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 Sec. 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------------------------------------------------------------------------5301 Group 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 05302 Group 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 05303 Group 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 05304 Group 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 05305 Group 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 05306 Group 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------------------------------------------------------------------------5307 Group 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 05308 Group 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 05309 Group 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------------------------------------------------------------------------5310 Group 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...................................................... 0Dorsal: (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.
5311 Group 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...................................................... 05312 Group 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------------------------------------------------------------------------
Rating------------------------------------------------------------------------5313 Group 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...................................................... 05314 Group 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...................................................... 05315 Group 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...................................................... 05316 Group 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...................................................... 05317 Group 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...................................................... 05318 Group 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------------------------------------------------------------------------* If bilateral, see Sec. 3.350(a)(3) of this chapter to determine
whether the veteran may be entitled to special monthly compensation.
The Torso and Neck------------------------------------------------------------------------
Rating------------------------------------------------------------------------5319 Group 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...................................................... 05320 Group 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...................................................... 05321 Group XXI. Function: Respiration. Muscles of respiration:
Thoracic muscle group..........................................
Severe or Moderately Severe................................. 20
Moderate.................................................... 10
Slight...................................................... 05322 Group 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
5323 Group 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.................................................... 10Slight.......................................................... 0------------------------------------------------------------------------
Miscellaneous------------------------------------------------------------------------
Rating------------------------------------------------------------------------5324 Diaphragm, rupture of, with herniation. Rate under
diagnostic code 7346...........................................5325 Muscle 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................................................5326 Muscle hernia, extensive. Without other injury to the
muscle--10.....................................................5327 Muscle, 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 Sec.
3.105(e) of this chapter. If there has been no local recurrence
or metastasis, rate on residual impairment of function.
5328 Muscle, neoplasm of, benign, postoperative. Rate on
impairment of function, i.e., limitation of motion, or scars,
diagnostic code 7805, etc......................................5329 Sarcoma, 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 Sec.
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]
The Organs of Special Sense