38 CFR 4.73 - Schedule of ratings—muscle injuries.

Updated to:July 2013
CONTENT

Title 38: Pensions, Bonuses, and Veterans' Relief

CHAPTER I: DEPARTMENT OF VETERANS AFFAIRS

PART 4: SCHEDULE FOR RATING DISABILITIES

Subpart B: Disability Ratings

: The Musculoskeletal System

4.73 - Schedule of ratings?muscle injuries.

Note:

When evaluating any claim involving muscle injuries resulting in loss of use of any extremity or loss of use of both buttocks (diagnostic code 5317, Muscle Group XVII), refer to ? 3.350 of this chapter to determine whether the veteran may be entitled to special monthly compensation.

The Shoulder Girdle and Arm

Rating Dominant Nondominant
5301Group I. Function: Upward rotation of scapula; elevation of arm above shoulder level. Extrinsic muscles of shoulder girdle: (1) Trapezius; (2) levator scapulae; (3) serratus magnus
Severe 40 30
Moderately Severe 30 20
Moderate 10 10
Slight 0 0
5302Group II. Function: Depression of arm from vertical overhead to hanging at side (1, 2); downward rotation of scapula (3, 4); 1 and 2 act with Group III in forward and backward swing of arm. Extrinsic muscles of shoulder girdle: (1) Pectoralis major II (costosternal); (2) latissimus dorsi and teres major (teres major, although technically an intrinsic muscle, is included with latissimus dorsi); (3) pectoralis minor; (4) rhomboid

Severe 40 30
Moderately Severe 30 20
Moderate 20 20
Slight 0 0
5303Group III. Function: Elevation and abduction of arm to level of shoulder; act with 1 and 2 of Group II in forward and backward swing of arm. Intrinsic muscles of shoulder girdle: (1) Pectoralis major I (clavicular); (2) deltoid

Severe 40 30
Moderately Severe 30 20
Moderate 20 20
Slight 0 0
5304Group IV. Function: Stabilization of shoulder against injury in strong movements, holding head of humerus in socket; abduction; outward rotation and inward rotation of arm. Intrinsic muscles of shoulder girdle: (1) Supraspinatus; (2) infraspinatus and teres minor; (3) subscapularis; (4) coracobrachialis

Severe 30 20
Moderately Severe 20 20
Moderate 10 10
Slight 0 0
5305Group V. Function: Elbow supination (1) (long head of biceps is stabilizer of shoulder joint); flexion of elbow (1, 2, 3). Flexor muscles of elbow: (1) Biceps; (2) brachialis; (3) brachioradialis

Severe 40 30
Moderately Severe 30 20
Moderate 10 10
Slight 0 0
5306Group VI. Function: Extension of elbow (long head of triceps is stabilizer of shoulder joint). Extensor muscles of the elbow: (1) Triceps; (2) anconeus.
Severe 40 30
Moderately Severe 30 20
Moderate 10 10
Slight 0 0

The Forearm and Hand

Rating Dominant Nondominant
5307Group VII. Function: Flexion of wrist and fingers. Muscles arising from internal condyle of humerus: Flexors of the carpus and long flexors of fingers and thumb; pronator
Severe 40 30
Moderately Severe 30 20
Moderate 10 10
Slight 0 0
5308Group VIII. Function: Extension of wrist, fingers, and thumb; abduction of thumb. Muscles arising mainly from external condyle of humerus: Extensors of carpus, fingers, and thumb; supinator
Severe 30 20
Moderately Severe 20 20
Moderate 10 10
Slight 0 0
5309Group IX. Function: The forearm muscles act in strong grasping movements and are supplemented by the intrinsic muscles in delicate manipulative movements. Intrinsic muscles of hand: Thenar eminence; short flexor, opponens, abductor and adductor of thumb; hypothenar eminence; short flexor, opponens and abductor of little finger; 4 lumbricales; 4 dorsal and 3 palmar interossei

Note: The hand is so compact a structure that isolated muscle injuries are rare, being nearly always complicated with injuries of bones, joints, tendons, etc. Rate on limitation of motion, minimum 10 percent.

The Foot and Leg

Rating
5310Group X. Function: Movements of forefoot and toes; propulsion thrust in walking. Intrinsic muscles of the foot: Plantar: (1) Flexor digitorum brevis; (2) abductor hallucis; (3) abductor digiti minimi; (4) quadratus plantae; (5) lumbricales; (6) flexor hallucis brevis; (7) adductor hallucis; (8) flexor digiti minimi brevis; (9) dorsal and plantar interossei. Other important plantar structures: Plantar aponeurosis, long plantar and calcaneonavicular ligament, tendons of posterior tibial, peroneus longus, and long flexors of great and little toes
Severe 30
Moderately Severe 20
Moderate 10
Slight 0

Dorsal: (1) Extensor hallucis brevis; (2) extensor digitorum brevis. Other important dorsal structures: cruciate, crural, deltoid, and other ligaments; tendons of long extensors of toes and peronei muscles
Severe 20
Moderately Severe 10
Moderate 10
Slight 0

Note: Minimum rating for through-and-through wounds of the foot?10.

5311Group XI. Function: Propulsion, plantar flexion of foot (1); stabilization of arch (2, 3); flexion of toes (4, 5); Flexion of knee (6). Posterior and lateral crural muscles, and muscles of the calf: (1) Triceps surae (gastrocnemius and soleus); (2) tibialis posterior; (3) peroneus longus; (4) peroneus brevis; (5) flexor hallucis longus; (6) flexor digitorum longus; (7) popliteus; (8) plantaris
Severe 30
Moderately Severe 20
Moderate 10
Slight 0
5312Group XII. Function: Dorsiflexion (1); extension of toes (2); stabilization of arch (3). Anterior muscles of the leg: (1) Tibialis anterior; (2) extensor digitorum longus; (3) extensor hallucis longus; (4) peroneus tertius
Severe 30
Moderately Severe 20
Moderate 10
Slight 0

The Pelvic Girdle and Thigh

* If bilateral, see ? 3.350(a)(3) of this chapter to determine whether the veteran may be entitled to special monthly compensation.

Rating
5313Group XIII. Function: Extension of hip and flexion of knee; outward and inward rotation of flexed knee; acting with rectus femoris and sartorius (see XIV, 1, 2) synchronizing simultaneous flexion of hip and knee and extension of hip and knee by belt-over-pulley action at knee joint. Posterior thigh group, Hamstring complex of 2-joint muscles: (1) Biceps femoris; (2) semimembranosus; (3) semitendinosus
Severe 40
Moderately Severe 30
Moderate 10
Slight 0
5314Group XIV. Function: Extension of knee (2, 3, 4, 5); simultaneous flexion of hip and flexion of knee (1); tension of fascia lata and iliotibial (Maissiat's) band, acting with XVII (1) in postural support of body (6); acting with hamstrings in synchronizing hip and knee (1, 2). Anterior thigh group: (1) Sartorius; (2) rectus femoris; (3) vastus externus; (4) vastus intermedius; (5) vastus internus; (6) tensor vaginae femoris
Severe 40
Moderately Severe 30
Moderate 10
Slight 0
5315Group XV. Function: Adduction of hip (1, 2, 3, 4); flexion of hip (1, 2); flexion of knee (4). Mesial thigh group: (1) Adductor longus; (2) adductor brevis; (3) adductor magnus; (4) gracilis
Severe 30
Moderately Severe 20
Moderate 10
Slight 0
5316Group XVI. Function: Flexion of hip (1, 2, 3). Pelvic girdle group 1: (1) Psoas; (2) iliacus; (3) pectineus
Severe 40
Moderately Severe 30
Moderate 10
Slight 0
5317Group XVII. Function: Extension of hip (1); abduction of thigh; elevation of opposite side of pelvis (2, 3); tension of fascia lata and iliotibial (Maissiat's) band, acting with XIV (6) in postural support of body steadying pelvis upon head of femur and condyles of femur on tibia (1). Pelvic girdle group 2: (1) Gluteus maximus; (2) gluteus medius; (3) gluteus minimus
Severe *50
Moderately Severe 40
Moderate 20
Slight 0
5318Group XVIII. Function: Outward rotation of thigh and stabilization of hip joint. Pelvic girdle group 3: (1) Pyriformis; (2) gemellus (superior or inferior); (3) obturator (external or internal); (4) quadratus femoris
Severe 30
Moderately Severe 20
Moderate 10
Slight 0

The Torso and Neck

Rating
5319Group XIX. Function: Support and compression of abdominal wall and lower thorax; flexion and lateral motions of spine; synergists in strong downward movements of arm (1). Muscles of the abdominal wall: (1) Rectus abdominis; (2) external oblique; (3) internal oblique; (4) transversalis; (5) quadratus lumborum
Severe 50
Moderately Severe 30
Moderate 10
Slight 0
5320Group XX. Function: Postural support of body; extension and lateral movements of spine. Spinal muscles: Sacrospinalis (erector spinae and its prolongations in thoracic and cervical regions)

Cervical and thoracic region:

Severe 40
Moderately Severe 20
Moderate 10
Slight 0

Lumbar region:

Severe 60
Moderately Severe 40
Moderate 20
Slight 0
5321Group XXI. Function: Respiration. Muscles of respiration: Thoracic muscle group
Severe or Moderately Severe 20
Moderate 10
Slight 0
5322Group XXII. Function: Rotary and forward movements of the head; respiration; deglutition. Muscles of the front of the neck: (Lateral, supra-, and infrahyoid group.) (1) Trapezius I (clavicular insertion); (2) sternocleidomastoid; (3) the ?hyoid? muscles; (4) sternothyroid; (5) digastric
Severe 30
Moderately Severe 20
Moderate 10
Slight 0
5323Group XXIII. Function: Movements of the head; fixation of shoulder movements. Muscles of the side and back of the neck: Suboccipital; lateral vertebral and anterior vertebral muscles
Severe 30
Moderately Severe 20
Moderate 10
Slight 0

Miscellaneous

Rating
5324Diaphragm, rupture of, with herniation. Rate under diagnostic code 7346
5325Muscle injury, facial muscles. Evaluate functional impairment as seventh (facial) cranial nerve neuropathy (diagnostic code 8207), disfiguring scar (diagnostic code 7800), etc. Minimum, if interfering to any extent with mastication?10
5326Muscle hernia, extensive. Without other injury to the muscle?10
5327Muscle, neoplasm of, malignant (excluding soft tissue sarcoma)?100

Note: A rating of 100 percent shall continue beyond the cessation of any surgery, radiation treatment, antineoplastic chemotherapy or other therapeutic procedures. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of ? 3.105(e) of this chapter. If there has been no local recurrence or metastasis, rate on residual impairment of function.

5328Muscle, neoplasm of, benign, postoperative. Rate on impairment of function, i.e., limitation of motion, or scars, diagnostic code 7805, etc
5329Sarcoma, soft tissue (of muscle, fat, or fibrous connective tissue)?100

Note: A rating of 100 percent shall continue beyond the cessation of any surgery, radiation treatment, antineoplastic chemotherapy or other therapeutic procedures. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of ? 3.105(e) of this chapter. If there has been no local recurrence or metastasis, rate on residual impairment of function.

(Authority: 38 U.S.C. 1155)

[62 FR 30239, June 3, 1997]