Shoulder VA Rating: Diagnostic Codes 5200 to 5203 Explained

Shoulder ratings look complicated because four diagnostic codes cover the joint and the percentages change depending on which arm is affected. In practice, most claims come down to one question the examiner answers with a goniometer: how far can the arm be raised?

The dominant arm rule

Before any percentage makes sense, 38 CFR 4.69 has to be applied. The VA rates the dominant upper extremity as major and the other as minor, and the rating schedule assigns lower percentages to the minor arm at several levels. Handedness is taken as the veteran states it unless the record shows otherwise, and only one extremity can be the major one.

DC 5201 - limitation of arm motion

This is the code most shoulder conditions are rated under. It measures flexion and abduction, meaning how far the arm can be lifted forward and out to the side. The current criteria read:

• 40 percent major, 30 percent minor - flexion and/or abduction limited to 25 degrees from the side
• 30 percent major, 20 percent minor - motion limited to midway between the side and shoulder level, roughly 45 degrees
• 20 percent major, 20 percent minor - motion limited to shoulder level, roughly 90 degrees

Normal shoulder flexion and abduction are each 0 to 180 degrees under 38 CFR 4.71, with shoulder level at 90 degrees. The VA uses the worse of flexion or abduction, and the measurement is taken on active motion with the effects of pain considered.

DC 5200 - ankylosis of the scapulohumeral articulation

Ankylosis means the joint is fixed, with the scapula and humerus moving as one piece. It is rated by how useful the fixed position is:

• Favorable ankylosis, abduction to 60 degrees with the hand able to reach the mouth and head - 30 percent major, 20 percent minor
• Intermediate, between favorable and unfavorable - 40 percent major, 30 percent minor
• Unfavorable, abduction limited to 25 degrees from the side - 50 percent major, 40 percent minor

DC 5202 - other impairment of the humerus

This code covers instability and structural damage rather than motion:

• Malunion with moderate deformity - 20 percent major, 20 percent minor; with marked deformity - 30 percent major, 20 percent minor
• Recurrent dislocation at the scapulohumeral joint with infrequent episodes and guarding of movement only at shoulder level - 20 percent either arm; with frequent episodes and guarding of all arm movements - 30 percent major, 20 percent minor
• Fibrous union of the humerus - 50 percent major, 40 percent minor
• Nonunion, a false flail joint - 60 percent major, 50 percent minor
• Loss of the head of the humerus, a flail shoulder - 80 percent major, 70 percent minor

The dislocation criteria matter to a lot of veterans whose shoulders came out repeatedly in service. Our shoulder instability guide covers what the records have to show for that code.

DC 5203 - impairment of the clavicle or scapula

Malunion of the clavicle or scapula is rated 10 percent for either arm. Nonunion without loose movement is 10 percent, nonunion with loose movement is 20 percent, and dislocation of the clavicle or scapula is 20 percent. The code also allows evaluation on impairment of function of the contiguous joint, which is often the more favorable path when motion is limited.

Arthritis, painful motion, and functional loss

Degenerative arthritis established by imaging under DC 5003 is rated on limitation of motion under the appropriate code. When motion is limited but not enough to be compensable, a 10 percent rating applies for the major joint affected.

Two regulations do a great deal of work in shoulder claims. 38 CFR 4.59 provides that actually painful motion is entitled to at least the minimum compensable rating for the joint. 38 CFR 4.40 and 38 CFR 4.45 require the VA to consider functional loss from pain, weakness, fatigability, and incoordination, including during flare-ups and after repeated use. A shoulder that reaches 120 degrees once in a quiet exam room but gives out after ten repetitions is not a 120-degree shoulder, and the examination has to capture that.

Our C&P exam guide explains how to describe flare-ups and repeated use so the measurement reflects your actual function.

Separate ratings and pyramiding

Nerve impairment in the same arm is rated separately under 38 CFR 4.124a because it is different symptomatology, as our brachial neuritis guide explains. Surgical scars that are painful or unstable can also be rated separately.

What 38 CFR 4.14 prohibits is rating the same disability twice under different codes. Limitation of motion under DC 5201 and recurrent dislocation under DC 5202 both address the shoulder joint, so the VA generally assigns whichever is more favorable rather than both, unless the manifestations are genuinely distinct.

Multiple ratings are combined under the table in 38 CFR 4.25, not added. Our combined rating calculator shows how that math works for your specific percentages.