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What Is the VA Disability Rating for Rotator Cuff Repair?

What Is the VA Disability Rating for Rotator Cuff Repair?

Military duties often involve a lot of physical labor, whether lifting items, carrying heavy gear, or engaging in conflict. Because of their duties, many Veterans experience injuries or disabilities to their rotator cuffs, which are the sensitive areas of tissue around the shoulders.

If you’ve been injured and your rotator cuffs are injured or require treatment, you could qualify for VA disability benefits. Learn more about the VA disability ratings for rotator cuff repair and injuries.

What Are Rotator Cuff Injuries?

Your rotator cuff is a collection of tendons and muscles that attach to the head of your upper arm bone or humerus. The rotator cuff also ensures the humerus sits firmly and stably within your shoulder socket. 

Each arm has its rotator cuff, and you can injure either or both depending on your work. Your rotator cuffs contain several important muscles, including the:

  • Supraspinatus, which holds the humerus in place and keeps your upper arm stable
  • Infraspinatus, the primary muscle that allows your shoulder to rotate and extend
  • Teres minor, the smallest of the rotator cuff muscles that helps to rotate your arm away from the body
  • Subscapularis, a muscle that holds your upper arm bone to the shoulder blade and assists with arm rotation

If one of your rotator cuffs is injured, you may feel a variety of side effects or symptoms, including:

  • A dull, deep ache located somewhere in your shoulder
  • Arm weakness
  • Lack of arm flexibility (you might find it difficult to reach behind your back or lift your shoulder, for example)
  • Difficulty sleeping

Furthermore, these symptoms can vary heavily in terms of severity. Some individuals experience minor rotator cuff injuries, while others are so severe that they prevent their victims from working or doing day-to-day tasks.

Rotator cuff injuries need to be treated and surgically repaired in some cases. If left unchecked, rotator cuff injuries can worsen over time, resulting in severe muscle damage, inability to move one’s arm, and even total loss of arm functionality.

How Can Rotator Cuff Injuries Occur?

Rotator cuff injuries can occur for many different reasons. Most people develop rotator cuff injuries because of wear and tear or from repetitive motions over and over, like lifting their arms over their heads or picking up their arms over and over. 

In these cases, you may injure your rotator cuffs without knowing it, only determining that you have torn serious muscles after some time has passed. However, rotator cuff injuries can also occur because of single incidents, like your arm getting jerked up suddenly if your sleeve gets caught on something, like machinery.

In the military, your duties might put you at a higher risk of suffering from rotator cuff injuries. If you are on base doing a lot of physical labor, for instance, you could put extra strain on your rotator cuffs, wearing them down and putting them at risk of severe tears.

You might also suffer a rotator cuff tear from falling on your shoulder or from combat. Regardless, many Veterans experience rotator cuff tears and other injuries and need to get disability benefits to pay for medical bills and to compensate them for lost working hours.

What Is Rotator Cuff Repair?

Rotator cuff repair means treating rotator cuff injuries through various options and methods.

Some of the most conservative methods for repairing rotator cuffs include placing ice on the affected area or using over-the-counter pain medications. Different treatments, such as physical therapy, may be required depending on the severity and nature of a given rotator cuff injury.

In the worst-case scenarios, Veterans may need rotator cuff surgeries to repair tears and other injuries. These include:

  • Open tendon repair
  • Tendon transfer surgeries
  • Shoulder replacement surgeries
  • Arthroscopic tendon repair surgeries

Surgery is only utilized when it’s necessary. But in these circumstances, Veterans may be unable to pay for surgeries themselves, especially if the military exacerbated their rotator cuff injuries or worsened after they were discharged.

Can You Receive Both Direct and Secondary Service Connections for Rotator Cuff Injuries?

The VA may provide disability benefits for direct and secondary service-connected rotator cuff injuries.

Direct, service-connected rotator cuff tears and injuries occur as a direct result of one’s military service or a specific event in the military. 

For instance, if you had healthy shoulders before joining the military and developed rotator cuff tears because of physical labor, you could receive service connection and disability benefits later on.

Secondary service connections are awarded to Veterans with rotator cuff injuries that occurred due to some other direct service-connected injury. Say that you have service connection for degenerative arthritis in your shoulder. 

Because this condition causes your shoulder joint to weaken, you develop rotator cuff injuries over time. Since you wouldn’t have developed those injuries were it not for your degenerative arthritis, the VA is still liable to pay you disability benefits.

VA Disability Ratings for Rotator Cuff Injuries

The VA rates rotator cuff injuries and disabilities based on the location and type of injuries sustained. Here are some examples:

  • A Veteran might receive a disability rating under Diagnostic Code 5200 for scapulohumeral articulation or ankylosis. Possible disability ratings range from 50% to 20%, depending on the abduction range of the affected limbs and shoulders. If a Veteran’s range of motion is very limited, they will receive a higher disability rating.
  • Veterans may also receive disability ratings according to Diagnostic Code 5201, which is used for limitation of motion of the arm. Your diagnostic rating will range from 40% to 20% depending on the range of motion you can display (20% at shoulder level and 40% if you can only move your arm 25° from side to side).
  • Furthermore, you can receive a disability rating for rotator cuff repair surgery. Your rotator cuff repair surgery rating will compensate you for both the initial lack of mobility you will experience and for recovery after the surgery concludes. Your VA disability rating will be 10% or 20%, depending on the severity of side effects and your resulting range of motion.

Can You Get TIDU for Rotator Cuff Injuries?

Total disability individual unemployability (TDIU) is a special VA benefits status awarded to Veterans whose on-paper disability ratings are not 100%. Still, their symptoms prevent them from maintaining substantially gainful employment. If you qualify for TDIU for rotator cuff injuries, you will receive disability benefits as if you had a 100% disability rating.

This rating is only available if your rotator cuff injuries are so severe that you are prevented from working because of your service connected rotator cuff injury. If you believe that your current disability rating is too low, you can contact Veterans law attorneys.

With attorneys’ help, you can file an appeal with the VA and get your disability rating increased. You may also eventually qualify for TDIU and many more benefits by providing substantiating evidence. 

What Happens If the VA Denies Your Claim for Rotator Cuff Repair Disability?

If your initial claim for rotator cuff repair disability is denied, don’t give up. Knowledgeable Veterans law attorneys may be able to help you through the appeals process.

In general, the VA denies benefits claims because there isn’t enough evidence to substantiate a Veteran’s claims about their symptoms or conditions. 

For instance, if your rotator cuff injuries are severe and stop you from working, you’ll need to provide evidence to prove that, including service records, medical documentation, and lay statements from your friends, family members, and coworkers.

If your initial claim didn’t have enough evidence, it might have been denied. Veterans law attorneys can gather additional evidence on your behalf and put together a stronger claim with a good chance of getting through the appeals process.

Contact Berry Law

Ultimately, you deserve disability benefits for your rotator cuff symptoms and treatment, including repair surgeries, if you acquired your initial injuries in the military. If your initial claim is denied or you don’t know where to start the claims process, Berry Law can help.

Our experienced attorneys are more than ready to hear the details of your case and guide you through the process from start to finish. Contact us today to learn exactly how we can help you.

Sources:

Rotator Cuff Injuries | MedlinePlus 

38 CFR § 4.71a – Schedule of ratings – musculoskeletal system. | Cornell Law

VA Individual Unemployability If You Can’t Work | Veterans Affairs

Berry Law

The attorneys at Berry Law are dedicated to helping injured Veterans. With extensive experience working with VA disability claims, Berry Law can help you with your disability appeals.

This material is for informational purposes only. It does not create an attorney-client relationship between the Firm and the reader, and does not constitute legal advice. Legal advice must be tailored to the specific circumstances of each case, and the contents of this blog are not a substitute for legal counsel.

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