VA Disability Rating for Shoulder Rotator Cuff Tear
Veterans often develop shoulder rotator cuff tears due to military service or another service-related injury. Veterans with a shoulder rotator cuff tear caused by time in service or triggered by a service-related injury may apply to the Department of Veterans Affairs for a VA disability rating.
A shoulder rotator cuff injury may cause a dull shoulder ache that worsens at night. It often occurs in people who perform repetitive overhead motions, such as carpenters and painters, but it may also result from a single injury.
If your shoulder rotator cuff tear resulted from your military service or was caused by another service-related injury, you may be eligible for VA disability benefits. Veterans Guide can help you understand how the VA determines the VA rating for your injury and assist with the benefits application and appeal processes.
Veterans and Shoulder Rotator Cuff Tear
A shoulder rotator cuff tear is an injury affecting the tendons and muscles surrounding the shoulder joint. The rotator cuff is a group of muscles and tendons that come together at the head of the humerus. It is instrumental in raising and rotating the arm.
The following four muscles comprise the rotator cuff:
- Supraspinatus, which holds the humerus in place, keeps the upper arm stable, and helps to lift the arm
- Infraspinatus, which allows shoulder rotation and extension
- Teres Minor, which assists with the rotation of the arm away from the body
- Subscapularis, which holds the upper arm bone to the shoulder blade and assists with rotating the arm, holding it straight, and lowering it
Some rotator cuff injuries do not cause pain. However, when a shoulder rotator cuff tear does cause pain, it may:
- Feel like a dull ache deep in the shoulder
- Make it hard to reach your back or comb your hair
- Make it harder to sleep
- Be accompanied by arm weakness
To diagnose a rotator cuff tear, medical professionals will move the arm into different positions and press on various parts of the shoulder. They will also test the strength of the muscles in the arms and around the shoulder. Providers may also use imaging tests, such as magnetic resonance imaging, ultrasounds, and X-rays, to diagnose your condition.
Service Connection for Shoulder Rotator Cuff Tear
Veterans may suffer shoulder rotator cuff tears if they perform repetitive overhead motions or engage in frequent heavy lifting during service or training activities. They may also develop rotator cuff injuries from accidents or falls.
If you are unsure of the exact cause of your shoulder rotator cuff tear, you may have difficulty determining the VA rating for your injury. A Veterans Guide advocate can help you understand the VA ratings for your injury.
How Does the VA Rate Shoulder Rotator Cuff Tears?
In the Schedule for Rating Disabilities, the VA rates shoulder rotator cuff tears using diagnostic codes 5200, 5304, and 5201. Here is a breakdown of VA disability ratings for shoulder rotator cuff tears.
Diagnostic Code 5200 - Scapulohumeral Articulation, Ankylosis
If you have a shoulder rotator cuff tear, you may experience scapulohumeral articulation problems—or issues where the scapula and the humerus meet—and ankylosis—abnormal stiffening and immobility of the shoulder rotator cuff.
The VA rates abnormal stiffening and immobility of the shoulder rotator cuff as follows:
- 20 percent (minor), 30 percent (major): Your condition is favorable. This means your shoulder abduction is limited to 60 degrees, and you can reach your mouth and head. Shoulder abduction is the ability to move your arm away from the middle of your body. A healthy abduction range is 150 degrees.
- 30 percent (minor), 40 percent (major): Your condition is between favorable and unfavorable.
- 40 percent (minor), 50 percent (major): Your condition is unfavorable. Your shoulder abduction is limited to 25 degrees from the side, and you cannot reach your mouth or head.
Diagnostic Code 5304 - Affects Shoulder Muscles
Your shoulder rotator cuff tear may affect the intrinsic muscles of the shoulder girdle. If your shoulder rotator cuff tear affects these muscles, the VA will rate your condition as follows:
- 0 percent (dominant and non-dominant arms) for slight injuries
- 10 percent (dominant and non-dominant arms) for moderate injuries
- 20 percent (dominant and non-dominant arms) for moderately severe injuries
- 30 percent (dominant arm) and 20 percent (non-dominant arm) for severe injuries
Diagnostic Code 5201 - Arm, Limitation of Range of Motion
A shoulder rotator cuff injury can also limit the range of motion in your arm. The VA rates the limitation of range of motion for arms using the following ratings:
- 20 percent (for minor and major): The limitation of range of motion is at shoulder level, and the flexion or abduction is limited to 90 degrees. Flexion is when you bend a limb or joint.
- 20 percent (minor), 30 percent (major): The limitation of the range of motion is midway between shoulder level and your side. The flexion or abduction is limited to 45 degrees.
- 30 percent (minor), 40 percent (major): Flexion or abduction limited to 25 degrees from the side.
Total Disability Individual Unemployability and Shoulder Rotator Cuff Tears
Veterans with service-connected shoulder rotator cuff tears may be eligible for Total Disability Based on Individual Unemployability, or TDIU, benefits if their injury prevents them from working. This means they will receive disability benefits or compensation at the same level as a veteran with a 100 percent disability rating.
You must demonstrate the following to receive Total Disability Individual Unemployability for shoulder rotator cuff tears:
- You have at least one service-connected condition rated at least 60 percent disabling or multiple service-connected disabilities with a combined rating of at least 70 percent and one rated at least 40 percent.
- You cannot hold down a substantially gainful job that supports you financially due to your service-connected disability. Odd jobs do not count as substantially gainful employment.
Shoulder Rotator Cuff Tear as a Secondary Disability
If you can establish that your shoulder rotator cuff tear is a secondary disability, you may be eligible for a VA disability rating and monthly disability compensation. A secondary disability is caused or aggravated by a direct service-connected condition, such as degenerative arthritis in the shoulder.
You must provide the VA with the following evidence to establish a shoulder rotator cuff tear as a secondary disability:
- Medical evidence and doctor reports demonstrating the relationship between the shoulder rotator cuff tear and the direct service-connected condition
- Medical records showing your shoulder rotator cuff tear diagnosis and treatment
How To Obtain VA Disability Compensation for Shoulder Rotator Cuff Tears?
When you file your claim, remember to provide as much evidence as possible, including a nexus letter showing that your shoulder rotator cuff tear was caused or aggravated by a direct service-connected condition and medical reports showing your diagnosis and treatment.
If the VA requires more information, they may ask you to submit more documents or undergo a Compensation and Pension Exam, or C&P Exam. This exam will determine whether you have a service-connected disability and help the VA rate it.
The VA will base your rating on the severity of your disability, and this rating will affect the compensation you receive. You may need more than one VA claim exam if you submit a claim for more than one condition, need follow-up exams, or request a review of your claim decision.
We understand that navigating the VA system can be challenging. Contact Veterans Guide today to learn more about the VA ratings for shoulder rotator cuff tears. Our advocates will help you obtain the maximum benefit possible.