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VA disability rating for Shoulder / Arm Limitation

Limited shoulder and arm motion is rated by how high you can raise the arm, with higher ratings for the dominant side.

Diagnostic code 5201 · §4.71a · Musculoskeletal system · up to 40%

Rating criteria

RatingWhen it applies
40%Major arm: flexion and/or abduction limited to 25° from side
30%Major arm: midway between side and shoulder level (limited to 45°); Minor arm: limited to 25° from side
20%At shoulder level (flexion and/or abduction limited to 90°)
20%Minor arm: midway between side and shoulder level (flexion and/or abduction limited to 45°)

Related conditions

Conditions often claimed with shoulder / arm limitation: Shoulder instability, Rotator cuff tear, Cervical strain (compensating), Opposite shoulder (compensating), and Depression (chronic pain).

A secondary claim needs a medical nexus linking the condition to a service-connected one.

Related guides

Peer-reviewed research on shoulder / arm limitation

17 peer-reviewed studies linked to shoulder / arm limitation (diagnostic code 5201), from PubMed and the U.S. National Library of Medicine. Each citation links to its source.

  1. Review
    Factors associated with persistent shoulder pain following arthroscopic rotator cuff repair: a scoping review.
    Pain Manag · 2026
    • A substantial subset of patients report persistent shoulder pain after arthroscopic rotator cuff repair
    • Consistent predictors included higher preoperative pain, preoperative narcotic use, depression/anxiety, female sex, smoking, and workers' compensation claims
    • Persistent pain spans biological, psychological, and social domains

    Demonstrates that surgery frequently does not eliminate symptoms, directly supporting ongoing functional impairment and chronicity in shoulder claims.

    View on PubMed ↗
  2. Cohort study
    Does surgical intervention alter the natural history of degenerative rotator cuff tears? Comparative analysis from a prospective longitudinal study.
    J Shoulder Elbow Surg · 2025
    • The natural history of degenerative tears involves progressive pain, tear enlargement, and worsening muscle fatty degeneration
    • Surgically treated shoulders had significantly lower pain, higher ASES/ADL scores, greater strength, and greater active elevation and external rotation than nonoperatively managed controls at follow-up
    • Surgery was protective against progressive supraspinatus and infraspinatus fatty degeneration

    Characterizes the progressive natural history of rotator cuff disease and the residual functional deficits in untreated shoulders, directly relevant to prognosis for rated impairment.

    View on PubMed ↗
  3. Review
    Adhesive Capsulitis.
    Phys Med Rehabil Clin N Am · 2023
    • Adhesive capsulitis affects approximately 2-5% of the general population, with possibly higher true incidence given mild self-limited cases.
    • Involves progressive glenohumeral fibrosis causing limited active and passive range of motion, capsular contracture, and shoulder pain.

    Provides epidemiology and the pathologic basis of limited active and passive shoulder motion, foundational for a limitation-of-arm-motion claim.

    View on PubMed ↗
  4. Cohort study
    Long-term functional and structural outcome of rotator cuff repair in patients 60 years old or less.
    JSES Int · 2023
    • Functional improvements after repair were durable at 15+ years but declined slightly from short- to long-term and showed structural deterioration
    • Recurrent tears occurred in 49% (31% full-thickness, 18% partial) and 35% developed cuff tear arthropathy
    • More medical comorbidities and larger initial tear size predicted worse long-term outcomes

    Provides long-term prognosis showing repair delays but does not arrest progressive rotator cuff disease, supporting the chronic and progressive nature of the impairment.

    View on PubMed ↗
  5. Case series
    Midterm Outcomes After Arthroscopic Repair of Type VIII SLAP Lesions in Active Duty Military Patients Younger Than 35 Years
    Orthopaedic Journal of Sports Medicine · 2022
    • Midterm follow-up of arthroscopic SLAP repair in young active duty
    • Improvements in pain and ROM but residual functional deficits common
    • Return-to-duty rates documented; some require profile/discharge

    Persistent shoulder motion limitations after in-service repair supports DC 5201

    View on PubMed ↗
  6. Meta-analysis
    Exercise Therapy Is Effective for Improvement in Range of Motion, Function, and Pain in Patients With Frozen Shoulder: A Systematic Review and Meta-analysis.
    Arch Phys Med Rehabil · 2022
    • Systematic review/meta-analysis (33 studies qualitative, 19 meta-analyzed) of exercise therapy for adhesive capsulitis (limited shoulder range of motion).
    • Supervised exercise was more beneficial than home exercise for range of motion and function.
    • Multimodal programs and muscle-energy techniques added little beyond exercise alone for ROM.

    Addresses restoration of restricted shoulder range of motion, directly relevant to evaluating treatment outcomes for a limitation-of-arm-motion claim.

    View on PubMed ↗
  7. Meta-analysis
    Treatment of rotator cuff tears: a systematic review and meta-analysis.
    J Shoulder Elbow Surg · 2022
    • Double-row and single-row arthroscopic repairs produced similar function and pain, but double-row had lower retear rates
    • Tendon transfer and superior capsular reconstruction yielded comparable functional results for massive/irreparable tears
    • Optimal timing of surgery could not be determined due to inconsistent evidence

    Confirms that no surgical technique fully restores normal shoulder function and retears are common, underpinning the durability of rated shoulder impairment.

    View on PubMed ↗
  8. Meta-analysis
    Conservative versus surgical management for patients with rotator cuff tears: a systematic review and META-analysis.
    BMC Musculoskelet Disord · 2021
    • At 12 and 24 months, shoulder function (Constant-Murley score) did not differ significantly between surgical and conservative management
    • Surgery gave a modest pain advantage at one year (VAS difference -1.08), but functional scores converged
    • Authors concluded long-term superiority of either approach remains unproven

    Shows that even with treatment many patients retain meaningful functional limitation, supporting persistence of shoulder impairment regardless of management.

    View on PubMed ↗
  9. Review
    Posterior Shoulder Instability
    Sports Health · 2016
    • Higher prevalence of posterior shoulder instability in military and athletic populations
    • Repetitive overhead/pushing loads characteristic of military duties precipitate condition
    • Variable return of motion after stabilization

    Occupational link between military loads and shoulder limitation of motion under DC 5201

    View on PubMed ↗
  10. Cohort study
    Trends in the diagnosis of SLAP lesions in the US military
    Knee Surgery, Sports Traumatology, Arthroscopy · 2015
    • Substantial and growing incidence of SLAP lesions in US service members
    • High-risk demographic and occupational subgroups identified
    • Shoulder labral injury as service-related contributing to motion loss

    Primary military-cohort epidemiology supports nexus for DC 5201

    View on PubMed ↗
  11. Cohort study
    Shoulder impingement in the United States military.
    J Shoulder Elbow Surg · 2015
    • 106,940 cases of shoulder impingement yielded an incidence of 7.77 per 1,000 person-years in U.S. military personnel
    • Incidence rose with age and was highest at age 40+ (IRR 4.90); men had 9.5% higher rates
    • Army, Air Force, and Marine Corps had higher rates than Navy

    Directly quantifies shoulder impingement burden in active-duty service members, strongly supporting service connection for shoulder impairment in veterans.

    View on PubMed ↗
  12. Cross-sectional
    Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: From mass-screening in one village.
    J Orthop · 2013
    • 22.1% of screened residents had full-thickness rotator cuff tears, increasing from 0% under age 50 to 36.6% in the 80s
    • Asymptomatic tears were about twice as common as symptomatic tears (65.3% vs 34.7%)
    • Prevalence was higher in men than women in the 50s and 60s

    Confirms age-dependent prevalence of cuff tears and that many tears are clinically silent, relevant to documenting how often impairment underlies symptomatic shoulder limitation.

    View on PubMed ↗
  13. Cohort study
    Prevalence and risk factors of a rotator cuff tear in the general population.
    J Shoulder Elbow Surg · 2010
    • Full-thickness rotator cuff tears were present in 20.7% of shoulders in the general population, with prevalence rising sharply with age
    • Independent risk factors for a tear were a history of trauma, dominant-arm involvement, and age; heavy labor was also associated
    • Tears correlated with reduced active forward elevation and weaker abduction/external-rotation strength on exam

    Establishes that rotator cuff tears are highly prevalent and tied to trauma and heavy physical labor, supporting both baseline prevalence and occupational/service causation for shoulder limitation-of-motion claims.

    View on PubMed ↗
  14. Review
    Common Occupational Upper Extremity Musculoskeletal Disorders.
    Am Fam Physician · 2025
    • Rotator cuff tendinopathy is a degenerative disorder commonly identified in workers performing repetitive overhead work
    • It is diagnosed clinically and generally managed nonoperatively with NSAIDs, physical therapy, and corticosteroid injections
    • A careful occupational history helps establish whether the injury is work-related

    Establishes repetitive overhead occupational exposure as a recognized cause of rotator cuff tendinopathy, supporting environmental/occupational service causation arguments.

    View on PubMed ↗
  15. Systematic review
    Shoulder Rotator Cuff Disorders: A Systematic Review of Clinical Practice Guidelines and Semantic Analyses of Recommendations.
    Arch Phys Med Rehabil · 2020
    • Systematic review of clinical practice guidelines and systematic reviews for shoulder rotator cuff disorders.
    • Synthesizes recommendations relevant to diagnosis and management of rotator cuff-related shoulder dysfunction.

    Consolidates guideline-level evidence on rotator cuff disorders, a common cause of limited and painful shoulder motion, supporting diagnostic and management context for an arm-motion claim.

    View on PubMed ↗
  16. Meta-analysis
    Manual therapy and exercise for rotator cuff disease.
    Cochrane Database Syst Rev · 2016
    • Cochrane review of manual therapy and exercise for rotator cuff disease, a major cause of shoulder pain and limited motion.
    • Synthesized RCT evidence on benefits and harms for pain, function, and pain on motion.
    • Part of an updated Cochrane series on physiotherapy interventions for shoulder pain.

    Evaluates conservative treatment of rotator cuff disease that commonly produces painful, restricted shoulder motion, supporting treatment-outcome evidence for an arm-motion claim.

    View on PubMed ↗
  17. Systematic review
    Exercise for rotator cuff tendinopathy: a systematic review.
    Physiotherapy · 2012
    • Available RCTs supported loaded/resistance exercise for reducing pain and functional disability in rotator cuff tendinopathy
    • Evidence base was small (four studies) with methodological limitations including lack of blinding
    • Conclusions were favorable but tentative, with calls for more research

    Addresses conservative treatment effectiveness for cuff tendinopathy, framing how shoulder symptoms and functional disability are managed and may persist.

    View on PubMed ↗

Citations are provided for general educational use and are not medical advice.

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