Rating Schedule for The Shoulder and Upper Arm
IMPORTANT NOTE:
For the purposes of Range of Motion (ROM), the examiner/rater are REQUIRED to consider flair ups in your conditions. Meaning, if you do not happen to have an Examination on your worst day, the examiner is required to reasonably estimate your impairment on your worst day! The rater is required to use this estimate, unless your ROM is somehow noted as being worse during ROM testing during the exam. In any event, the rater is to use the most impaired ROM measurements noted by the examiner!
NOTE:
For Veterans who are ambidextrous the affected limb WILL be considered dominant.
Amputation Rule
Veterans CANNOT have a total Combined rating for places in the body higher than a Veteran who had those areas amputated. IE A veteran who has various disabilities in their knee, ankle, and foot; Those ratings cannot combine to be more than a Veteran who had their leg amputated just above the knee.
5120/5121/5122 Amputation
Veteran is entitled to Special Monthly Compensation.
| Dominant Rating | Non-Dominant Rating |
Degree of Amputation |
|---|---|---|
| 80% | 70% | Below the point where the Deltoid attaches to the arm. |
| 90% | 80% | Below the shoulder, but above the point where the Deltoid attaches to the arm. |
| 90% | 90% | From the shoulder joint down. |
| 100% | 100% | Forequarter amputation (involving complete removal of the humerus along with any portion of the scapula, clavicle, and/or ribs). |
5201 Ratings Based Off Limitations of Range of Motion (ROM)
When Veterans cannot raise their arm to their side (abduction) or directly in font of them (flexion).
PYRAMIDING NOTE:
Veterans will NOT receive separate ratings if both their abduction and flexion range of motions are affected.
| Dominant Rating |
Non-Dominant Rating |
Limitation of Abduction or Flexion |
|---|---|---|
| 20% | 20% | No more than 90° (shoulder level). |
| 30% | 20% | No more than 45°. |
| 40% | 30% | 25° or less. |
Dislocations
When things pop out of place.
PYRAMIDING NOTES:
If dislocation(s) impact ROM, then separate evaluations for ROM and dislocation(s) are NOT allowed; you will get the higher of the 2 evaluations.
If dislocation does NOT impact ROM, then you CAN have a separate evaluation for ROM AND dislocation.
If BOTH bones dislocate AND BOTH do NOT impact ROM, separate evaluations CAN be awarded for BOTH dislocations AND ROM.
Separate grants for collar bone/shoulder bone dislocation and collar bone/shoulder bone healing issues are NOT allowed.
5202a Upper Arm (Humerus Bone)
| Dominant Rating |
Non-Dominant Rating |
Description |
|---|---|---|
| 20% | 20% | Infrequent episodes and guarding of movement only at shoulder level. |
| 30% | 20% | Frequent episodes and guarding of all arm movements. |
Bones
When things go missing, break, or never heal.
PYRAMIDING NOTES:
If the bone(s) impact ROM, then separate evaluations for ROM and dislocation are NOT allowed; you will get the higher of the 2 evaluations.
If the bone does NOT impact ROM, then you CAN have a separate evaluation for ROM AND dislocation.
If BOTH bones healed poorly and/or were removed AND BOTH do NOT impact ROM, then separate evaluations CAN be awarded for BOTH bones AND ROM.
Separate grants for collar bone/shoulder bone dislocation and collar bone/shoulder bone healing issues are NOT allowed.
5202b Upper Arm (Humerus Bone)
Funniest bone in the body.
| Dominant Rating |
Non-Dominant Rating |
Description |
|---|---|---|
| 20% | 20% | Bone broke and healed improperly, causing a slight visual deformity. |
| 30% | 20% | Bone broke and healed improperly, causing a SEVERE visual deformity. |
| 50% | 40% | Bone is connected to the shoulder by muscle and other tissues instead of bone (fibrous union). |
| 60% | 50% | Neck of the bone never heals (false flail joint). |
| 80% | 70% | Head of the bone has been removed (flail shoulder). |
5203b Collar Bone (Clavicle) or Shoulder Bone (Scapula)
The following ratings and descriptions apply to both of these bones. The Veteran does not need to have both bones affected.
| Dominant Rating |
Non-Dominant Rating |
Description |
|---|---|---|
| 10% | 10% | Bone broke and healed improperly. |
| 10% | 10% | Bone broke and never healed. |
| 20% | 20% | Bone broke and never healed. Resulting in loose or uncontrolled movement. |
Miscellaneous Ratings
The Veteran will NOT receive an additional rating if they fit the criteria of any of these miscellaneous cases. The Veteran will get a single rating for the ROM or Miscellaneous rating; Whichever rating is higher!
Pain with Motion
PYRAMIDING NOTE:
When there is an award based on pain with motion with movement of the shoulder. The VA will only award a SINGLE rating under range of motion! No matter how many ranges of motion are impacted!
| Rating |
Description |
|---|---|
| 20% |
Pain with motion. |
Arthritis
When a Veteran's arthritis does not warrant a rating based upon ROM or other miscellaneous situations. The Veteran's condition will be rated under degenerative arthritis.
For an explanation of arthritis ratings click HERE.
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