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Shoulder and arm

What it is

Your shoulder is the ball-and-socket joint that lets you lift and turn your arm; VA rates it mostly by how high you can raise your arm, and pays more for your dominant (main) arm.

Normal movement (what VA counts as normal)

  • Flexion (lift arm forward and up)0 to 180°
  • Abduction (lift arm out to the side and up)0 to 180°
  • External rotation0 to 90°
  • Internal rotation0 to 90°

VA's code numbers for this: 5200, 5201, 5202, 5203, 5051, 5003, 5010, 5019, 5024

What the examiner will do

  • The examiner asks how and when the problem started, what treatment you have had, and how it affects work and daily life.
  • They ask about flare-ups: how often, how long, what sets them off, and what you cannot do during one.
  • They measure how far you can move the joint yourself (active motion) with a goniometer. They should note where pain begins.
  • They move the joint for you (passive motion). They test it with weight on it and without weight on it. They compare it to your other side if that side is healthy. (Correia v. McDonald, 2016; 38 CFR 4.59.)
  • They have you repeat each motion at least 3 times, then measure again (repetitive-use testing).
  • They check strength, muscle loss (atrophy), tenderness, and whether the joint is stuck (ankylosis).
  • They look at X-rays or other imaging, or order them.
  • They ask about braces, canes, or other devices and how often you use them.
  • Special shoulder tests: the examiner may press or move your arm in set ways to check the rotator cuff, the joint at the top of the shoulder, and whether the shoulder slips out.

The examiner fills out a form called a DBQ. You can read it ahead of time: Shoulder and Arm Conditions DBQ (updated 2025-04-15) (opens VA's site).

The rating levels, in plain words

VA rates most joints by how far they move. The less you can move, the higher the level.

Flexion or abduction

  • Up to 90°

    Your dominant arm

    20%

    Your other arm

    20%

    Can you lift your arm (forward or out to the side) only to about shoulder level, like pointing straight ahead and no higher? That is 20% for either arm.

    Rule: 38 CFR 4.71a, DC 5201

  • Up to 45°

    Your dominant arm

    30%

    Your other arm

    20%

    Can you lift your arm only about halfway to shoulder level (about 45 degrees, hand around belt-to-chest height)? That is 30% for your dominant arm.

    Rule: 38 CFR 4.71a, DC 5201

  • Up to 25°

    Your dominant arm

    40%

    Your other arm

    30%

    Can you lift your arm only about 25 degrees, barely away from your side? That is 40% for your dominant arm.

    Rule: 38 CFR 4.71a, DC 5201

Ankylosis (frozen joint)

  • Your dominant arm

    30%

    Your other arm

    20%

    Shoulder blade and arm bone are stuck moving as one piece, but you can lift the arm to 60 degrees and reach your mouth and head (favorable). 30% dominant / 20% other.

    Rule: 38 CFR 4.71a, DC 5200

  • Your dominant arm

    40%

    Your other arm

    30%

    Stuck in between favorable and unfavorable (intermediate). 40% dominant / 30% other.

    Rule: 38 CFR 4.71a, DC 5200

  • Your dominant arm

    50%

    Your other arm

    40%

    Stuck so you can lift the arm only 25 degrees from your side (unfavorable). 50% dominant / 40% other.

    Rule: 38 CFR 4.71a, DC 5200

Recurrent dislocation

  • Your dominant arm

    20%

    Your other arm

    20%

    Shoulder pops out now and then, and you guard (protect) it only when you raise your arm to shoulder level. 20% either arm.

    Rule: 38 CFR 4.71a, DC 5202

  • Your dominant arm

    30%

    Your other arm

    20%

    Shoulder pops out often and you guard ALL arm movements. 30% dominant / 20% other.

    Rule: 38 CFR 4.71a, DC 5202

Upper arm bone healed crooked (malunion)

  • 20%

    Moderate deformity: 20% either arm. Marked deformity: 30% dominant / 20% other.

    Rule: 38 CFR 4.71a, DC 5202

Upper arm bone: fibrous union / nonunion / loss of head

  • Your dominant arm

    50%

    Your other arm

    See text

    Fibrous union 50% dominant / 40% other; nonunion (false flail joint) 60% / 50%; loss of the ball (flail shoulder) 80% / 70%.

    Rule: 38 CFR 4.71a, DC 5202

Collarbone or shoulder blade

  • 10%

    Healed crooked (malunion) or broken and not healed but not loose: 10%. Dislocated, or not healed and loose: 20%. Or VA may rate it by how it limits the shoulder, whichever is higher.

    Rule: 38 CFR 4.71a, DC 5203

Painful motion, no big limit

  • 10%

    Motion is close to normal but painful because of an injury or arthritis: at least the lowest paid rating for the joint (10% under arthritis rules).

    Rule: 38 CFR 4.59; DC 5003

Your dominant arm is the one you write and eat with. Only one arm counts as dominant (38 CFR 4.69).

Measured at home? Check which level your number falls in.

Measure it at home

With a helper and a cheap tool. Your home numbers help you describe your bad days honestly at the exam.

The tool to get

  • Best: a clear plastic goniometer (say GO-nee-OM-eh-ter). It looks like a protractor with two long arms joined by a pin. A 12-inch, 360-degree one costs about $5 to $10 online or at a medical supply store. This is the same kind of tool most examiners use.

  • Free: a phone goniometer or inclinometer (angle-measuring) app. Many are free. Tape or hold the phone flat along the body part, set it to zero at the start, then move.

  • No money and no phone: print a paper protractor (half circle, 0 to 180 degrees) on stiff paper. Tape two straws or paper strips to the center with a brad so they swing. Lay it against the joint.

  • A pen and the log sheet below. A second person (spouse, adult child, friend) to hold the tool, because you cannot measure yourself well.

  • Know which arm is dominant: the hand you write and eat with. Only one arm counts as dominant (38 CFR 4.69).

No tool yet? Print our paper protractor below.

Step by step, with a helper

  1. 1. Flexion (forward raise)

    How to stand or lie
    Stand with your back against a wall, arms at your sides, thumbs pointing forward. Or lie on your back on a firm bed.
    Where the tool goes
    Pin (center) of the goniometer on the outside of the shoulder, just below the bony tip at the top. Fixed arm points straight down your side toward your hip. Moving arm lies along the outside of the upper arm, pointing at the elbow.
    Who holds what
    Helper holds the pin on the shoulder and keeps the fixed arm pointing straight down. Helper moves the other arm of the tool along with your arm and reads the number the moment you say 'pain.' Then reads again where you stop.

  2. 2. Abduction (side raise)

    How to stand or lie
    Stand with your back to the helper. Arm at your side, palm facing your leg. Turn the palm up as the arm passes shoulder level.
    Where the tool goes
    Pin on the back of the shoulder joint. Fixed arm straight down, parallel to your spine. Moving arm along the back of the upper arm toward the elbow.
    Who holds what
    Helper stands behind you, holds the pin steady, follows your arm, and calls out the number when you say 'pain' and when you stop. Watch that you do not lean your body to the side; that adds fake degrees.

  3. 3. External and internal rotation

    How to stand or lie
    Lie on your back. Arm out to the side at shoulder height, elbow bent so your hand points at the ceiling.
    Where the tool goes
    Pin on the tip of the elbow. Fixed arm points straight up at the ceiling. Moving arm along the forearm toward the wrist.
    Who holds what
    Helper reads the angle as you let your hand fall back toward the bed above your head (external) and forward toward your hip (internal). Stop at pain.

Stop at the first real pain. Never force a joint to get a number. Stand close for balance during back and hip tests.

Check your number

1. Which motion did you measure?
2. Which arm?

Type the number where you had to stop.

degrees

Type your number above to see where it falls.

This is only to help you understand. The VA examiner measures and the VA decides.

The levels for flexion (pick an arm):

  • 0° to 25°40%
  • 26° to 45°30%
  • 46° to 90°20%

If your number is close to the next level, VA may give the higher one (38 CFR 4.7).

Your log: what to write each time

  1. DateExample: 10/12
  2. TimeExample: 7 pm
  3. Good day or flare-up day?Example: Flare-up day
  4. Body part and side (R/L)Example: Right shoulder
  5. MotionExample: Lift arm forward
  6. Degrees where pain STARTSExample: 70
  7. Degrees where you had to STOPExample: 85
  8. After 3 tries: degrees where you stopExample: 75
  9. Pain 0-10Example: 7
  10. Medicine taken today (what and when)Example: Ibuprofen 8 am
  11. Who measuredExample: Spouse
  12. Notes (clicking, giving way, swelling)Example: Hurt more after the 3rd try

Write it down (one line per try):

Measure on a normal day and again on a bad day. Do it 2 or 3 times over a few weeks. Bring the sheet to the exam.

Tap Print this page to get a blank log sheet and your exam-day checklist on paper.

Printable paper protractor

01801516530150451356012075105909010575120601354515030165151800Center: push a brad through this dot
  • Print at 100% scale; check the 90° line with a square corner (like the corner of a sheet of paper).
  • Glue it to stiff paper or a cereal box. Push a brad through the center dot.
  • Tape two paper strips or straws to the brad so they swing. One stays on the body part that doesn't move. The other follows the moving part.
  • The top numbers count from the left. The small numbers count from the right. Use whichever side starts at 0.

This is only to help you understand. The VA examiner measures and the VA decides.

Exam-day checklist

Tick each one off. Nothing you tick is saved or sent anywhere.

Tell the examiner

Flare-ups

A flare-up is a time when your joint gets much worse for a while. The examiner must ask about your flare-ups and estimate, in degrees, how much motion you lose during them, even if your exam is on a good day (Sharp v. Shulkin, 2017). They can only skip this if they explain why after getting your information. Be ready to say: how often (for example, 2 times a week), how long each lasts (for example, 1 to 2 days), what triggers it, and exactly what you cannot do (for example, 'I can't lift my arm to comb my hair'). If you measured at home on a flare-up day, show that number.

Repeated use

The examiner will have you do each motion at least 3 times and then measure again. Tell them if pain, weakness, tiredness, or poor control gets worse with each try. The form also asks about repeated use over time, like at the end of a workday. Pain alone does not raise a rating; pain that actually limits how far, how strong, or how long you can move does (Mitchell v. Shinseki, 2011; DeLuca v. Brown, 1995; 38 CFR 4.40 and 4.45).

Honest exam rules

  • Move each joint until pain starts. Say 'pain starts here' out loud. Stop when pain or stiffness stops you. Do not push through sharp pain to look tough. Do not stop before pain or stiffness really stops you, either. The examiner writes down both points.
  • Give your real, full effort on strength tests. The goal is an exam that shows how you truly are.
  • Describe a typical day AND your worst days. Bad days count, but say they are bad days and how often they happen.
  • Take your medicine the way you normally do. Do not skip it, and do not take extra just for the exam. Tell the examiner what you took and when, and how you are when it wears off. (Court decisions Jones v. Shinseki (2012) and Ingram v. Collins (2025) say VA should not lower a joint rating because medicine helps, when the rating rules do not mention medicine. VA tried to change this by rule in February 2026 and took the change back on February 27, 2026.)
  • Wear or bring any brace, cane, crutches, or walker you normally use. Bring the prescription or a record showing a provider ordered it.
  • Bring a one-page list: your diagnoses, surgeries, treatments tried, medicines, how often you have flare-ups, your home measurement log, and what you can no longer do at work and at home.
  • If you do not know or do not remember, say so. Do not guess.
  • Fraud warning: knowingly giving VA false information is a federal crime (18 U.S.C. 1001) and can cost you all VA benefits (38 U.S.C. 6103). Honest, complete reporting is all you need.

Common mistakes

  • Pushing through pain so the examiner only writes down your end point. Painful motion is a key factor, and the exam should record where pain starts.

    Where this comes from: 38 CFR 4.59; Burton v. Shinseki, 25 Vet. App. 1 (2011); Mitchell v. Shinseki, 25 Vet. App. 32 (2011)

  • Saying 'I'm fine' or only describing a good day. Flare-ups that are not described cannot be estimated.

    Where this comes from: Sharp v. Shulkin, 29 Vet. App. 26 (2017); DBQ flare-up section

  • An exam that skipped passive motion, weight-bearing testing, or the opposite joint. That exam may be inadequate; you or your representative can point this out.

    Where this comes from: Correia v. McDonald, 28 Vet. App. 158 (2016)

  • Not asking for at least the minimum rating when the joint is actually painful, unstable, or out of line from an old injury.

    Where this comes from: 38 CFR 4.59; Petitti v. McDonald, 27 Vet. App. 415 (2015)

  • Not telling the examiner which arm is dominant. The dominant arm pays more at most levels.

    Where this comes from: 38 CFR 4.69; 38 CFR 4.71a (Major/Minor columns)

  • Leaning the body or shrugging to get the arm higher. That makes the number look better than your shoulder really is. Keep your body straight.

    Where this comes from: DBQ instructions; 38 CFR 4.71 (standard measurement)

  • Thinking you need both forward AND side raise limited. Limitation in either one can be rated under DC 5201.

    Where this comes from: 38 CFR 4.71a DC 5201 ('flexion and/or abduction'); Yonek v. Shinseki, 722 F.3d 1355 (Fed. Cir. 2013) (verify)

Questions to ask together

A spouse, grown child or friend can read these out loud. Talk about each one before the exam, so nothing gets left out.

  1. Can you reach the top shelf of the kitchen cabinet with that arm?
  2. Can you wash or comb the back of your hair with that hand?
  3. Can you put on a jacket or tuck in a shirt behind your back without help?
  4. Can you sleep on that shoulder?
  5. When it flares up, how many days does it last, and what can't you do then?

Sources

Checked against VA's rules on October 30, 2026.

Helping The Brave doesn't file or prepare claims. This guide is free education, not medical or legal advice. The VA examiner measures and VA decides your rating.