VA shoulder rating: range of motion, pain and surgery

Shoulders are usually rated on how far you can lift your arm, measured in degrees with a goniometer. Which arm it is can change the number, and that is the part many people do not expect.

Last reviewed October 2026 · Not legal advice, VA.gov always controls

VA rates a service-connected shoulder on what the evidence shows it can do: how far the arm lifts forward and out to the side, functional loss from pain, flare-ups and repeated use, and any instability, fracture damage or joint replacement. Limitation of motion is rated from 20% to 40%, with higher percentages for your dominant arm at some levels, and surgery is rated on recovery and what is left afterward (38 CFR § 4.71a).

Shoulder and arm disabilities are rated under diagnostic codes 5200 through 5203 in 38 CFR § 4.71a. Rotator cuff tears, impingement, and labral tears do not have codes of their own, and the codes that do exist for bursitis (DC 5019), tendinitis (DC 5024), and arthritis (DC 5003 and 5010) send the rater back to motion. All of them are rated on the result, which is often limitation of motion under DC 5201.

Major and minor: your dominant arm rates higher

The shoulder table has two columns. Major means your dominant arm, minor means the other one, and for identical loss of motion the major arm is often rated higher. At several levels, a right-handed veteran with a badly damaged right shoulder rates above the same veteran with the same damage to the left shoulder.

Make sure the examiner records your handedness correctly. It is a single box on the exam form (Right / Left / Ambidextrous), and a wrong entry can cost a rating step wherever the major and minor columns differ. Under § 4.69 only one hand can be dominant, and for an ambidextrous veteran the injured arm, or the more severely injured one, is treated as the major arm.

DC 5201: limitation of arm motion

This is the code most shoulder claims are rated under. It measures flexion (raising the arm forward) and abduction (raising it out to the side), and it takes whichever is worse.

Normal shoulder flexion and abduction is 0 to 180 degrees. Shoulder level is 90 degrees, roughly arm straight out sideways. So the schedule does not begin paying under 5201 until you cannot raise your arm past horizontal.

The painful motion rule

Under § 4.59, painful motion of a joint is entitled to at least the minimum compensable rating for that joint, even where the measured range of motion would otherwise be non-compensable. For the shoulder that minimum is 20%, not 10%. Since May 23, 2016, VA's adjudication manual (M21-1) has defined the minimum as the lowest rating the applicable diagnostic code lists, and the lowest DC 5201 lists is 20%. Before that date VA treated the minimum as 10% whatever the code. The same manual accepts credible lay evidence of painful motion for this minimum, such as pain reported during repeated use or flare-ups; objective findings are not required.

Alongside it, §§ 4.40 and 4.45 require the rater to consider functional loss from pain, weakness, fatigability, and incoordination, including during flare-ups and after repeated use, rather than only the single best measurement taken in a quiet exam room. This is the argument for a shoulder that measures 120 degrees on a good morning but cannot be lifted at all by the end of a shift.

For that argument to work the examiner has to record it, which means describing repeated use and flare-ups clearly at the exam. See the C&P exam guide.

DC 5202: humerus impairment and recurrent dislocation

This code covers instability and structural damage, and it reaches much higher than 5201.

If your shoulder dislocates or subluxes repeatedly, this is the code to look at. "Guarding" means you have learned to hold the arm in ways that avoid the dislocation. How often it happens and exactly which movements you avoid are what separate the tiers: the 30% major-arm tier needs frequent episodes and guarding of all arm movements, the 20% tier infrequent episodes and guarding only at shoulder level.

DC 5200 and 5203

DC 5200 covers ankylosis of the shoulder joint, where, in the schedule's words, the scapula and humerus move as one piece. Rated 30% to 50% for the major arm depending on whether the fusion is favourable, intermediate, or unfavourable.

DC 5203 covers the clavicle or scapula: dislocation at 20%, nonunion with loose movement at 20%, nonunion without loose movement at 10%, and malunion at 10%, the same for either arm. It also allows rating on impairment of function of the contiguous joint instead. This is the code that produces a compensable rating for a badly healed collarbone break.

Arthritis in the shoulder

Degenerative arthritis (DC 5003) is rated on the resulting limitation of motion, and post-traumatic arthritis (DC 5010) on limitation of motion, dislocation, or instability of the joint. Where the limitation is non-compensable but objectively confirmed, by swelling, muscle spasm, or satisfactory evidence of painful motion, DC 5003 allows 10% for each major joint affected. VA's manual illustrates that 10% with a shoulder that shows swelling but no painful motion; where motion is painful, its examples apply the 20% DC 5201 minimum instead. Only where there is no limitation of motion at all does the X-ray rule apply: involvement of two or more major joints supports 10%, or 20% with occasional incapacitating exacerbations. The shoulder counts as a major joint under § 4.45.

What you cannot do is receive a separate rating for arthritis and for limitation of motion in the same shoulder, because both compensate the same impairment. That is pyramiding, prohibited by § 4.14.

Two shoulders, and the bilateral factor

Each shoulder is rated separately. Where both shoulders (or any disabilities of both arms) are service connected at a compensable level, meaning 10% or more each, the bilateral factor applies: the two are combined with each other first and an additional 10% of that subtotal is added before combining with anything else. If leaving a bilateral disability out of that step and combining it separately would give a higher combined rating, § 4.26(d) has VA do that instead. It is a small adjustment, but it can carry a borderline combined rating over a rounding line. The combined rating guide works it through, and the calculator applies it automatically.

Service connection routes

• Direct. A documented in-service injury: a fall, a parachute landing, a lifting injury, a vehicle accident. Sick call entries and profiles are the evidence.
• Cumulative. Years of load-bearing, overhead work, or repetitive movement in an MOS that demanded it. Your personnel file establishing the job is as important as the medical record here.
• Secondary. A shoulder that took over for an injured other arm, or altered mechanics from a service-connected neck or back condition. See secondary conditions.
• Surgical scars. A scar from shoulder surgery can be rated separately if it meets a scar code, for example as painful or unstable under DC 7804. See when a surgical scar is rated.

The exam

The shoulder DBQ records range of motion in both arms, measured with a goniometer as § 4.46 requires, active and passive, before and after repetitive use, plus stability and rotator cuff testing, and whether there is pain on motion, weight-bearing or not. It asks which motions are painful and, separately, the degree at which any limitation is specifically attributable to pain, weakness, fatigability, or incoordination. That figure can sit short of where motion finally stops, and it matters, so say when pain begins rather than pushing silently through.

Bring imaging reports, the operative report if you have had surgery, and any physical therapy notes. If your shoulder is materially worse on some days than others, say so explicitly and give frequency, because a single measurement on a good day otherwise becomes the whole record.

The checklist

1. Confirm your handedness is recorded correctly on the exam.
2. Range of motion measurements in degrees, for flexion and abduction.
3. Imaging and any operative reports.
4. A record of flare-ups and function after repeated use, not just a single best measurement.
5. If the shoulder dislocates, frequency and which movements you guard against.
6. Separate claims for any painful surgical scar and for the other shoulder if both are affected.

Sources

• 38 CFR § 4.71a, Diagnostic Codes 5200 through 5203: the current shoulder and arm tables with major and minor columns, DC 5051 for shoulder replacement, plus DC 5003, 5010, 5019, and 5024 for arthritis, bursitis, and tendinitis.
• 38 CFR § 4.30, Convalescent ratings: the temporary 100% rating after surgery that needs at least a month of convalescence or leaves severe postoperative residuals.
• 38 CFR § 4.40, Functional loss: pain, weakness, fatigability and incoordination as part of the disability.
• 38 CFR § 4.59, Painful motion: the minimum compensable rating for a painful joint, and the active, passive, weight-bearing testing rule.
• M21-1, Part V, Subpart iii, Chapter 1, Section A: VA's rater guidance setting the painful-motion minimum for the shoulder at 20% under DC 5201 since May 23, 2016, with worked shoulder examples.
• 38 CFR § 4.69, Dominant hand: how handedness is decided, and which arm counts as major for an ambidextrous veteran.
• 38 CFR § 4.71, Plate I: normal shoulder flexion and abduction of 0 to 180 degrees, with 90 degrees at shoulder level.
• 38 CFR § 4.45, The joints and § 4.46, Accurate measurement: the functional-loss factors a rater must consider, the shoulder listed as a major joint for arthritis, and the goniometer as indispensable when VA measures limitation of motion.
• 38 CFR § 4.26, Bilateral factor: the extra 10% added when both arms have compensable disabilities.
• Shoulder and Arm Conditions Disability Benefits Questionnaire: the exam form, including the dominant-hand box, active and passive range of motion, and the recurrent dislocation tiers.