Shoulder

The shoulder is the second-hardest orthopedic joint to get a meaningful VA rating on. In my analysis of 621 BVA shoulder cases, the grant rate is 21 percent. Only the elbow comes in lower among the major joints. The denial rate is roughly 58 percent. The remand rate is about 21 percent.

The reason isn't that shoulder injuries are uncommon. Rotator cuff tears, impingement syndrome, labral injuries, and post-traumatic arthritis are some of the most frequently filed orthopedic claims in the VA system. The reason the grant rate stays low is the rating math. DC 5201 (limitation of motion of the arm), which is the most-used shoulder code by a wide margin, requires the arm to be limited to "shoulder level" or worse before any rating attaches. Veterans with chronic shoulder pain, documented rotator cuff pathology, and meaningful functional limitation routinely fail to meet the 90-degree threshold required for the 20 percent floor.

This page covers DC 5200 through DC 5203, the dominant-versus-non-dominant rules, the rotator cuff pattern that dominates the docket, the secondary chain to cervical spine, and what wins shoulder claims at the Board.

TL;DR

• 621 shoulder cases in my BVA dataset. The grant rate is roughly 21 percent, lower than knee, lower than back, second-lowest in the orthopedic cluster behind only the elbow.
• The shoulder is covered by four diagnostic codes (DC 5200 through DC 5203) in 38 CFR § 4.71a. DC 5201 (limitation of motion of the arm) is the most-used code in practice.
• The DC 5201 floor is at shoulder level (90 degrees of flexion or abduction). Veterans whose motion stays above 90 degrees do not get a rating under DC 5201 even with significant pain and functional loss. The DeLuca framework can sometimes bridge this gap.
• Dominant-arm ratings are 10 percentage points higher than non-dominant at most tiers. The Board generally accepts the veteran's stated dominance with lay-statement support.
• DC 5200 (ankylosis), DC 5202 (humerus impairment with flail joint, fibrous union, recurrent dislocation, malunion), and DC 5203 (clavicle or scapula impairment) cover the more severe shoulder pathologies. These codes climb higher than DC 5201 but require end-stage findings most veterans do not have.
• The cervical spine to shoulder secondary chain is real. Cervical radiculopathy in the C5 or C6 distribution presents with shoulder symptoms and rates under the peripheral nerve framework rather than under the shoulder joint codes.
• The path to higher ratings on the shoulder almost always runs through one of three doors: documented severe limitation of motion that clears the 45-degree threshold, recurrent dislocation under DC 5202, or scapular ankylosis under DC 5200.

DC 5200 Through DC 5203: The Four Shoulder Codes

The shoulder gets four diagnostic codes in 38 CFR § 4.71a, covering ankylosis, limitation of motion, humerus impairment, and clavicle/scapula impairment. Each has its own rating ladder, and most cases run through one or two of these codes in practice.

DC 5200, ankylosis of the scapulohumeral articulation

Ankylosis (fusion) of the shoulder joint is rated based on the position of the fusion:

• Favorable position, abduction to 60 degrees, can reach mouth and head: 30 percent (dominant), 30 percent (non-dominant)
• Intermediate, between favorable and unfavorable: 40 percent (dominant), 30 percent (non-dominant)
• Unfavorable, abduction limited to 25 degrees from side: 50 percent (dominant), 40 percent (non-dominant)

Ankylosis is rare in shoulder claims. Most veterans with severe shoulder pathology have not progressed to complete joint fusion. When it does apply, it produces meaningfully higher ratings than limitation of motion codes. The ankylosis question turns on whether the joint has any active motion at all. A shoulder with even minimal active flexion or abduction is generally not ankylosed for rating purposes.

DC 5201, limitation of motion of the arm

This is the workhorse shoulder code. Most BVA shoulder cases run through DC 5201, and the rating turns on the arc of motion at flexion or abduction (whichever is more limited):

• At shoulder level (90 degrees of flexion or abduction): 20 percent (dominant), 20 percent (non-dominant)
• Midway between side and shoulder level (roughly 45 degrees): 30 percent (dominant), 20 percent (non-dominant)
• To 25 degrees from side: 40 percent (dominant), 30 percent (non-dominant)

The structural feature of DC 5201 that traps many claims is the floor. There is no 10 percent tier. The rating starts at 20 percent, and it starts when the arm cannot be raised above shoulder level. A veteran with documented rotator cuff tear who can raise the arm to 120 degrees with pain gets no rating under DC 5201, because 120 degrees is above the 90-degree threshold.

This is why the shoulder grant rate stays low. Veterans with real pathology routinely fail the DC 5201 floor. The DeLuca framework (38 CFR § 4.40 and § 4.45) can sometimes bridge this by accounting for pain, weakened movement, excess fatigability, or incoordination on repeated use. When the C&P examiner documents that flexion drops from 120 degrees to 90 degrees after repetitive testing, the rating can attach. When the examiner only documents the static measurement, it usually does not.

DC 5202, other impairment of humerus

This code covers a cluster of humerus pathologies, each with its own rating:

• Loss of head of humerus (flail shoulder): 80 percent (dominant), 70 percent (non-dominant)
• Nonunion of surgical neck (false flail joint): 60 percent (dominant), 50 percent (non-dominant)
• Fibrous union of humerus: 50 percent (dominant), 40 percent (non-dominant)
• Recurrent dislocation of scapulohumeral joint:
• Frequent episodes and guarding of all arm movements: 30 percent (dominant), 20 percent (non-dominant)
• Infrequent episodes and guarding of movement only at shoulder level: 20 percent (dominant), 20 percent (non-dominant)
• Malunion of humerus:
• Marked deformity: 30 percent (dominant), 20 percent (non-dominant)
• Moderate deformity: 20 percent (dominant), 20 percent (non-dominant)

The recurrent-dislocation subcode is the most clinically relevant for younger veterans with shoulder instability after in-service injury. Recurrent anterior dislocation from a labral tear is a common pattern in veterans with documented in-service shoulder injuries, and the DC 5202 rating runs in parallel with whatever DC 5201 limitation of motion rating applies.

DC 5203, impairment of clavicle or scapula

This code covers clavicle and scapula pathologies:

• Dislocation: 20 percent (dominant), 20 percent (non-dominant)
• Nonunion with loose movement: 20 percent (dominant), 20 percent (non-dominant)
• Nonunion without loose movement: 10 percent (dominant), 10 percent (non-dominant)
• Malunion: 10 percent (dominant), 10 percent (non-dominant)

The rater also has discretion to rate clavicle or scapula impairment on the basis of limitation of motion of the affected part. In practice, this means a veteran with a healed clavicle fracture that produces limitation of shoulder motion can be rated under DC 5203 or under DC 5201, depending on which produces the more favorable rating.

The Dominance Distinction

For most shoulder codes that have separate dominant and non-dominant tiers, the dominant arm gets 10 percentage points higher at the upper tiers. The 20 percent tier under DC 5201 is the same for either arm. The 30 and 40 percent tiers under DC 5201 differ by 10 points. The ankylosis and humerus impairment ratings under DC 5200 and DC 5202 also differ by 10 points at most tiers.

The dominance assessment is functional. The Board generally accepts the veteran's stated dominance, supported by lay statements about which hand is used for writing, eating, and fine motor tasks. Mixed dominance is rare but documented in some cases.

For shoulder claims specifically, the dominance question matters most at the 30 and 40 percent tiers of DC 5201. A veteran with right-arm dominance whose right shoulder is limited to 45 degrees of flexion sits at 30 percent. The same limitation on the left (non-dominant) arm sits at 20 percent. That single distinction is worth roughly $220 per month in 2026 compensation rates.

The Rotator Cuff Pattern

Rotator cuff injuries (tendinopathy, partial-thickness tears, full-thickness tears) are the dominant medical pathology in the shoulder claim docket. Veterans file these claims at high volume, and the medical story is generally clean: documented in-service shoulder trauma or repetitive overhead use, ongoing shoulder symptoms after separation, MRI showing rotator cuff pathology, and progressive functional limitation.

What trips up rotator cuff claims is the rating math. A torn supraspinatus tendon produces pain, weakness, and limitation of motion. The pain is real. The weakness is real. But if the active arc of motion stays above shoulder level (90 degrees of flexion or abduction), there is no DC 5201 rating. Veterans with documented rotator cuff pathology routinely sit at 0 percent ratings because the C&P measurements stay above the threshold.

The path past this typically involves:

• A C&P examination that explicitly addresses repeated use, with measurements taken after the veteran has performed multiple repetitions of the motion
• DeLuca documentation of pain on motion, weakened movement, excess fatigability, and incoordination
• Treating orthopedic surgeon or physiatry records that describe the functional impact in clinical terms (inability to lift overhead, weakness with resisted external rotation, positive impingement signs)
• MRI documentation of the underlying pathology, anchoring the diagnosis defensibly

When the documentation supports limitation to shoulder level or below, the DC 5201 rating attaches at 20 percent. When the documentation supports recurrent shoulder instability with frequent dislocation episodes, the DC 5202 rating can add or replace.

The Cervical Spine to Shoulder Secondary Chain

Some shoulder claims that fail on the joint codes succeed when re-framed through the cervical spine. C5 and C6 cervical radiculopathy presents with shoulder symptoms (pain radiating from the neck into the upper trapezius, deltoid weakness, sensory changes in the lateral arm), and these symptoms are rated under the peripheral nerve framework at 38 CFR § 4.124a, not under the shoulder joint codes.

The relevant peripheral nerve codes for upper extremity radiculopathy:

• DC 8510, paralysis of upper radicular group (C5-C6): up to 70 percent for complete paralysis (dominant), 60 percent (non-dominant)
• DC 8511, paralysis of middle radicular group: up to 70 percent (dominant), 60 percent (non-dominant)
• DC 8512, paralysis of lower radicular group: up to 70 percent (dominant), 60 percent (non-dominant)
• DC 8513, paralysis of all radicular groups: up to 90 percent (dominant), 80 percent (non-dominant)

Incomplete paralysis is rated at lower tiers (mild, moderate, moderately severe) depending on the severity of the neurological deficit.

For veterans with both cervical spine and shoulder pathology, the cervical spine claim is often the cleaner primary claim, with shoulder symptoms rated as radiculopathy secondary to the cervical condition. This routing matters because the radiculopathy framework produces higher ratings at lower severity thresholds than DC 5201 does. A mild C5-C6 radiculopathy with weakness and sensory changes can rate at 20 to 30 percent under the peripheral nerve framework even when the underlying shoulder examination shows preserved range of motion.

What Wins Shoulder Claims at the Board

A few patterns I see consistently in granted shoulder cases.

Documented in-service shoulder trauma or repetitive use. Service treatment records showing an acute shoulder injury (often from a fall, vehicle accident, parachute jump, or weapon recoil), or documented repetitive overhead activity (mechanics, infantry with significant load-bearing, helicopter aviation roles, anyone doing significant overhead work). Veterans with clean in-service documentation have substantially easier paths than veterans relying on lay statements alone.

Measurements that clear the DC 5201 threshold. Active flexion or abduction limited to 90 degrees or worse, documented in the C&P examination or in private orthopedic records. The threshold is binary: above 90 degrees produces no DC 5201 rating, at or below 90 degrees produces at least 20 percent.

A C&P examination that addresses DeLuca factors after repeated use. When the examiner measures the arc of motion before and after repetitive testing and documents pain, weakness, fatigability, and incoordination, the rating can attach even when the initial static measurement is above threshold. The repeated-use measurement is what often bridges the gap between documented pathology and a ratable measurement.

MRI or imaging supporting the diagnosis. Rotator cuff tear documented on MRI, labral tear on MRI arthrogram, or post-traumatic arthritis on plain X-ray. Imaging anchors the diagnosis defensibly and supports the underlying pathology even when the range of motion measurements are borderline.

Recurrent dislocation documentation under DC 5202. Veterans with documented recurrent shoulder dislocations (instability events, often from labral tear with anterior dislocation pattern) can rate under DC 5202 in addition to DC 5201. The recurrent-dislocation subcode requires documentation of the dislocation episodes and the resulting guarding of arm movements.

Strong nexus opinion when on the direct lane. A well-developed medical opinion that addresses the in-service injury, the time course of symptoms, and the medical mechanism connecting the two is often dispositive on direct claims. Generic opinions that state the condition is "at least as likely as not" related to service without engaging with the specific in-service event tend to fail.

Bottom Line

Shoulder conditions rate under DC 5200 through DC 5203 in 38 CFR § 4.71a. DC 5201 (limitation of motion of the arm) is the most-used code, and the rating ladder starts at 20 percent for motion limited to shoulder level. There is no 10 percent tier. The dominant arm rates 10 percentage points higher than the non-dominant arm at the 30 and 40 percent tiers. In my BVA dataset of 621 cases, the grant rate is roughly 21 percent, the second-lowest in the orthopedic cluster. The rating math is the primary obstacle: veterans with documented rotator cuff pathology routinely fail the 90-degree threshold required for the DC 5201 floor. The DeLuca framework can bridge this when the C&P examiner documents repeated-use findings. DC 5202 (recurrent dislocation, humerus impairment, flail joint) and DC 5200 (ankylosis) cover the more severe pathologies and climb higher. For veterans with overlapping cervical and shoulder symptoms, the cervical spine to shoulder radiculopathy chain under DC 8510-8513 sometimes produces higher ratings than the shoulder joint codes do.

Methodology and Limitations

• Data source: 38 CFR § 4.71a DC 5200 through DC 5203 (shoulder), 38 CFR § 4.124a DC 8510 through DC 8513 (upper extremity peripheral nerves), the DeLuca v. Brown framework for functional loss under 38 CFR § 4.40 and § 4.45, 38 CFR § 3.310 for secondary service connection, and Claim Raven's analysis of BVA decisions tagged with the shoulder as the primary condition.
• Sample size: 621 BVA decisions involving the shoulder as the primary condition, with a grant rate of roughly 21 percent. Subcategory breakdowns (connection-type splits, denial-reason splits, rating-tier distributions) are summarized in directional terms rather than precise counts because the underlying classifications continue to be refined as the dataset is reprocessed.
• Limitations: The dataset captures BVA-level decisions. Shoulder claims granted at the regional office without appeal are not in the sample, and those claims are likely structurally easier than the appealed claims that reach the Board. The dominant-versus-non-dominant distinction depends on documentation of the veteran's actual dominance; some cases have ambiguous documentation. The DeLuca framework continues to be inconsistently applied across BVA decisions, and the bridge between static measurements and repeated-use findings often turns on the specific C&P examiner's documentation practices. These observations describe BVA patterns and are not predictions of individual outcomes. Claim Raven is data analysis, not legal, medical, or VA-accredited advice. If you need help with a shoulder claim, work with an accredited representative.