What's the VA Rating for Shoulder Pain in 2024?
If you’re a Veteran who’s suffering from a limited range of motion in your arm, you’re far from alone. In fact, limited arm motion represent the fourth-most common disability in fiscal year 2023, with over 100,000 new VA benefits recipients. Limited motion of the arm has been one of the most common VA disability claims among Veterans for years, with over a million Veterans total receiving compensation due to a limited range of motion in their shoulder or arm.
Here, we’ll take a deeper look at how the VA evaluates shoulder and arm disabilities during your compensation and pensions (C&P) exam, the different types of shoulder and arm disabilities you could be rated for, and ratings and compensation for those specific disabilities. Let’s get right to it.
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What to Expect During Your C&P Exam for Shoulder Pain
After you file a claim with the VA for disability compensation due to shoulder pain or arm pain, you’ll undergo a Compensation & Pensions exam (C&P exam). Here’s what you can expect during this examination:
A Review of Your Medical History, Medical Records, and Current Symptoms
First, your medical records will be reviewed, and you’ll be asked to provide a holistic account of your current symptoms and the kind of shoulder pain or arm pain you’re experiencing. . This includes describing the pain, treatments you currently take, and any additional symptoms. You’ll also be asked to share your history of injuries to your arms and shoulder, hospitalizations, and surgeries. Finally, you’ll be asked to share how your injury or pain impacts your daily life.
The Examiner Will Measure Your Range of Motion
Next, you’ll undergo a physical exam. During this, your examiner will inspect your arms and shoulder. They will assess the degree to which your range of motion is impacted by measuring your movements with a tool called a goniometer, which is like a protractor.
For most shoulder and arm injuries, your range of motion is critical because it’s the basis for your disability rating. The less mobility you have in your arms or shoulder, and the higher your disability rating will be in most cases.
Some of the motions you might be asked to do will measure your:
Scapulohumeral articulation: This measures how well your shoulder joint — where your humerus and scapula meet — moves. Motions that use this joint include things like swimming and throwing a ball.
Flexion of your arm: This essentially measures how well you can raise your arms straight in front of you, like if your were waving to a friend or raising a cup to your mouth.
Abduction of your arm: Abduction refers to your ability to raise your arms to the side, like you would if you were doing a jumping jack.
Supination of your elbow and forearm: Supination refers to your ability to turn your palms up. If you have pain or stiffness in your forearms that prevents supine movements, you might struggle with tasks like turning the ignition of a car.
Pronation of your elbow and forearm: Pronation is the reverse of supination. It’s your ability to turn your palm downward. Pain or stiffness preventing your arm’s pronation could make it difficult to do things like turn doorknobs counterclockwise.
As you’re making these movements, your examiner will be watching for ‘guarding.’ Guarding refers to whether you resist certain movements because you’re anticipating pain.
Your examiner will also assess you for ankylosis, which refers to your arm or shoulder being stiff or inflexible. Your ankylosis could leave your arm or shoulder fixed in a position that is either considered ‘favorable’ or ‘unfavorable,’ meaning it causes you pain.
The VA Rating Schedule for Shoulder and Arm Pain in 2024
The VA’s rating schedule for shoulder and arm disabilities is explained in Title 38, Section 4.71a of the Code of Federal Regulations. Ratings for arm and shoulder disabilities vary depending on your level of immobility or ankylosis.
Your rating will be based on the evaluation of your shoulder, upper arm, and forearm and elbow. Therefore, I’ve broken down the disability ratings for shoulder and arm pain based on those areas. Let’s take a closer look at the VA’s rating for shoulder pain and arm pain here.
Note that for limitation of motion in the arm and shoulder, the VA rates your disability based on whether your dominant or non-dominant hand is affected. Disabilities in your non-dominant arm or shoulder will receive a minor rating, 10% lower than the rating for your dominant arm.
VA Ratings for Shoulder Pain in 2024
The 2024 VA ratings for scapulohumeral articulation is included in section diagnostic code 5200. The current ratings are:
50% rating (40% minor), $1,075.16 per month: Unfavorable ankylosis of the shoulder and upper arm, meaning you can’t move your arm more than 25º when measured from your torso. What does this look like? Imagine doing a jumping jack or a snow angel: your arms would only be able to rise 25º from hanging naturally by your sides.
40% rating (30% minor), $755.28 per month: The VA rates 50% as unfavorable, 30% as favorable, and 40% between those two.
30% rating (20% minor), $524.31 per month: You could be rated with 30% disability for scapulohumeral articulation if you’re able to extend your arms 60º from the body and reach your head and mouth.
VA Ratings for Arm Pain and Limited Motion of the Arm
Ratings for limitation of motion in the arm is listed under diagnostic code 5201 in the CFR. The ratings are:
40% rating (30% minor), $$755.28 per month: Limited arm motion is measured similarly to scapulohumeral disabilities. For a 40% disability rating for limited arm motion, your ability to raise your arms to the sides and forward must be less than 25º.
30% rating (20% minor), $$524.31 per month: For a 30% disability rating, your arm movement should be 45º or less.
20% rating, $338.49 per month: You could receive a 20% disability rating if your range of motion in your arm is limited to 90º or less.
VA Ratings for Upper Arm Disabilities
Injuries and disabilities related to your humerus (the bone in your upper arm that connects to your scapula) are rated according to diagnostic code 5202. The ratings for humeral injuries include:
80% rating (70% minor), $1,995.01 per month: If you suffered an injury that severely damaged the head of your shoulder, it could leave you with what’s called a flail shoulder. That means your shoulder is very weak, can’t support your arm, and is typically very painful to move. For this condition, you could receive an 80% disability rating.
60% rating (50% minor), $1,361.88 per month: Certain injuries don’t do so much damage that they leave you with a flail joint. However, if the head of your humerus doesn’t heal properly, it can manifest similar symptoms in what’s known as a false flail joint. This can leave you with a 60% disability rating.
50% rating, $1,075.16 per month: Humeral injuries can heal improperly in other ways than a false flail joint. In some cases, if you suffered a fracture, your humerus could heal with a fibrous union. So, instead of the bone reconnecting and becoming whole again, scar tissue forms and holds the bone together. This is weaker than normal recoveries, and as a result, can lead to pain during movement, which could lead to a 50% disability rating.
30% rating, $524.31 per month: If you frequently dislocate the joint of your humerus and scapula, and guard your arm from movement as a result, you could be entitled to a 30% disability rating. You could also be entitled to a 30% rating if you have malunion — a broken bone that healed in the wrong position — that leaves you with an obvious deformity.
20% rating, $338.49 per month: You could receive a 20% if you infrequently dislocate your joint, and only begin guarding your movements when your arm raises to shoulder. Additionally, you could receive a 20% rating if you have a malunion with only a moderate deformity.
VA Disability Ratings for Collar Bone and Shoulder Disabilities
Clavicle (collar bone) and scapula (shoulder) disabilities are rated according to diagnostic code 5203.
20% rating, $ per month: You could receive a 20% if your shoulder or collarbone are dislocated or frequently dislocate. You could also receive a 20% rating if you broke one of these bones, they never healed properly, and they move loosely. This is called a nonunion, and it’s distinct from a malunion, which is what happens in the case of the fibrous union that’s sometimes seen with humeral fractures.
10% rating, $ per month: You could receive a 10% if you broke one of these bones, have a nonunion, but don’t have any loose movement. Additionally, you could receive 10% if you have a malunion of one of these bones.
VA Ratings for Elbow and Forearm Disabilities
Finally, let’s talk about the VA’s ratings for elbow and forearm disabilities. There are several different diagnostic codes that the VA uses to rate Veterans accurately for their specific elbow or forearm disability. Let’s look at those now.
H4: Ankylosis of the Elbow:
If you have ankylosis in your elbow, you could receive up to a 60% disability rating.
60%: Unfavorable ankylosis, meaning you can’t bend to 50º, and that you’re unable to move your arm in the supine and prone motions mentioned earlier.
50%: Intermediate ankylosis, meaning you can move your elbow more than 90º, or between 50º and 70º
40%: Finally, you could receive a 40% disability rating if you can move your elbow between 70º and 90º.
H4: Limitation of Flexion and Extension of the Forearm
Flexion (moving your arm like you’re doing a bicep curl) and extension (moving your arm like you’re opening a door) are rated similarly, although they are rated under unique diagnostic codes (5206 and 5207, respectively). Let’s look at them together, as the movements mirror one another.
50%: You could be rated 50% if your forearm’s flexion is limited to 45º, or if your forearm’s extension is limited to 110º.
40%: You could be rated 40% if your forearm’s flexion is limited to 55º, or if your forearm’s extension is limited to 100º.
30%: You could be rated 30% if your forearm’s flexion is limited to 70º, or if your forearm’s extension is limited to 90º.
20%: You could be rated 20% if your forearm’s flexion is limited to 90º, or if your forearm’s extension is limited to 75º.
10%: You could be rated 10% if your forearm’s flexion is limited to 100º, or if your forearm’s extension is limited to between 60º and 45º.
You could also be rated at 20% if your flexion is limited to 100º and your extension is limited to 45º.
How to Prove a Service Connection for Back Pain
Proving a service connection for shoulder and forearm disabilities is essential for getting the compensation you’re entitled to. Without a service connection, your claim is likely to be rejected. There are three main things that you’ll need to demonstrate a service connection.
First, you’ll need a current diagnosis, whether it’s from a VA healthcare provider or a private physician.
Second, you’ll need an in-service injury, stressor, or illness. This could be something like an impact or crash you were involved in that was directly related to your service. Additionally, your shoulder or arm pain could be secondary to another service-connected disability. For example, image your broke your arm during your service and were treated surgically, but over time your arm became stiff as a result, leading to a reduced range of motion and pain.
Finally, you’ll need to prove that there’s a link between your current diagnosis and your in-service injury or stressor. You may be able to make the link clear through your military service or medical records. Buddy letters can also be helpful for proving that your shoulder or arm pain began during or as a result of your service. However, one of the easiest way to prove a connection or ‘nexus’ between your current condition and your in-service injury is with a nexus letter from a private physician. If you’re not familiar with nexus letters, my article on nexus letters will answer your questions.
When your claim for shoulder or arm checks all these boxes, your VA disability claim has a stronger chance of being granted.
How to File a VA Disability Claim for Shoulder and Arm Disabilities
The first step to filing a VA disability claim for shoulder and arm conditions is to fill out the VA’s disability benefits questionnaire (DBQ) for those conditions. When you submit your claim, be sure to include all the records necessary to establish a service connection, such as your military medical records, your military service records, and diagnoses from your primary care physician.
What Should I Do if My VA Claim for a Shoulder Disability is Denied?
If you filed a VA disability claim for a shoulder or arm disability and were denied, it can be exhausting. On top of dealing with a reduced quality of life, difficulties with daily tasks, and potentially ongoing pain, the process of filing an appeal can be a daunting task. However, if your condition is service connected, you should receive the compensation you’re entitled to.
Depending on your circumstances, a hearing before a Board of Veterans’ Appeals, a higher-level review or supplemental claim could help you receive the benefits you’re entitled to. To learn which type of appeal makes the most sense for your claim, contact me today to schedule a free case evaluation.