Shoulder: limited motion, dislocation and the exam

How VA rates shoulder and upper-arm conditions

38 CFR 4.69, 4.71a, 4.59

Shoulder ratings use two columns: dominant (major) arm and non-dominant (minor) arm. Handedness is decided by the evidence of record or by testing on the VA exam. Only one hand counts as dominant, and for an ambidextrous person the injured (or most severely injured) hand is treated as dominant.

The shoulder codes cover ankylosis (5200), limited motion of the arm (5201), other humerus problems including dislocation (5202), and the clavicle or scapula (5203). Motion is measured with VA’s standard method, which sets the anatomical position as 0 degrees, with shoulder rotation measured with the arm abducted to 90 degrees and the elbow bent to 90 degrees.

The regulation on painful motion says the schedule intends to recognize painful motion with joint or periarticular pathology as productive of disability. For how limited motion is evaluated on the exam, including flare-ups, see shoulder secondary conditions.

Limitation of arm motion

38 CFR 4.71a, DC 5201

• Flexion and/or abduction limited to 25 degrees from the side: 40% dominant, 30% non-dominant.
• Midway between side and shoulder level (limited to 45 degrees): 30% dominant, 20% non-dominant.
• At shoulder level (limited to 90 degrees): 20% for either arm.

Most shoulder claims, such as rotator cuff tears, impingement and arthritis, are rated on how far the arm can move. The exam form records active and passive flexion, abduction, internal rotation and external rotation, and where pain begins.

Ankylosis of the shoulder joint

38 CFR 4.71a, DC 5200

Ankylosis here means the scapula and humerus move as one piece.

• Unfavorable, abduction limited to 25 degrees from the side: 50% dominant, 40% non-dominant.
• Intermediate between favorable and unfavorable: 40% dominant, 30% non-dominant.
• Favorable, abduction to 60 degrees, can reach mouth and head: 30% dominant, 20% non-dominant.

Humerus and dislocation

38 CFR 4.71a, DC 5202

• Loss of the head of the humerus (flail shoulder): 80% dominant, 70% non-dominant.
• Nonunion (false flail joint): 60% dominant, 50% non-dominant.
• Fibrous union: 50% dominant, 40% non-dominant.
• Recurrent dislocation at the scapulohumeral joint: with frequent episodes and guarding of all arm movements, 30% dominant and 20% non-dominant. With infrequent episodes and guarding of movement only at shoulder level, 20% for either arm.
• Malunion: marked deformity, 30% dominant and 20% non-dominant. Moderate deformity, 20% for either arm.

Collarbone and shoulder blade

38 CFR 4.71a, DC 5203

• Dislocation of the clavicle or scapula: 20% for either arm.
• Nonunion: with loose movement 20%; without loose movement 10%. Either arm.
• Malunion: 10% for either arm.
• The schedule also allows rating on impairment of function of the contiguous joint instead, which is the shoulder.

How shoulder ratings fit with other ratings

38 CFR 4.25, 4.26

A shoulder can be rated more than once only when the effects are separate. Muscle injury to the shoulder girdle, nerve damage in the arm and scars are rated under their own codes. See nerve damage ratings and skin and scar ratings. When both arms are affected, see the paired extremities rule and combined rating math. Loss of use of a hand or arm can bring special monthly compensation.

What VA’s shoulder exam form covers

VA Shoulder and Arm Conditions DBQ (version marked 2025-04-15)

• Diagnosis by side, and a history that includes flare-ups, their frequency, duration, triggers and effect on function.
• Initial active and passive flexion, abduction, internal rotation and external rotation, with where pain starts, crepitus and tenderness.
• Repetitive-use testing with at least three repetitions, estimated motion after repeated use over time, and estimated motion during flare-ups.
• Muscle atrophy with arm circumference measurements, and whether the joint is fused.
• Rotator cuff tests (Hawkins’, empty can, external rotation and lift-off), instability and dislocation tests, labral findings, and clavicle, scapula, AC and SC joint findings.
• Humerus findings, surgery, braces and other devices, imaging, and functional impact on work.

See Preparing for Your C&P Exam.

What I could not verify

• Rating levels come from the eCFR text of 38 CFR 4.71a, 4.69, 4.59 and 4.71, current as of October 16, 2026. eCFR is unofficial, and the official text wins over me.
• I did not restate the normal range-of-motion figures for the shoulder, because they are in a diagram (Plate I) I could not read as text. See the regulation.
• I did not cover the shoulder-girdle muscle injury ratings, the other rules on functional loss (38 CFR 4.40 and 4.45) or arthritis codes (5003). The muscle injury page and the secondary conditions page cover related ground.
• I checked the exam form through a text reader, not line by line. The form itself is the authority.