38 CFR 4.73: VA Muscle Groups, Severity Levels, and Ratings

Under 38 CFR 4.73, the VA rates a muscle injury by matching it to one of 23 muscle groups (diagnostic codes 5301 through 5323) and assigning a percentage based on how badly the muscle functions after the injury. The schedule covers five body regions and four severity grades, and the resulting percentage translates directly into tax-free monthly compensation, ranging from $180.42 at 10 percent to $3,938.58 at 100 percent for a veteran with no dependents in 2026.¹

The 23 Muscle Groups and Diagnostic Codes

The regulation splits the body’s skeletal muscles into 23 groups across five anatomical regions, each with its own code.² Your claim’s medical evidence must identify which specific group is affected. “Shoulder pain” or “leg weakness” without a group is often what stalls a rating.

Shoulder girdle and arm, Groups I–VI, codes 5301–5306. Rotating the shoulder blade, lifting the arm, bending the elbow, rotating the forearm.
Forearm and hand, Groups VII–IX, codes 5307–5309. Wrist flexion, finger movement, grip.
Foot and leg, Groups X–XII, codes 5310–5312. Toe movement, push-off, knee and ankle flexion.
Pelvic girdle and thigh, Groups XIII–XVIII, codes 5313–5318. Hip extension, knee stabilization, thigh movement. Group XVII (buttock) tops out at 50 percent for a severe injury.
Torso and neck, Groups XIX–XXIII, codes 5319–5323. Abdominal wall, spinal support, respiration, swallowing. Group XX in the lumbar region reaches 60 percent at the severe level, the highest single-group rating in the schedule.³

Dominant Versus Non-Dominant Hand

Upper-extremity groups (codes 5301–5309) pay more when the injury is on your dominant side. A severe injury to Group I rates 40 percent on the dominant arm and 30 percent on the non-dominant. This split applies at the moderately severe and severe grades. At the slight and moderate grades, most groups rate the same either way. Lower-extremity and torso groups have no dominant/non-dominant distinction.³

How Severity Is Graded

38 CFR 4.73 is essentially a rating table. The criteria that decide whether an injury counts as slight, moderate, moderately severe, or severe live in a companion regulation, 38 CFR 4.56.⁴ For each grade the VA weighs three things: the type of wound, your documented history and complaints, and the objective findings on exam.

Slight

A simple wound that healed without infection or surgical cleaning. Service records show a superficial injury, short treatment, and return to duty. On exam: a minimal scar, no lost tissue, no muscle wasting, no retained fragments, no ongoing symptoms. Slight ratings are usually noncompensable — service-connected at zero percent, no monthly payment.⁴

Moderate

A deeper, penetrating wound with a short track through the muscle, without the explosive damage from a high-velocity projectile. Records show in-service treatment and a consistent pattern of at least one cardinal symptom, especially fatigue after average use. On exam: small or linear scars, some loss of the deep fascia or muscle substance, and measurable weakness or fatigue compared to the uninjured side. Moderate ratings usually fall between 10 and 20 percent depending on the group.⁴

Moderately Severe

A high-velocity or large projectile wound with prolonged infection, tissue breakdown, or scarring between muscle layers. The medical history documents extended hospitalization and consistent cardinal symptoms, potentially with evidence that you couldn’t keep up with work demands. Objective findings include scars along the projectile’s path through one or more groups, palpable loss of tissue or normal firmness compared to the sound side, and strength and endurance testing confirming impairment. Moderately severe ratings run from 20 to 40 percent depending on the group and dominance.⁴

Severe

The highest grade. High-velocity wounds, shattered bones, open fractures with extensive surgical cleaning, prolonged infection, and scarring that binds muscle layers together. Documented symptoms are worse than the moderately severe picture, and the objective findings are stark: ragged, depressed scars adhering to underlying tissue, soft or flabby muscles in the wound area, muscles that swell and harden abnormally when you try to contract them. Additional markers include visible wasting, X-ray evidence of scattered fragments, scar tissue stuck to bone, reduced response to electrical muscle testing, and wasting of muscles outside the wound path. Severe ratings reach 40 percent for most upper-extremity groups, 50 percent for Groups XVII and XIX, and 60 percent for Group XX.⁴³

The Six Cardinal Signs of Muscle Disability

38 CFR 4.56(c) defines six symptoms that signal a muscle isn’t working properly. Examiners use them at every grade above slight, and the count and consistency matter.⁴

Loss of power. The muscle can’t generate the force it should.
Weakness. Reduced ability to resist an outside force.
Lowered threshold of fatigue. The muscle tires out faster than normal.
Fatigue-pain. Pain that worsens with repeated use.
Impairment of coordination. Jerky, explosive, or poorly controlled movement.
Uncertainty of movement. The muscle gives way or collapses unpredictably under load.

These are recorded as objective observations, not just as your complaints. A moderate rating needs a consistent history of at least one. Moderately severe and severe expect a pattern of several, documented in both your medical records and the exam. Thin records on these specifics is one of the most common reasons a rating comes back lower than the actual impairment warrants.

What the C&P Exam Measures

The Compensation and Pension exam for muscle injuries follows a standardized Disability Benefits Questionnaire that walks the examiner through every element the rating schedule requires.⁵ The examiner identifies the affected group, documents the original injury, evaluates scarring and any defects in the fascia layer, and checks for loss of muscle substance, visible wasting, and altered contraction patterns.

Muscle strength is scored on a 0-to-5 scale, with 5/5 normal and 0/5 no detectable movement, tested on both the injured side and the uninjured side. When wasting is present, the examiner measures the circumference of both limbs at the point of maximum bulk, in centimeters.⁵ The examiner records which cardinal symptoms are present and whether each occurs occasionally, consistently, or severely, then assesses functional impact: assistive devices, whether a prosthetic would serve you as well as the impaired limb, and work impact.

Each finding maps directly to the severity criteria in 4.56, so a thorough exam builds or breaks the case. If the examiner skips a DBQ section, you can request it be completed before the report is finalized.

Combining Multiple Muscle Injuries

Many veterans have injuries across more than one group. The VA does not simply add the percentages. 38 CFR 4.55 sets out specific combination rules based on region and joint.²

Same region, same joint. When multiple groups in one region act on a single joint that still moves, the combined rating must stay below the rating for complete immobility of that joint. The one exception is Groups I and II acting on the shoulder.
Same region, different joints. Take the rating for the most severely injured group and move it up one severity level. That becomes the combined rating for the region.
Different regions. Rate separately, then combine using the standard combined ratings table in 38 CFR 4.25.

Muscles acting on a fully ankylosed (frozen) joint generally get no separate rating, because the joint’s immobility already accounts for the functional loss. Two narrow exceptions exist for disabled Group XIII at an ankylosed knee and severely disabled Groups I and II at an ankylosed shoulder.²

The Bilateral Factor

When muscle injuries affect both sides of the body, 38 CFR 4.26 adds a bilateral factor. The VA combines the right and left side ratings using the standard table, then adds 10 percent of that combined value (not 10 percentage points, 10 percent of the number itself). The adjusted figure is then treated as a single disability for further combinations. The factor only applies when each side is at least compensable; a zero-percent side doesn’t trigger it.⁶

The Anti-Pyramiding Rule

Muscle injuries frequently overlap with nerve damage and joint problems, but 38 CFR 4.14 prohibits rating the same functional impairment under multiple codes.⁷ A muscle injury rating can’t be stacked on a peripheral nerve paralysis rating for the same body part unless the two affect different functions. If a shrapnel wound damaged your bicep and the nerve running through it, but both produce the same result (weakness bending the elbow), you get one rating. If the nerve damage also causes numbness in the hand (a function the muscle rating doesn’t cover), a separate nerve rating may fit.²

The Amputation Cap

The amputation rule sits in 38 CFR 4.68 rather than 4.73, but it caps what your muscle ratings can total. The combined rating for all conditions affecting one extremity can’t exceed what the VA would assign if that limb had been amputated at the nearest surgical level.⁸ Below-the-knee amputation (code 5165) rates at 40 percent. If your combined muscle ratings for the foot, calf, and lower leg exceed 40 percent, the final rating is reduced to 40. That figure can still combine with ratings for conditions above the knee, but the total cannot exceed the amputation rating at the next higher level. No exceptions for muscle injuries.

Functional Loss Beyond the Table

The percentages in 4.73 track the severity grades, but 38 CFR 4.40 also requires the VA to account for functional loss. Musculoskeletal disability is fundamentally about the inability to perform normal movements with normal strength, speed, coordination, and endurance. If pain, adhesions, or nerve damage cuts your function beyond what the severity grade captures, the VA is supposed to account for it. A muscle that becomes painful with use must be treated as seriously disabled, and weakness carries the same weight as limited range of motion.⁹

This is where many veterans leave money on the table. Make sure the C&P examiner documents how symptoms change with repetitive movement and sustained activity, not just what happens on a single test.

Challenging a Muscle Injury Rating

If the rating doesn’t reflect the severity of the injury, three options exist under the VA’s decision review system: a supplemental claim with new and relevant evidence, a higher-level review by a more senior adjudicator on the same evidence, or a direct appeal to the Board of Veterans’ Appeals for a decision by a Veterans Law Judge.¹⁰

For muscle claims specifically, the strategy that most often works is filling gaps left by the C&P exam. If the examiner didn’t measure atrophy, didn’t compare strength side to side, or didn’t document all six cardinal symptoms, a private medical exam that covers those points can move the rating. The Board has repeatedly noted there’s no mechanical formula for assigning severity grades — the evidence is weighed as a whole, and a well-documented case can overcome a thin initial exam.

2026 Compensation Rates

Your rating converts to a specific monthly payment. These rates apply to veterans with no dependents, effective December 1, 2025:¹

10%: $180.42
20%: $356.66
30%: $552.47
40%: $795.84
50%: $1,132.90
60%: $1,435.02
70%: $1,808.45
80%: $2,102.15
90%: $2,362.30
100%: $3,938.58

Veterans rated at 30 percent or higher receive additional compensation for dependents. Those rated at 10 or 20 percent do not. Because most single muscle group injuries rate between 10 and 40 percent, service-connected conditions combined under the VA’s combined ratings table often push the overall disability figure well above any single rating alone.

1
U.S. Department of Veterans Affairs. Veterans Disability Compensation Rates
2
eCFR. 38 CFR 4.55 – Principles of Combined Ratings for Muscle Injuries
3
eCFR. 38 CFR 4.73 – Schedule of Ratings—Muscle Injuries
4
eCFR. 38 CFR 4.56 – Evaluation of Muscle Disabilities
5
U.S. Department of Veterans Affairs. Muscle Injuries Disability Benefits Questionnaire
6
eCFR. 38 CFR 4.26 – Bilateral Factor
7
eCFR. 38 CFR 4.14 – Avoidance of Pyramiding
8
eCFR. 38 CFR 4.68 – Amputation Rule
9
eCFR. 38 CFR Part 4 Subpart B – Disability Ratings
10
U.S. Department of Veterans Affairs. Supplemental Claims