Common Service-Connected Musculoskeletal Conditions

The musculoskeletal system—which includes bones, muscles, joints, tendons, and ligaments—is one of the most common categories for medical evaluations related to VA disability. Years of rigorous training, carrying heavy gear, and physically demanding jobs can take a toll. Common conditions documented include:

• Degenerative Arthritis (Osteoarthritis)
• Back and Neck Conditions (e.g., Lumbosacral Strain, Cervical Strain)
• Knee, Hip, and Shoulder Conditions (e.g., Meniscal Tears, Rotator Cuff Tears)
• Limited Range of Motion in any joint
• Radiculopathy (nerve pain radiating from the spine)

For a complete overview, please visit our medical evidence guide for musculoskeletal conditions.

How the VA Uses Range of Motion (ROM) to Determine Your Rating

For most joint-related disabilities, the primary factor in determining a disability rating is the functional loss measured by Range of Motion (ROM). During a C&P exam, the examiner will use a tool called a goniometer to measure how far you can bend, flex, and extend the affected joint. They will compare your measurements to the standard range of motion for that joint. The more limited your ROM, the higher the documented severity of the condition will be based on clinical standards.

The Importance of Painful Motion, Flare-ups, and Repetitive Use

Medical evaluations must consider factors beyond just simple ROM measurements. It’s crucial to explain these symptoms during your clinical assessment:

• Painful Motion: If you experience pain at any point during the ROM test, examiners document this as functional loss. Even if you can move your joint through the full range, if it causes pain, it is documented as functional loss consistent with clinical disability standards.
• Flare-ups: Describe how your symptoms worsen during a flare-up. How often do they happen? How long do they last? What is your ROM like during a flare-up? This provides a more accurate clinical picture of your condition.
• Repetitive Use: Can you perform the same motion repeatedly without pain, fatigue, or lack of coordination? If your ROM worsens after several repetitions, that is also documented as functional loss.

What to Expect at a Musculoskeletal C&P Exam

The examiner will review your medical file and ask about your condition. They will then perform a physical exam, including the ROM testing. Be prepared to describe your pain (dull, sharp, radiating), what makes it better or worse, and how it impacts your functional daily life and ability to work. Be honest and do not push past the point of pain during the exam.

FAQ: Musculoskeletal Medical Evidence

Can I get separate ratings for my left and right knee?

Yes. Each limb and joint is evaluated separately. If you have conditions in both knees, you will receive a clinical assessment for each, and they will be documented for evaluation using medical standards.

How does the bilateral factor apply here?

Musculoskeletal evaluations are where the bilateral factor is most common. If you have clinical documentation for a condition on both your right and left leg (e.g., both knees) or both arms, the VA applies the bilateral factor, which is a calculation used to determine the final combined rating.

What if my condition is secondary to another disability?

This is common in medical documentation. For example, a veteran may have a service-connected left knee injury. Over years of favoring that knee, they may develop arthritis in their right knee or their hip. In this case, the arthritis can be clinically linked as a secondary condition, and it is documented based on the same medical criteria as a primary condition.