Muscle Injuries

All muscle conditions are either rated on the Slight to Severe Scale (the links in the rating discussions will take you straight to the scale), or on the limited motion of the joint the muscle condition affects, whichever gives a higher rating. 

Muscle conditions can be rated on the Slight to Severe Scale. The severity of a muscle disability is decided by the presence of the “cardinal signs and symptoms.” These include loss of power, weakness, easily fatigued, pain with fatigue, lack of coordination, and decreased movement control. Definitions of the different severities are listed below, but each bullet point does not have to be met in order for the condition to qualify under that severity. For example, many muscle conditions are not caused by injuries, so the requirements for the type of wound or scar would not apply.

SLIGHT muscle disability:

MODERATE muscle disability:

MODERATELY SEVERE muscle disability:

SEVERE muscle disability:

Combined Ratings for Muscle Injuries (§4.55): The muscles of the body are divided into groups. Each group of muscles controls a single function. For example, all the muscles in Group X control the pointing and flexing of the toes. The following bullet points lay down rules on combining ratings for muscles with other ratings (for nerves, limited motion, etc.).

Painful Motion (§4.59): This is the most commonly used principle. Basically, regardless of how much the service member can move his knee (or any joint), if it hurts when he moves it, then he will get at least the lowest compensable rating for the knee–for example, 10% (money) instead of 0% (no money). Pain with motion must be clearly documented by the physician in order for this principle to apply. Just because the service member may say that his knee hurts at the beginning of the exam does not mean that the physician will find proof of pain with motion.

The Painful Motion rule applies to mainly joint-specific conditions, like arthritis, but also comes into play for any condition that is rated primarily on limited motion. For example, this rule would apply to a muscle condition if the muscle condition is rated on limited motion but not if it is rated on the Slight to Severe Scale.

When deciding whether to apply this rule, the Rating Authorities will look for obvious notes that a physician should make during range of motion testing. Notes like limping, wincing, pained facial expressions, and other similar signs are good evidence of pain with motion. Crepitation is also good evidence of a diseased joint, but may not be enough in and of itself to support painful motion. If pain is not clearly noted in an exam, it is assumed that there is none (the service member saying it hurt yesterday is not enough). Keep in mind that there are tests that are used by the examining physician to see if the service member is faking the pain. The physician may not say it straight out in the notes, but the Rating Authorities are always looking for evidence of those tests.