Condition Guide · ROM-based
Shoulder VA rating 2026 — DC 5200–5203
Updated June 2026 · CFR source: 38 CFR §4.71a
Shoulder conditions are rated under 38 CFR §4.71a using multiple diagnostic codes depending on the type of impairment. Range of motion (arm elevation) is the primary measurement. When both shoulders are service-connected, the bilateral factor applies — often pushing the combined shoulder sub-total significantly higher before folding with other ratings.
Rating schedule — DC 5201 (arm, limitation of motion)
| Rating | 2026 monthly | Criteria — arm elevation limited to |
|---|---|---|
| 40% | $795.84 | 25° from side (major extremity) / 30° (minor) |
| 30% | $552.47 | 45° from side (major) / 60° (minor) |
| 20% | $356.66 | 90° (major) / 90° (minor) |
| 10% | $180.42 | Beyond 90°, above the horizontal (major) |
DC 5200 — Scapulohumeral articulation, ankylosis
| Rating | 2026 monthly | Criteria |
|---|---|---|
| 50% | $1,132.90 | Unfavorable ankylosis — in abduction position or with internal rotation. |
| 40% | $795.84 | Favorable ankylosis — arm at side or slightly forward. |
Service connection for shoulder conditions
Establishing service connection for a shoulder condition requires:
- Current diagnosis. A physician-confirmed diagnosis — rotator cuff tear, labral tear, glenohumeral instability, AC joint separation, shoulder impingement, or degenerative joint disease — documented in medical records.
- In-service event or injury. Documentation of in-service shoulder trauma (fall, physical training injury, carrying heavy loads), sustained overhead activity (aircraft crew, construction MOS), or documented symptoms during service. Service treatment records showing shoulder complaints or treatment are the strongest evidence.
- Nexus. A medical opinion linking the current shoulder condition to in-service activity. For post-surgical shoulders, the nexus letter should connect the original injury to service even if the surgery occurred after separation.
Secondary service connection is available when a shoulder condition is caused or aggravated by another SC condition. Common examples: shoulder impingement secondary to a SC cervical spine condition causing altered arm mechanics, or rotator cuff degeneration secondary to SC nerve damage.
C&P exam — what to document
The shoulder C&P exam measures arm elevation and range of motion. To maximize the accuracy of your rating:
- State the angle at which pain begins. Under 38 CFR §4.59 (painful motion), pain onset during motion is ratable even when maximum ROM exceeds the lowest threshold. Tell the examiner "pain begins at approximately X degrees" on both abduction and forward flexion.
- Demonstrate authentic ROM. Do not overperform. Lift your arm only to the point where pain prevents further movement. The angle the examiner records determines your rating tier under DC 5201.
- Report instability and weakness. Describe any episodes of subluxation, weakness when lifting, or inability to perform overhead activities. These support DC 5202 or DC 5203 ratings if ROM limitations alone do not capture the full impairment.
- Both shoulders. If both shoulders are affected, ensure both are examined in the same appointment so the bilateral factor (§4.26) can be applied to the combined sub-total.
- Bring imaging and surgical records. MRI results documenting rotator cuff tears, labral damage, or prior surgical reports are objective evidence the examiner records alongside ROM findings.
Bilateral shoulder impact
Example: Left shoulder 20% + right shoulder 10% (bilateral group):
- Bilateral combined: combine(20, 10) = 28%.
- Bilateral bonus: 28 × 1.10 = 30.8%.
- With PTSD 50%: 50 + (30.8% of 50%) = 65.4% → rounds to 70%.
- Without bilateral: combine(50, 28) = 64% → rounds to 60%.
- Bilateral factor gains one full tier: 60% → 70% = +$372.80/month.
Rotator cuff conditions
Rotator cuff tears are rated under DC 5201 or DC 5203 (impairment of humerus) based on functional limitation. A surgically repaired rotator cuff is still rated based on residual functional impairment post-surgery. Full recovery does not eliminate service connection — document any residual weakness, pain, or limited ROM.
FAQ
Which shoulder diagnostic code gives the highest rating?
DC 5201 (arm, limitation of motion) rates based on arm elevation angle and can reach 40%. DC 5202 (humerus, other impairments) can reach 50% for flail joint. The applicable code depends on the specific impairment — ROM limitation vs. structural instability vs. ankylosis.
Do both shoulders qualify for the bilateral factor?
Yes. If both shoulders are service-connected, the bilateral factor under 38 CFR §4.26 applies — combining the shoulder sub-total, adding 10%, then folding into the overall rating. This is the same bilateral factor that applies to bilateral knee or bilateral arm conditions.
Can I get a separate rating for shoulder nerve damage?
Yes. If shoulder injury caused brachial plexus damage or peripheral nerve involvement (long thoracic nerve, axillary nerve, radial nerve), those neurological residuals can be rated separately under the nerve damage diagnostic codes in addition to the shoulder structural rating.
What range of motion does VA measure for shoulder rating?
VA measures arm elevation (abduction), forward flexion, and rotation. Normal arm abduction is 0–180°. DC 5201 rates elevation limited to 25° = 40%; limited to 45° = 30%; limited to 90° = 20%; limited beyond 90° = 10%. Painful motion under §4.59 can add a minimum compensable rating when ROM is technically adequate but painful.
Related: Bilateral factor · Knee · Cervical spine