Shoulder & Arm: VA Rating Criteria

Plain-language guide

What this rating actually turns on

The one fact that changes every shoulder number is which arm it is: the identical injury pays a full step more on your dominant side. Under 38 CFR 4.71a, the shoulder-and-arm pathways are: limitation of arm motion (DC 5201); ankylosis, a joint fused in place (DC 5200); impairment of the humerus including flail shoulder, nonunion, fibrous union, recurrent dislocation, and malunion (DC 5202); and clavicle or scapula impairment (DC 5203).

Each of these codes carries two columns, major (dominant) and minor (non-dominant), and VA determines your dominant arm from the record or on exam under 38 CFR 4.69. The same disability pays more on your dominant side. Under DC 5201, limited arm motion rates 20 percent at shoulder level (flexion and/or abduction limited to 90 degrees), 30 percent major / 20 percent minor midway between side and shoulder level (limited to 45 degrees), and 40 percent major / 30 percent minor when limited to 25 degrees from the side. Note that “at shoulder level” pays 20 percent on both arms; the major/minor split only opens up as motion gets worse.

Those explicit degree equivalents were written into DC 5201 by VA’s 2021 rewrite of the musculoskeletal schedule (85 FR 76453, effective February 7, 2021), so an examiner’s goniometer reading now maps directly to a percentage. DC 5202 is where the high numbers live: loss of the humeral head (flail shoulder) is 80 major / 70 minor, nonunion (false flail joint) 60 / 50, and fibrous union 50 / 40. Recurrent dislocation rates 30 / 20 with frequent episodes and guarding of all arm movements, or 20 / 20 with infrequent episodes and guarding only at shoulder level. DC 5200 ankylosis runs 30 / 20 favorable (abduction to 60 degrees, can reach mouth and head) up to 50 / 40 unfavorable (abduction limited to 25 degrees from side); remember the scapula and humerus move as one piece, so a “frozen” reading has to reflect the whole articulation.

A worked example

Say a right-handed veteran has a service-connected rotator-cuff injury in the right shoulder, and the record establishes the right arm as dominant under 38 CFR 4.69. At the C&P exam the examiner measures active abduction, and the arm rises to only 45 degrees before pain and weakness stop it, repeated three times. On DC 5201, motion limited to 45 degrees is “midway between side and shoulder level.” Because this is the dominant arm, it reads on the major column at 30 percent, the amount shown in the pay table below. Had this been the non-dominant arm, the same 45-degree measurement would read on the minor column at 20 percent, which is exactly why getting the dominant hand stated in the record is worth the effort.

What the C&P exam measures

The examiner completes the Shoulder and Arm Conditions DBQ. It requires range of motion in degrees for flexion, abduction, external and internal rotation, active and passive, with the opposite shoulder tested for comparison, plus three repetitions to capture additional loss after repeated use. It records your description of flare-ups (frequency, duration, severity), and the examiner must estimate your motion in degrees during a flare based on your account even if you are not flaring at the appointment. The exam also documents crepitus, guarding, instability, dislocation history, and whether there is ankylosis, because those findings route you off DC 5201 and onto DC 5200 or 5202, which often pay more. 38 CFR 4.59 entitles an actually painful joint to at least the minimum compensable rating even when your measured motion would not otherwise qualify.

What to have in your file

Per VA’s evidence requirements: service treatment records tying the shoulder to service, imaging (X-ray, MRI, arthrogram) showing the structural problem, and any operative reports. Surgical records are what establish nonunion, fibrous union, or a failed repair under DC 5202, and they document which shoulder, which matters because the dominant-side columns pay more. Buddy and lay statements (VA Form 21-10210) describing flare-ups, dislocations, and what you can no longer lift or reach feed the exact DBQ questions the examiner has to answer.

Common mistakes

• Not flagging your dominant hand. If the record is silent, get it stated. On the arm you write with, the same limited motion or humerus impairment pays a full step higher.
• Letting an exam stop at “limited motion” when the joint is unstable or fused. Recurrent dislocation (5202) and ankylosis (5200) have their own, often higher, criteria; a bare 5201 range-of-motion reading can undersell those.
• Expecting a bilateral bump on one shoulder. The bilateral factor applies only when both arms carry compensable ratings. A single shoulder never gets it, no matter how severe.

Worth knowing

If both shoulders (or a shoulder and another paired-limb disability) are compensable, the bilateral factor adds 10 percent of their combined value before the rest of your conditions are combined; see the bilateral-factor guide and run the numbers on the calculator. Shoulder impingement, rotator-cuff tears, and arthritis are frequently secondary to a service-connected neck or the overuse of a limb compensating for another injury; if so, read secondary service connection. Preparing for the appointment itself is covered in what to expect at your C&P exam.

If your rating came back lower than this

A decision that ignores the criteria above is a frequent reason veterans are underpaid. Line your decision up against the levels on this page. If the evidence supports a higher level than VA assigned, you have three ways to challenge it, and the right one depends on why it went wrong:

• Something was missing from the record (an exam finding, a prescription, a flare-up statement, a nexus letter): add it with a Supplemental Claim.
• The evidence was already there and VA misread it: ask for a Higher-Level Review by a more senior rater, with no new evidence needed.
• A legal or judgment error: take it to the Board of Veterans' Appeals.

Before you file, recombine this rating with your others (VA math does not add ratings), check how long each lane is taking right now, and remember a VA-accredited representative or VSO will help you for free. You can also browse every other condition's criteria to make sure you are claiming everything you are owed.