Chronic Trapezius/Paraspinal Muscle Strain

DC 5321Musculoskeletal38 CFR 4.73, DC 5321

Chronic strain and injury to the muscles of the upper back and shoulder region, specifically the trapezius and paraspinal muscles classified as Muscle Group XXI. These muscles are involved in respiration and movement of the thoracic spine and shoulder girdle. The VA rates this condition based on the severity of muscle damage and functional impairment.

How the VA rates this condition

The VA rates this condition based on how much it affects your ability to work and carry out daily activities. The examiner will focus on the functional limitations your condition causes, not just the diagnosis itself.

Diagnostic code

DC 5321

Rating range

0% – 30%

Rating levels

Rating criteria are defined in 38 CFR 4.73, DC 5321. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

You have moderately severe to severe muscle disability with significant weakness, frequent muscle spasm, and inability to perform physical work. Your symptoms affect your breathing with exertion due to thoracic muscle involvement.

What the VA looks for

Significant muscle weakness (3/5 or less) documented
Visible muscle atrophy or wasting on examination
Frequent or constant muscle spasm
Impact on breathing with exertion from thoracic muscle weakness
Inability to perform physical occupational tasks documented

Common Pitfalls

⚠Not specifying the correct muscle group — Muscle Group XXI covers the thoracic muscles of respiration (including trapezius and paraspinal muscles). If the wrong muscle group is rated, the rating criteria will not match your symptoms.
⚠Not documenting how the injury occurred during service — whether from heavy lifting, carrying equipment, physical training, or trauma, the specific mechanism of injury helps establish service connection.
⚠Failing to report the impact on breathing during exertion — Muscle Group XXI includes muscles of respiration, so if your upper back strain affects your ability to take deep breaths during physical activity, this should be documented.
⚠Not requesting separate ratings for associated conditions — chronic muscle strain often comes with cervical spine problems, shoulder impingement, or tension headaches that should be claimed separately.
⚠Not documenting the cardinal signs of muscle disability — the VA looks for specific findings: loss of power, weakness, lower threshold of fatigue, pain, impairment of coordination, and uncertainty of movement. Make sure the examiner tests and documents each of these.

Related DBQ Forms

DBQ Muscle Injuries

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

Chronic Trapezius/Paraspinal Muscle Strain

How the VA rates this condition

Diagnostic code

DC 5321

Rating range

0% – 30%

Rating levels

Rating Levels

What the VA looks for

Significant muscle weakness (3/5 or less) documented
Visible muscle atrophy or wasting on examination
Frequent or constant muscle spasm
Impact on breathing with exertion from thoracic muscle weakness
Inability to perform physical occupational tasks documented

Common Pitfalls

⚠Not specifying the correct muscle group — Muscle Group XXI covers the thoracic muscles of respiration (including trapezius and paraspinal muscles). If the wrong muscle group is rated, the rating criteria will not match your symptoms.

⚠Not documenting how the injury occurred during service — whether from heavy lifting, carrying equipment, physical training, or trauma, the specific mechanism of injury helps establish service connection.

⚠Failing to report the impact on breathing during exertion — Muscle Group XXI includes muscles of respiration, so if your upper back strain affects your ability to take deep breaths during physical activity, this should be documented.

⚠Not requesting separate ratings for associated conditions — chronic muscle strain often comes with cervical spine problems, shoulder impingement, or tension headaches that should be claimed separately.

⚠Not documenting the cardinal signs of muscle disability — the VA looks for specific findings: loss of power, weakness, lower threshold of fatigue, pain, impairment of coordination, and uncertainty of movement. Make sure the examiner tests and documents each of these.