Evidence Checklist: Shoulder Limitation of Motion

Orthopedic evaluation with shoulder range of motion measurementsCritical

Examination documenting forward flexion, abduction, internal rotation, and external rotation in degrees. The VA rates primarily on forward flexion and abduction under DC 5200-5203. Pain on motion and after repetitive use must be documented.

Nexus opinion linking shoulder limitation to service ("at least as likely as not")Critical

A medical opinion connecting your shoulder motion limitation to in-service injury, repetitive duties, or events during military service.

Imaging studies (X-ray or MRI of shoulder)

Radiographs showing arthritis, calcifications, or structural changes; MRI documenting rotator cuff integrity, labrum, and joint effusion.

Documentation of dominant vs. non-dominant armCritical

Medical records noting which arm is dominant. The major (dominant) extremity receives a higher rating than the minor (non-dominant) extremity under the VA schedule.

Treatment records (physical therapy, injections, surgery)

Records documenting the course of treatment including physical therapy, corticosteroid injections, and any surgical procedures.

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.

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.

Completed DBQ Shoulder and Arm ConditionsCritical

Standardized form capturing shoulder range of motion in all planes, pain on motion, and functional limitations.

Service treatment records (STRs)Critical

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