VA Disability Rating for Arm and Shoulder Injuries

Arm and shoulder injuries are common among veterans due to the physical demands of military service. These injuries can have a significant impact on daily life and job performance. If you’re a veteran struggling with arm or shoulder issues, understanding VA disability ratings can be crucial in securing the benefits and support you need.

This guide will walk you through the types of arm and shoulder injuries recognized by the VA, how to establish service connection, disability rating criteria, and tips for maximizing your benefits.

Arm and Shoulder Injuries Recognized by the VA

The VA recognizes various types of arm and shoulder injuries that can qualify for disability benefits:

Shoulder Injuries

• Shoulder Dislocation: A painful condition where the upper arm bone is forced out of the shoulder socket, potentially leading to chronic instability if not properly treated.
• Shoulder Separation: An injury involving stretching or tearing of ligaments connecting the collarbone to the shoulder blade, distinct from a dislocation as it affects the acromioclavicular joint.
• Rotator Cuff Injuries: Damage to the group of muscles and tendons surrounding the shoulder joint, resulting in pain, weakness, and reduced range of motion.
• Frozen Shoulder: A condition characterized by stiffness and pain in the shoulder joint, developing gradually and potentially lasting for months or years.
• Shoulder Bursitis: Inflammation of the bursa in the shoulder, causing pain, especially during overhead movements.
• Labral Tears: Damage to the cartilage rim surrounding the shoulder socket, often associated with dislocations or repetitive overhead motions.

Arm Injuries

• Bicep Tendon Rupture: Tearing of the tendon connecting the bicep muscle to the shoulder or elbow, often occurring during heavy lifting or sudden movements.
• Tricep Tendon Rupture: A less common but significant injury affecting the tendon that connects the tricep muscle to the elbow.
• Elbow Injuries: Conditions like tennis elbow or golfer’s elbow, resulting from repetitive motions or overuse common in military tasks.
• Forearm Fractures: Breaks in the radius or ulna bones, potentially requiring casting or surgical repair depending on severity.
• Nerve Injuries: Conditions such as ulnar nerve entrapment or radial nerve palsy causing numbness, tingling, or weakness in the arm and hand.
• Shoulder or Arm Amputation: Loss of part or all of the arm, rated under specific VA guidelines based on the level of amputation and whether the dominant arm is affected.

Establishing Service-Connection for Arm and Shoulder Injuries

To receive VA disability benefits for arm and shoulder injuries, you must establish a service connection. Here are the primary ways to do so:

Direct Service Connection

If your arm or shoulder injury occurred during your military service, you can establish a direct service connection. This requires medical evidence and service records showing the injury happened while in service.

Presumptive Service Connection

Certain chronic conditions may be presumptively service-connected if they manifested to a compensable degree within one year of separation from service. While it is rare for arm conditions to be presumptively linked to service, it is possible in some cases.

Secondary Service Connection

If another service-connected condition caused or aggravated your arm or shoulder injury, you may establish a secondary service connection. For example, if a service-connected back condition led to altered body mechanics, causing a shoulder injury.

VA Disability Rating Criteria for Arm and Shoulder Injuries

The VA assigns disability ratings for arm and shoulder injuries based on the specific condition and its severity. Ratings are typically based on factors such as range of motion, pain, and functional loss.

Here are some common rating criteria:

Shoulder Conditions (38 CFR § 4.71a)

• Diagnostic Code 5201 (Arm, limitation of motion):
  • 40%: To 25° from side (major arm)
  • 30%: To 25° from side (minor arm)
  • 30%: Midway between side and shoulder level (major arm)
  • 20%: Midway between side and shoulder level (minor arm)
  • 20%: At shoulder level (major or minor arm)
• Diagnostic Code 5202 (Humerus, other impairment of):
  • 80%: Loss of head of humerus (flail shoulder) (major arm)
  • 70%: Loss of head of humerus (flail shoulder) (minor arm)
  • 60%: Nonunion of humerus (false flail joint) (major arm)
  • 50%: Nonunion of humerus (false flail joint) (minor arm)

Elbow and Forearm Conditions (38 CFR § 4.71a)

• Diagnostic Code 5206 (Forearm, limitation of flexion):
  • 50%: Flexion limited to 45° (major arm)
  • 40%: Flexion limited to 45° (minor arm)
  • 40%: Flexion limited to 55° (major arm)
  • 30%: Flexion limited to 55° (minor arm)
• Diagnostic Code 5213 (Impairment of supination and pronation):
  • 40%: Loss of supination and pronation (bone fusion) with the hand fixed in supination or hyperpronation (major arm)
  • 30%: Loss of supination and pronation (bone fusion) with the hand fixed in supination or hyperpronation (minor arm)

The VA distinguishes between the major (dominant) and minor (non-dominant) arm when assigning ratings.

Gathering Evidence for Your Arm and Shoulder Injury Claim

To support your VA disability claim for arm and shoulder injuries, you’ll need to provide compelling evidence:

Medical Evidence

• Diagnosis from a qualified medical professional
• Treatment records, including surgeries, physical therapy, and medications
• Imaging results (X-rays, MRIs, CT scans)
• Range of motion measurements
• Strength and stability test results

Lay Evidence

Personal statements from you and buddy statements from family, friends, or fellow service members can help show VA how the injury occurred (if during service) and its impact on your daily life and work abilities.

VA Examinations

The VA may schedule a Compensation and Pension (C&P) exam to assess the severity of your arm or shoulder injury. This typically includes a physical examination and range of motion tests. Attending these exams is crucial, as missing an appointment can result in denial of benefits.

Special Considerations for Arm and Shoulder Injury Claims

Bilateral Factor

If you have injuries to both arms or shoulders, you may be eligible for the bilateral factor. This increases your VA disability rating when you have disabilities affecting both sides of your body (e.g., both arms, both legs). It recognizes that paired disabilities create a greater overall impact than their individual ratings suggest.

Here’s how it works:

1. Combining Disability Ratings: The VA uses a “whole person” method to combine disability ratings, not simple addition. For example, if you have a 30% disability in the left shoulder and a 20% disability in the right shoulder, these ratings are combined using VA’s combined rating table, resulting in a 44% rating.
2. Applying the Bilateral Factor: After combining the ratings for paired disabilities, the VA adds 10% of this combined value. In our example:
   • Combined rating for left and right shoulders: 44%
   • 10% of 44% is 4.4%, rounded to 4%
   • New combined rating: 44% + 4% = 48%, which VA rounds up to 50%

This process ensures that the compounding impact of having disabilities in paired extremities is properly accounted for in your overall disability rating. This would be the same calculation even if the disabilities were to different parts of the arm. Like a left shoulder and right wrist, for example.

Flare-ups and Functional Loss

Be sure to document any flare-ups of pain or instances where your arm or shoulder condition causes additional functional loss. This can include difficulty with lifting, reaching, or performing repetitive motions. VA should assign a rating consistent with symptoms during flare-ups regardless of whether you are experiencing a flareup at the time of your VA exam.

Tips for Maximizing Your Arm and Shoulder Injury VA Disability Rating

Consider these tips to increase your chances of receiving the highest possible VA disability rating:

Seek Regular Medical Treatment

Consistently seeking medical care demonstrates the ongoing severity of your condition. Follow your doctor’s treatment plan and keep all appointments.

Document Range of Motion Issues

If your arm or shoulder injury limits your range of motion, ensure this is well-documented by your healthcare provider.

Consider the Impact on Your Daily Life

When describing your condition, explain how your arm or shoulder injury affects your ability to work, perform household chores, engage in hobbies, and carry out daily activities.

Be Prepared for VA Examinations

During C&P exams, be honest about your pain levels and limitations. Don’t try to push through pain during range of motion tests, as this can lead to an inaccurate assessment of your disability.

You want to make sure the examiner understands the impact of any flare-ups and if symptoms become worse after repetitive use.

Also, if you take any anti-inflammatory medications or painkillers, you want to make sure those medications are well documented, and the examiner is aware of the medications, and can describe what the condition is like without the medications.

Appeal Unfavorable Decisions

If the VA denies your arm or shoulder injury claim or assigns a lower rating than you believe is fair, don’t give up. The appeals process can be difficult to navigate, but you don’t have to go through it alone. At ProVet Legal, our VA disability attorneys understand the nuances of these cases and can help you build a strong appeal.

Don’t let confusion over the appeals process cost you the benefits you’ve earned. Contact ProVet Legal today for a free consultation, and let us fight for the compensation you deserve.