Two veterans with identical rotator cuff tears can walk away with different ratings, and both decisions can be correct. The shoulder schedule pays more for the dominant arm than for the other arm at several levels, so which hand you write with is part of the math. It is one of the few places in 38 CFR 4.71a where handedness changes the number.
How VA rates the shoulder
The shoulder is rated under 38 CFR 4.71a, and two codes do most of the work: limitation of arm motion (DC 5201) and other impairment of the humerus (DC 5202). One feature is unusual here: the dominant (major) arm is rated higher than the non-dominant (minor) arm for the same problem.
Limitation of motion (DC 5201)
Normal shoulder motion lets the arm rise to about 180 degrees. "At shoulder level" means about 90 degrees. The ratings (major arm / minor arm):
- arm motion limited at shoulder level: 20 percent / 20 percent
- arm motion limited midway between the side and shoulder level: 30 percent / 20 percent
- arm motion limited to 25 degrees from the side: 40 percent / 30 percent
Most rotator cuff, impingement, and frozen-shoulder claims are rated here, on how far you can raise the arm.
Humerus impairment and dislocation (DC 5202)
DC 5202 covers instability and structural damage (major / minor):
- recurrent dislocation at the shoulder joint: frequent episodes with guarding of all arm movements is 30 percent / 20 percent; infrequent episodes with guarding only at shoulder level is 20 percent / 20 percent
- malunion of the humerus: marked deformity 30 percent / 20 percent; moderate deformity 20 percent / 20 percent
- fibrous union: 50 percent / 40 percent
- nonunion (false flail joint): 60 percent / 50 percent
- loss of the humeral head (flail shoulder): 80 percent / 70 percent
Ankylosis (a frozen, fused joint) is rated under DC 5200, and the clavicle or scapula under DC 5203.
Functional loss counts
Range of motion is measured after repetitive use, and pain, weakness, and fatigue count (38 CFR 4.40 and 4.45, the DeLuca rule). A shoulder that moves on the first try but seizes after a few repetitions should be measured at its worst.
Common rating details veterans overlook
- Your dominant arm rates higher for the same limitation, so make sure the exam records which arm is dominant.
- Recurrent dislocations have their own code (5202), separate from simple motion loss; document the frequency and any guarding.
- Painful motion and flares matter, so the after-repetition measurement, not the first easy lift, should drive the rating.
- Rotator cuff tears are usually rated on motion (5201), so the degrees you can raise the arm are the key numbers.
- A separate scar or nerve issue from shoulder surgery can add its own rating on top of the joint evaluation.