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Evidence checklist

Adhesive Capsulitis (Frozen Shoulder)

DC 520138 CFR § 4.71aMusculoskeletal

Evidence strength

Mark what you already have below and your evidence strength appears here.

Target
Saved locally
01

Specialist opinion

Highest value0 of 2 collected
Orthopedic evaluation with shoulder range of motion measurementsCritical

An examination documenting shoulder flexion, abduction, internal rotation, and external rotation in degrees, including pain on motion and functional limitations.

Private provider · independent opinion
Nexus opinion linking adhesive capsulitis to serviceCritical

A medical opinion stating it is "at least as likely as not" that your frozen shoulder is connected to in-service injury, surgery, or prolonged immobilization during military service.

Private provider · independent opinion
02

Treatment records

0 of 3 collected
Documentation of dominant vs. non-dominant armCritical

Medical records noting which arm is dominant. The dominant arm (major extremity) receives a higher rating under the shoulder diagnostic codes.

VA or private records · written request
Imaging showing capsular thickening or joint changes

MRI or arthrogram showing capsular thickening, reduced joint volume, or other findings consistent with adhesive capsulitis.

VA or private records · written request
Physical therapy records documenting ROM progression

Records from physical therapy showing range of motion measurements over time, treatment response, and functional progress or plateau.

VA or private records · written request
03

Lay statements

0 of 2 collected
Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
04

Benefits questionnaire

0 of 1 collected
Completed DBQ Shoulder and Arm ConditionsCritical

Standardized form capturing shoulder range of motion, pain, and functional limitations.

Provider-completed · VA DBQ formHow to get this →
05

Service records

0 of 1 collected
Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.

NPRC / milConnect · SF-180

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