Shoulder VA Disability Ratings and Diagnostic Codes

Complete VA shoulder rating table (DC 5200–5203, DC 5051, and 38 CFR 4.59)

The table below lists the percentage evaluations and criteria for shoulder conditions under current 38 CFR 4.71a and 38 CFR 4.59 for both the dominant (Major) and non-dominant (Minor) arm.

Under the veteran-alone compensation schedule effective 2025-12-01, a 10% rating pays $180.42 per month, a 20% rating pays $356.66, a 30% rating pays $552.47, and a 40% rating pays $795.84.

Dominant (major) vs. non-dominant (minor) arm rules under 38 CFR 4.69

Upper-extremity ratings distinguish between your dominant (major) arm and your non-dominant (minor) arm. Under 38 CFR 4.69, the VA determines handedness using three rules:

1. Evidence or testing: Handedness is determined by the evidence of record or by testing during a VA examination.
2. One dominant hand: Only one hand is considered dominant. If you claim both shoulders, one is rated under the Major column and the other under the Minor column.
3. Ambidextrous veterans: The injured hand, or the most severely injured hand if both arms are affected, is treated as the dominant hand for rating purposes.

At the 10% painful motion tier, the 20% shoulder-level tier (90° under DC 5201), infrequent dislocation under DC 5202, and all tiers of DC 5203, the Major and Minor ratings are equal. Once arm motion drops to 45° or 25° under DC 5201, or when recurrent dislocations occur frequently under DC 5202, the dominant arm receives a 10% higher evaluation.

Normal range of motion (Plate I) and Diagnostic Code 5201

Under 38 CFR 4.71 and Plate I, standing upright with your arms hanging straight down at your sides is 0 degrees:

• Forward elevation (flexion): Raising your arm straight forward and overhead from 0° to 180° (shoulder level is 90°).
• Abduction: Raising your arm out to the side from 0° to 180° (shoulder level is 90°).
• External rotation: With the arm abducted to 90° and elbow flexed to 90°, rotating the forearm upward from 0° to 90°.
• Internal rotation: From the same 90° abducted, 90° elbow-flexed midpoint, rotating the forearm downward from 0° to 90°.

Diagnostic Code 5201 assigns ratings based on flexion and/or abduction:

• 20% (Major or Minor): Flexion and/or abduction limited to 90° (shoulder level).
• 30% (Major) / 20% (Minor): Flexion and/or abduction limited to 45° (midway between side and shoulder level).
• 40% (Major) / 30% (Minor): Flexion and/or abduction limited to 25° from the side.

In its musculoskeletal rating schedule revision (85 FR 76453, effective February 7, 2021), the VA confirmed that Diagnostic Code 5201 applies when flexion and/or abduction reaches these cutoffs; restriction in either plane qualifies.

Rotator cuff tears, impingement, and the 10% painful motion rule

The VA rating schedule does not list a standalone percentage table for rotator cuff tears or impingement syndrome. Instead, soft-tissue and arthritic diagnoses are rated through limitation of motion:

• Rotator cuff tendinitis, tendinosis, or tendinopathy (DC 5024) and bursitis (DC 5019): Under the Note to Diagnostic Codes 5013–5024 in 38 CFR 4.71a, these conditions are evaluated as degenerative arthritis under Diagnostic Code 5003 based on limitation of motion of the affected joint.
• Degenerative arthritis (DC 5003) and post-traumatic arthritis (DC 5010): Rated on limitation of motion under Diagnostic Code 5201.

If you can lift your arm above 90° (making your range of motion noncompensable under DC 5201), three regulations protect your claim:

1. Painful motion (38 CFR 4.59): Actually painful, unstable, or malaligned joints are entitled to at least the minimum compensable rating. Under DC 5003 and 38 CFR 4.45 (which classifies the shoulder as a major joint), noncompensable limitation of motion under DC 5201 still warrants 10% when painful motion, swelling, or spasm is objectively confirmed.
2. Functional loss (38 CFR 4.40): Disability includes inability to perform normal movements with normal excursion, strength, speed, coordination, and endurance due to pain or weakness.
3. Flare-ups and repetitive use (38 CFR 4.45 and DeLuca v. Brown): If repetitive motion or periodic flare-ups reduce your functional range of motion to 90°, 45°, or 25°, the VA must evaluate your shoulder based on the estimated degrees of motion lost during flare-ups or after repeated use.

Instability, humerus impairments (DC 5202), and clavicle/scapula codes (DC 5203)

Traumatic subluxations, labral tears (including Bankart and SLAP lesions), and humeral fractures are rated under Diagnostic Code 5202:

• Recurrent dislocation at the scapulohumeral joint: Infrequent episodes with guarding of movement only at shoulder level (flexion and/or abduction at 90°) warrant 20% (Major or Minor). Frequent episodes with guarding of all arm movements warrant 30% (Major) / 20% (Minor).
• Humerus bone defects: Malunion with moderate deformity is rated at 20% (Major or Minor); malunion with marked deformity is 30% (Major) / 20% (Minor); fibrous union is 50% (Major) / 40% (Minor); nonunion (false flail joint) is 60% (Major) / 50% (Minor); and loss of the humeral head (flail shoulder) is 80% (Major) / 70% (Minor).

Collarbone, shoulder blade, and acromioclavicular (AC) joint injuries fall under Diagnostic Code 5203:

• 10% (Major or Minor): Malunion of the clavicle or scapula, or nonunion without loose movement.
• 20% (Major or Minor): Dislocation of the clavicle or scapula (including AC joint separation), or nonunion with loose movement. Alternatively, DC 5203 directs the VA to rate on impairment of function of the contiguous shoulder joint if that provides a higher rating.

For veterans who undergo total shoulder arthroplasty under Diagnostic Code 5051, the VA grants a temporary 100% rating for 1 year following implantation (commencing after the initial 1-month convalescent period under 38 CFR 4.30), followed by 60% (Major) / 50% (Minor) for severe painful motion or weakness, or a permanent minimum rating of 30% (Major) / 20% (Minor).

Under the anti-pyramiding rule in 38 CFR 4.14, a veteran cannot receive two separate ratings under DC 5201 for flexion and abduction on the same shoulder, because DC 5201 evaluates “flexion and/or abduction” as a single rating. Similarly, because DC 5202 recurrent dislocation explicitly incorporates guarding of arm movement, separate ratings under DC 5201 and DC 5202 on the same shoulder are not assigned when both reflect the same limitation of motion.

How the C&P exam and Shoulder and Arm DBQ measure your claim

During a shoulder Compensation and Pension exam, the examiner completes the Shoulder and Arm Conditions Disability Benefits Questionnaire (DBQ):

• Dominant Hand (header block) & Diagnosis (Section 1): Records whether you are right-handed, left-handed, or ambidextrous, and lists all verified shoulder diagnoses.
• Flare-Ups & Functional Loss (Section 2): Documents the frequency, duration, and functional impact of flare-ups and repeated use in your own words.
• Goniometer Range of Motion (Section 3): Measures active and passive flexion (180°), abduction (180°), internal rotation (90°), and external rotation (90°) on both shoulders; records pain on motion, crepitus, and tenderness; performs three repetitions of repetitive-use testing; and estimates range-of-motion endpoints during flare-ups.
• Orthopedic Maneuvers (Sections 6–8): Tests the rotator cuff using Hawkins’ Impingement Test, the Empty Can Test (supraspinatus), the External Rotation / Infraspinatus Strength Test, and the Lift-Off Subscapularis Test. The examiner also performs the Crank Apprehension and Relocation Test for glenohumeral instability or labral pathology and the Cross-Body Adduction Test for AC joint pain.

Stop moving your arm as soon as pain begins during goniometer testing so the examiner records your accurate functional limit, and clearly describe how your range of motion changes during flare-ups.

Secondary conditions, combined ratings, and accredited help

Under 38 CFR 3.310, a disability proximately caused or aggravated by a service-connected shoulder injury may qualify for secondary service connection with a medical nexus opinion:

• Opposite shoulder overuse: Favoring an injured shoulder places compensatory strain on the opposite arm, which may cause or aggravate contralateral rotator cuff tendinopathy or arthritis.
• Cervical spine strain and upper-extremity radiculopathy: Altered shoulder mechanics may strain the neck, while cervical disc pathology may cause radiating nerve pain or numbness down the arm (rated separately under 38 CFR 4.124a, DCs 8510–8513).
• Sleep and mood disorders: Chronic nocturnal shoulder pain and functional loss may contribute to secondary depressive or anxiety disorders under 38 CFR 4.130.

Multiple ratings—such as a shoulder rating combined with back pain or knee pain—combine under 38 CFR 4.25, which you can calculate with our VA combined rating calculator. When compensable disabilities affect both upper extremities, 38 CFR 4.26 adds a 10% bilateral factor to their combined value before combining with other conditions.

If your shoulder claim was denied or underrated, Veterans Service Organizations (VSOs) such as the DAV, VFW, and American Legion provide free representation, and VA-accredited attorneys or claims agents handle appeals. No representative can guarantee an outcome; verify accreditation through the VA Office of General Counsel Accreditation Search.