 percent for a dominant arm and 30 percent for a non-dominant arm. At 45 degrees, those ratings will be set at 30 percent and 20 percent. And if you can raise your arm to 90 degrees, or level with your shoulder, you’ll get a disability rating of 20 percent, no matter which arm the injury is on.
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 percent for a dominant arm and 20 percent for a non-dominant arm. If it only dislocates occasionally, it will be rated 20 percent for either arm. These injuries are coded 5202.
If you had your shoulder dislocated anytime during your active duty, make a note of it and tell us when you call. Once a dislocation happens, it can cause long-term weakness in your shoulder. Even. if you didn’t have any more shoulder problems until after you were discharged, they could be linked to that time your shoulder was dislocated.
Many veterans have non-combat PTSD for numerous reasons. Here one of our veterans disability lawyers talks about some of those cases.
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 are coded separately from shoulder dislocations. These receive a code of 5203. They are rated at 20 percent for either arm and regardless of severity.
Humerus Bone Injuries
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 percent for a dominant arm or 70 percent 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 percent or 50 percent.
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 percent or 40 percent. 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 percent or 20 percent, 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 percent, 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 percent. If you don’t have trouble controlling your movement, but your bones didn’t heal back together, you’ll get a rating of 10 percent. You’ll also get 10 percent 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 percent disability. However, if your arthritis is bad enough that you are completely bedridden, you’ll be eligible for a 100 percent disability rating.
VA Shoulder Pain Ratings and Grip Increases
There are a few principles the VA uses in determining disability ratings that apply to shoulder conditions. For instance, the Painful Motion principle states that if you have any pain when you move the joint, you are entitled to the minimum disability rating for that body part.
If your condition makes it impossible for you to grasp things with your hand, you may be eligible for the VA’s Special Monthly Compensation. When the VA is establishing ratings, they consider the shoulder to be a major joint. And if there’s ever a question about which of two or more evaluations to use, the VA will always use the evaluation that provides the higher rating.
Sometimes your rating might be at 80% but you know it should be full 100% disability. Here one of our certified VA disability lawyers talks about that increase.
Separate Ratings vs. Pyramiding
If you have more than one condition affecting your shoulder, might be able to get a disability rating for all of those conditions. However, you cannot simply combine these ratings to get an overall disability rating. So if you have a shoulder separation and a humerus injury that rate at 20 percent each, your disability rating is not 40 percent.
Instead, the VA uses a system that calculates the total disability you are entitled to. In our example above, you would receive 36 percent compensation for those two shoulder injuries. It is also important to note that you cannot receive two different ratings for effects stemming from the same root cause. Multiple ratings for the same condition is called pyramiding and the VA will try to avoid that, almost to the point of not giving you the ratings you deserve.
Qualifying for VA Disability Payments
There are a few requirements you must meet in order to qualify for VA disability payments. First of all, you must have a diagnosed shoulder or arm condition. You must visit a VA-approved physician to get this diagnosis and receive documentation of it.
You must also have experienced some sort of event, injury, or illness during your service time that caused your injury or condition. And you must be able to provide a medical nexus linking your condition to the in-service event that caused it. Once you have established these three things, the VA will move forward with your disability payments.
Learn More About Shoulder Injuries in the Military
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 navigating the VA disability process, reach out to us at Woods and Woods, LLC. We can help you apply for disability benefits or appeal a denied application. Start applying today and get the compensation you deserve.
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.