- Diagnostic Code
- 5202
- CFR Section
- §4.71a — Musculoskeletal
Rating Tiers
80%
Loss of head of (flail shoulder) · minor (non-dominant): 70%
60%
Nonunion of (false flail joint) · minor (non-dominant): 50%
50%
Fibrous union of · minor (non-dominant): 40%
30%
With frequent episodes and guarding of all arm movements · minor (non-dominant): 20% | Marked deformity · minor (non-dominant): 20%
20%
With infrequent episodes and guarding of movement only at shoulder level (flexion and/or abduction at 90 °) | Moderate deformity
Rated Under Formula
This condition is rated using the §4.71a general rating formula.
What Raters Look For
Based on M21-1 adjudication criteria for Musculoskeletal conditions. These are the factors a VA rater evaluates when assigning a rating percentage.
M21-1 III.iv.4.A- •Range of motion measurements in degrees for each affected joint, recorded on examination
- •Pain on motion — whether pain limits motion before the normal end point is reached
- •Functional loss — specific activities the Veteran cannot perform due to the condition
- •Flare-up history: how often they occur, how severe, and how long they last (Veteran's statement counts)
- •Effects of repetitive motion (whether additional loss of motion occurs after repeated use)
- •Muscle atrophy, guarding, or tenderness noted on physical exam
- •Whether ankylosis (complete fixation) is present and in a favorable or unfavorable position
- •Imaging findings: X-ray, MRI, or CT reports noting bone/joint changes
NoteRaters must consider functional loss from pain even if range of motion appears near-normal. A lay statement describing flare-ups carries evidentiary weight.