Shoulder Conditions

Diagnostic Codes 5201–5203 • 38 CFR § 4.71a

Ratings usually hinge on abduction / forward elevation, painful motion, ankylosis, or recurrent instability—dominance changes the percentage for the same motion.

DC range

5201–03

Shoulder Ratings & 2026 Compensation (veteran alone)

Motion-based ratings under DC 5201 compare your abduction (arm raised to the side) to regulatory benchmarks. Dominant arm typically receives the higher evaluation for the same limitation.

30–40%

Arm limited to ~25° from side (severe tier)

$552.47–755/mo

20–30%

Midway to shoulder level / shoulder level (dominance affects band)

$356.66–524/mo

10%

Painful motion or higher-tier mild limitation

$180.42/mo

5202/5203

Impairment / clavicle-scapula (when those codes apply)

varies

📖
View Official DC 5201 Reference Page

Complete regulatory criteria, CFR citations, and official rating notes for shoulder conditions

Three Compensation Scenarios

SCENARIO 1

Dominant shoulder 20% + tinnitus 10%

Shoulder (20%)5201
Tinnitus (10%)6260
Combined30%

20% + 10% → ~28–30% → $552.47/mo (2026 approx.).

SCENARIO 2

Bilateral shoulders

Example: 20% right + 20% left with bilateral factor.

Approx. combined

~40%

Monthly

~$795.84–855

SCENARIO 3

Shoulder + cervical strain + radiculopathy

20% shoulder + 30% neck + 20% radiculopathy often combines into the 60%+ range—illustrative only; run your exact percentages through the calculator.

Evidence Requirements

Measured abduction & flexion

Goniometer—not eyeball estimates. Repeated use if pain worsens.

Functional loss (DeLuca)

Fatigue, weakness, flare-ups after overhead work or ADLs.

MRI / surgical history

Rotator cuff, labrum, SLAP, prior stabilization surgery.

Dominance statement

Ensure the record clearly states dominant hand for ROM tables.

Lay statements

Dressing, reaching shelves, sleep positions, job limits.

Common Secondary Conditions

🔄 Opposite shoulder

STRONG

5201Overuse compensation

💪 Elbow / wrist strain

STRONG

5206Altered mechanics

🫳 Cervical strain

STRONG

5237Guarding and posture

⚡ Radiculopathy (UE)

MODERATE

8510Nerve irritation patterns

🧠 Depression

MODERATE

9434Chronic pain / job loss

🤕 Migraines

MODERATE

8100Cervicogenic headaches

Filing Timeline

1

Records

Imaging, PT, surgeon notes, steroid injections

2

File claim

List dominant side; claim instability separately if applicable

3

C&P

Stress that overhead tasks reproduce symptoms

4

Decision

Verify dominance & ROM tier

5

Appeal / increase

Add neck, elbow, mental health if warranted

What Gets You Higher Ratings

10% → 20%+

Show abduction limited toward or at shoulder level (90°) or below per schedule—not “it hurts” without measurements.

Instability / 5202

Document recurrent subluxation/dislocation or separate humeral impairment criteria when applicable.

Bilateral

Both shoulders SC increases combined value with bilateral factor.

Common Mistakes

Wrong dominance

Downgrades the percentage for the same ROM.

No overhead functional examples

Helps explain real-world impairment beyond a single ROM snap.

Single quick ROM test

Misses DeLuca fatigue / flare-up pattern.

Assuming MRI = rating %

Schedule still ties to motion or other criteria in the regulation.

FAQs

Forward flexion vs abduction—which matters?

Your exam should address the planes of motion in the schedule for your diagnostic code. Many shoulder claims focus on limitation of motion including abduction—follow your C&P sheet and § 4.71a wording.

Can I get separate ratings for shoulder and neck?

Yes, when each is distinctively documented—cervical spine uses different criteria than shoulder DCs.

Is surgery required for 30–40%?

No—rating is based on evidence meeting the schedule (motion, ankylosis, or other listed criteria). Surgery records can help but are not the only path.

DC Reference & Tools

⚠️ Important Disclaimer

This page provides general educational information only based on public VA regulations (38 CFR) and va.gov resources. It is not legal, medical, or claims assistance. Ratings and service connections are decided case-by-case by the VA based on the individual veteran’s evidence. We do not prepare claims, generate documents, or provide personalized advice. Always consult a VA-accredited Veterans Service Organization (VSO), attorney, or your physician for help with your specific situation. Verify the latest rules on va.gov.

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