Muscle Injuries Rating Guide
Muscle injuries, often from shrapnel, gunshot, blast, or surgery, are rated differently from joints. Instead of measuring degrees of motion, 38 CFR § 4.73 sorts the body's muscles into 23 muscle groups and scores each injury from slight to severe, based on the damage the wound left behind. This guide explains how the muscle group and the severity are chosen, then points you to the related joint, scar, and nerve guides.
The Rules That Decide Every Muscle-Injury Claim
A muscle injury is not rated on range of motion the way a joint is. It is rated on which muscle group was hit and how badly it was damaged. A handful of shared rules decide both, and they apply the same way to a thigh wound, a shoulder wound, and a forearm wound.
1. Every injury is assigned to one of 23 muscle groups
The VA divides the body's muscles into 23 muscle groups, numbered with Roman numerals I through XXIII, organized by body region and by the movement the muscles perform. The group your injury falls into determines which diagnostic code and which rating scale applies. Muscle codes run from DC 5301 to DC 5329.
2. The injury is graded slight, moderate, moderately severe, or severe (38 CFR 4.56)
Within a group, the wound is graded on a four-step scale: slight, moderate, moderately severe, or severe. The grade comes from the "cardinal signs and symptoms of muscle disability": loss of power, weakness, a lowered threshold of fatigue, fatigue-pain, impairment of coordination, and uncertainty of movement. The more of these signs the injury produces, and the more strongly, the higher the grade.
3. The wound history is part of the grade
The severity grade is not read from strength alone. The history of the wound counts too. A through-and-through or deep penetrating wound, debridement (surgical cleaning of the wound), a prolonged infection, retained metal fragments, loss of muscle tissue (substance), and deep or adherent scarring all point toward the higher grades. A small, clean, well-healed wound points toward the lower grades.
4. Muscle groups in the same limb do not simply add (38 CFR 4.55)
When more than one muscle group in the same limb is injured, the ratings do not just add together. 38 CFR § 4.55 sets specific rules for combining them, and it also ties muscle injuries to the joints they move: an injury to a muscle group that moves a joint is considered alongside any limitation of motion of that same joint, so the two are weighed together rather than counted as if they were unrelated.
Find the Guide for Your Condition
The muscle-group system has no single per-condition guide, because each of the 23 groups sits in a different part of the body. The closest related pages are the joint side the muscles move and the scar left by the wound:
| Area | Guide | DC codes |
|---|---|---|
| Joints the muscles move | Musculoskeletal Guide | 5301-5329 related |
| Scars from the wound | Scars & Burns Guide | 7800-7805 |
Muscle codes run from 5301 to 5329. For any specific muscle group, open its condition lookup page for the exact rating levels and Board data.
Common Secondary Conditions
A muscle wound rarely affects only the muscle. Because the muscle moves a joint and sits next to nerves, skin, and the opposite limb, one injury often opens the door to several related claims:
- Limitation of motion of the joint the muscle moves. A damaged muscle can no longer move its joint through the full range, so the joint's lost motion is weighed alongside the muscle rating.
- The opposite limb. Overcompensating for a weak or painful muscle overloads the other side over time, the way a weak leg makes you lean on the good one.
- Scars from the original wound. The scar the wound left is rated separately under the scar codes, on top of the muscle rating. See the scars and burns guide.
- Nerve damage. If the same wound also struck a nerve, that nerve injury is rated separately under the nerve codes. See the neurological guide.
For how a service-connected condition supports a related claim, see secondary conditions.
Evidence That Wins
- The service treatment and wound records, describing the type of wound, any surgery, debridement, and whether metal fragments were left in. This history is what sets the severity grade under 4.56.
- Strength testing that documents the weakness and the lowered threshold of fatigue, the cardinal signs the grade depends on.
- Imaging (X-ray, CT, or MRI) showing lost muscle tissue or retained metal fragments still in the muscle.
- Documentation of the resulting scar, its size, whether it is deep, tender, or adherent, so it can be rated separately.
- The matching DBQ for the muscle injury, which prompts the examiner to capture the wound history and the cardinal signs. See the DBQ guide.
Common Mistakes
- Assuming a muscle injury and a joint limitation cannot both be rated. They measure different things and often both apply. A muscle-group rating and a limitation-of-motion rating are weighed together under 4.55, not simply canceled.
- Not documenting the cardinal signs. Loss of power, weakness, fatigue, fatigue-pain, and impaired coordination are what set the severity grade. If the exam does not record them, the grade drops.
- Overlooking retained fragments and scars. Metal fragments left in the muscle and the scar the wound left are separate parts of the rating, not just background detail.
- Not describing the original wound in enough detail. A through-and-through wound, debridement, or a long infection all justify a higher grade, but only if the record actually describes them.
Frequently Asked Questions
How does the VA rate muscle injuries?
What are the muscle groups?
What makes an injury "severe" instead of "moderate"?
Can a muscle injury and a joint condition both be rated?
Do retained shrapnel fragments raise the rating?
Related Tools and Guides
Sources: 38 CFR 4.73, muscle-injury ratings · 4.56, evaluation of muscle disability. Educational only, not legal advice, and not a prediction of any individual claim. Rating criteria change; confirm current details in 38 CFR Part 4. For help with your claim, find a VA-accredited representative.