How the VA rates shoulder conditions

Shoulders are rated on how far you can lift your arm, measured in degrees with a goniometer. Which arm it is changes the number, and that is the part nobody expects.

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

Shoulder and arm disabilities are rated under diagnostic codes 5200 through 5203 in 38 CFR § 4.71a. Rotator cuff tears, impingement, labral tears, bursitis, and shoulder arthritis do not have codes of their own. They are rated on the result, which is almost always 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. A veteran who is right-handed with a destroyed right shoulder rates above the same veteran with a destroyed left shoulder.

Make sure the examiner records your handedness correctly. It is a single box on the exam form and it is occasionally ticked wrong, which quietly costs a rating step.

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. In practice this is usually applied as 10%.

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, and describing exactly which movements you avoid is what separates the 30% tier from the 20%.

DC 5200 and 5203

DC 5200 covers ankylosis, where the scapula and humerus have fused and move as one piece. Rated 30% to 50% for the major arm depending on whether the fusion is favourable, intermediate, or unfavourable. True ankylosis is uncommon.

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, whichever is more favourable. This is the code that produces a compensable rating for a badly healed collarbone break.

Arthritis in the shoulder

Degenerative arthritis is rated on the resulting limitation of motion. Where that limitation is non-compensable, X-ray evidence of arthritis in two or more major joints can support 10%, or 20% with occasional incapacitating exacerbations. The shoulder counts as a major joint.

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 are service connected, 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. It is a small adjustment that regularly carries 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. Shoulder surgery leaves scars, and painful or unstable ones rate separately under DC 7804. See the scars guide.

The exam

The shoulder DBQ records range of motion in both arms with a goniometer, before and after repetitive use, plus stability testing, strength, and whether there is pain on motion and at what point it begins. The point where pain starts is recorded separately from where motion stops, and it matters, so say when it 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.