When most veterans think of musculoskeletal VA claims, back pain is often the first condition that comes to mind. And for good reason—it’s one of the most common service-connected issues. But the musculoskeletal system is vast, covering joints, bones, muscles, tendons, ligaments, and connective tissues. Veterans experience a wide array of injuries and disorders beyond the spine, from shoulder dislocations to knee instability to arthritis in the hands.
If you’re experiencing chronic pain, restricted movement, or joint degeneration from your time in service, your condition may qualify for VA disability compensation. In this guide, we’ll walk through how the VA rates musculoskeletal conditions, what factors impact your rating, and how to build a strong claim—even if your injury isn’t spine-related.
What Counts as a Musculoskeletal Condition?
The VA’s musculoskeletal rating system is extensive, covering dozens of conditions affecting mobility, strength, and function. Common examples include:
Joint pain (shoulders, knees, elbows, hips, wrists)
Arthritis and degenerative joint disease (DJD)
Tendonitis and bursitis
Limited range of motion
Recurrent dislocations
Meniscus injuries or tears
Bone fractures with malunion
Plantar fasciitis
Ankylosis (joint stiffening or fusion)
Each of these conditions is evaluated using specific Diagnostic Codes (DCs) under 38 CFR § 4.71a.
How the VA Rates Musculoskeletal Disabilities
VA disability ratings for these conditions are primarily based on functional loss. This includes how much the condition limits your ability to move, lift, walk, or perform daily activities.
Key Rating Criteria Include:
Range of Motion (ROM) testing
Pain during movement
Instability or weakness
Recurrent dislocation or subluxation
Ankylosis (fusion of a joint)
Involvement of major vs. minor joints
Impact on weight-bearing function
Let’s look at a few examples.
Example 1: Knee Conditions
There are multiple ways to rate knee conditions, depending on what specifically is wrong:
DC 5260 (Limitation of Flexion): Max rating of 30% if you can’t bend your knee beyond 15 degrees.
DC 5261 (Limitation of Extension): Max rating of 50% if you can’t straighten your knee at all.
DC 5257 (Instability): Rated up to 30% if you have moderate to severe instability.
DC 5258 (Dislocated Meniscus): Rated at 20% for frequent episodes of locking and pain.
Each code can be rated separately, depending on how the condition affects different aspects of the knee.
Example 2: Shoulder and Arm Injuries
The shoulder is particularly vulnerable for combat and manual labor veterans. VA uses DC 5201 to rate limitation of motion in the shoulder:
20% for limited motion to shoulder level
30% for motion limited to halfway between side and shoulder
40% for motion limited to 25 degrees or less
Ratings may increase if the dominant arm is affected.
DeLuca Factors: The Game Changer
Range of motion isn’t the only factor. In DeLuca v. Brown, the Court held that the VA must also consider how pain, flare-ups, weakness, and fatigability affect a veteran’s functional ability.
This means that even if you technically have “normal” range of motion on exam, if you experience:
Significant pain with use
Reduced function during flare-ups
Muscle weakness or fatigue after activity
…your condition may warrant a higher rating.
🔎 Pro Tip: Always describe how your joint feels and functions on your worst days, not just during a single medical exam.
Multiple Ratings for Multiple Joints
If you have issues with both knees, or multiple joints (e.g. shoulder and elbow), each can receive its own rating as long as symptoms are independently verifiable.
You may also be entitled to a bilateral factor if both arms or both legs are affected, which can increase your combined disability percentage.
Arthritis and Degenerative Joint Disease
Arthritis is one of the most common musculoskeletal conditions in veterans. The VA distinguishes between:
Traumatic arthritis (DC 5010): Due to injury, rated under limitation of motion
Degenerative arthritis (osteoarthritis) (DC 5003): Rated when motion is painful but not significantly limited
Even X-ray evidence of arthritis, combined with painful motion, can qualify for a 10% rating per joint—even if range of motion is otherwise normal.
Secondary Conditions from Musculoskeletal Injuries
Veterans often develop secondary conditions because of musculoskeletal injuries, such as:
Depression or anxiety from chronic pain
Gait abnormalities leading to hip, knee, or back problems
Sleep disturbances due to pain
Radiculopathy or nerve damage from joint impingement
These secondary conditions can often be claimed in addition to your primary injury.
Lay Evidence: Tell Your Story
Even if imaging doesn’t show a severe injury, lay statements can help bolster your claim. You or someone close to you can submit a statement in support of claim describing:
Your pain levels and frequency
Impact on work, exercise, and daily living
How the condition limits your mobility
Examples of flare-ups or joint instability
The VA is legally obligated to consider competent lay evidence.
C&P Exams: Prepare to Speak Up
After filing your claim, you’ll likely be scheduled for a Compensation & Pension (C&P) exam. This is your chance to demonstrate the functional impact of your condition.
Tips for Success:
Describe flare-ups and how often they occur
Explain how your condition affects work or hobbies
Don’t “tough it out”—let them see the real pain
Bring a buddy letter or personal log of symptoms
Remember, the exam is just a snapshot. Your narrative fills in the rest.
Functional Loss Can Equal Higher Ratings
Sometimes, veterans don’t qualify for a high rating based on range of motion alone. But if the condition causes:
Limping or use of a cane
Loss of endurance
Frequent dislocations
Inability to perform certain movements repeatedly
…the VA must consider functional loss under 38 CFR § 4.40–4.45, which can justify an increased rating.
When Should You File for an Increase?
If your musculoskeletal condition is worsening, or your pain limits more daily activity than it used to, it may be time to file for a rating increase. Signs include:
Needing assistive devices (braces, cane, wheelchair)
Having more frequent or severe flare-ups
Missing work or limiting your duties due to joint pain
Being prescribed more potent pain management
Musculoskeletal Conditions and TDIU
Some veterans with orthopedic conditions are unable to work due to pain, limited mobility, or the need for frequent rest breaks. If your condition keeps you from maintaining substantial gainful employment, you may be eligible for Total Disability Individual Unemployability (TDIU).
This allows you to receive 100% compensation even if your individual ratings don’t add up to 100%.
Final Thoughts: It’s More Than Just a Sore Joint
Musculoskeletal conditions are complex, painful, and often worsen with age. But the VA’s rating system goes far beyond just back pain—it covers every major joint and function, with provisions for flare-ups, pain, weakness, and instability.
Whether you’re a veteran dealing with shoulder limitations, knee surgeries, arthritis in your hands, or post-fracture complications, you may be eligible for compensation. The key is documenting your symptoms, understanding the rating schedule, and telling your full story.
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