**§4.73 Schedule of Ratings-Muscle Injuries.**

**Note**: When evaluating any claim involving muscle injuries resulting
in loss of use of any extremity or loss of use of both buttocks
(diagnostic code 5317, Muscle Group XVII), refer to §3.350 of this
chapter to determine whether the veteran may be entitled to special
monthly compensation.

**[The Shoulder Girdle and Arm]{.smallcaps}**

Rating

*Non-*

*Domi-* *domi-*

*nant* *nant*

**5301** Group I. *Function*: Upward rotation of scapula; elevation of
arm

above shoulder level. Extrinsic muscles of shoulder girdle:

\(1\) Trapezius; (2) levator scapulae; (3) serratus magnus.

Severe 40 30

Moderately Severe 30 20

Moderate 10 10

Slight 0 0

**5302** Group II. *Function*: Depression of arm from vertical overhead
to hanging

at side (1, 2); downward rotation of scapula (3, 4); 1 and 2 act with

Group III in forward and backward swing of arm. Extrinsic muscles

of shoulder girdle: (1) Pectoralis major II (costosternal); (2)
latissimus

dorsi and teres major (teres major, although technically an intrinsic

muscle, is included with latissimus dorsi); (3) pectoralis minor;

\(4\) rhomboid.

Severe 40 30

Moderately Severe 30 20

Moderate 20 20

Slight 0 0

**5303** Group III. *Function*: Elevation and abduction of arm to level
of shoulder;

act with 1 and 2 of Group II in forward and backward swing of arm.

Intrinsic muscles of shoulder girdle: (1) Pectoralis major I
(clavicular);

\(2\) deltoid.

Severe 40 30

Moderately Severe 30 20

Moderate 20 20

Slight 0 0

Rating

*Non-*

*Domi-* *domi-*

*nant* *nant*

**5304** Group IV. *Function*: Stabilization of shoulder against injury
in strong

movements, holding head of humerus in socket; abduction; outward

rotation and inward rotation of arm. Intrinsic muscles of shoulder

girdle: (1) Supraspinatus; (2) infraspinatus and teres minor;

\(3\) subscapularis; (4) coracobrachialis.

Severe 30 20

Moderately Severe 20 20

Moderate 10 10

Slight 0 0

**5305** Group V. *Function*: Elbow supination (1) (long head of biceps
is stabilizer

of shoulder joint); flexion of elbow (1, 2, 3). Flexor muscles of elbow:

\(1\) Biceps; (2) brachialis; (3) brachioradialis.

Severe 40 30

Moderately Severe 30 20

Moderate 10 10

Slight 0 0

**5306** Group VI. *Function*: Extension of elbow (long head of triceps
is stabilizer

of shoulder joint). Extensor muscles of the elbow: (1) Triceps;

\(2\) anconeus.

Severe 40 30

Moderately Severe 30 20

Moderate 10 10

Slight 0 0

**[The Forearm and Hand]{.smallcaps}**

Rating

*Non-*

*Domi-* *domi-*

*nant* *nant*

**5307** Group VII. *Function*: Flexion of wrist and fingers. Muscles
arising from

internal condyle of humerus: Flexors of the carpus and long flexors of

fingers and thumb; pronator.

Severe 40 30

Moderately Severe 30 20

Moderate 10 10

Slight 0 0

**5308** Group VIII. *Function*: Extension of wrist, fingers, and thumb;
abduction

of thumb. Muscles arising mainly from external condyle of humerus:

Extensors of carpus, fingers, and thumb; supinator.

Severe 30 20

Moderately Severe 20 20

Moderate 10 10

Slight 0 0

**5309** Group IX. *Function*: The forearm muscles act in strong
grasping movements

and are supplemented by the intrinsic muscles in delicate manipulative

movements. Intrinsic muscles of hand: Thenar eminence; short flexor,

opponens, abductor and adductor of thumb; hypothenar eminence;

short flexor, opponens and abductor of little finger; 4 lumbricales;

4 dorsal and 3 palmar interossei.

Note: The hand is so compact a structure that isolated muscle injuries
are rare, being nearly always complicated with injuries of bones,
joints, tendons, etc. Rate on limitation of motion, minimum 10 percent.

**[The Foot and Leg]{.smallcaps}**

Rating

**5310** Group X. *Function*: Movements of forefoot and toes; propulsion
thrust

in walking. Intrinsic muscles of the foot: Plantar: (1) Flexor digitorum

brevis; (2) abductor hallucis; (3) abductor digiti minimi; (4) quadratus

plantae; (5) lumbricales; (6) flexor hallucis brevis; (7) adductor
hallucis;

\(8\) flexor digiti minimi brevis; (9) dorsal and plantar interossei.
Other

important plantar structures: Plantar aponeurosis, long plantar and

calcaneonavicular ligament, tendons of posterior tibial, peroneus
longus,

and long flexors of great and little toes.

Severe 30

Moderately Severe 20

Moderate 10

Slight 0

*Dorsal*: (1) Extensor hallucis brevis; (2) extensor digitorum brevis.
Other

important dorsal structures: cruciate, crural, deltoid, and other
ligaments;

tendons of long extensors of toes and peronei muscles.

Severe 20

Moderately Severe 10

Moderate 10

Slight 0

Note: Minimum rating for through-and-through wounds of the foot---10

**5311** Group XI. *Function*: Propulsion, plantar flexion of foot (1);
stabilization of

arch (2, 3); flexion of toes (4, 5); flexion of knee (6). Posterior and
lateral

crural muscles, and muscles of the calf: (1) Triceps surae
(gastrocnemius

and soleus); (2) tibialis posterior; (3) peroneus longus; (4) peroneus

brevis; (5) flexor hallucis longus; (6) flexor digitorum longus;

\(7\) popliteus; (8) plantaris.

Severe 30

Moderately Severe 20

Moderate 10

Slight 0

**5312** Group XII. *Function*: Dorsiflexion (1); extension of toes (2);
stabilization of

arch (3). Anterior muscles of the leg: (1) Tibialis anterior; (2)
extensor

digitorum longus; (3) extensor hallucis longus; (4) peroneus tertius.

Severe 30

Moderately Severe 20

Moderate 10

Slight 0

**[The Pelvic Girdle and Thigh Rating]{.smallcaps}**

Rating

**5313** Group XIII. *Function*: Extension of hip and flexion of knee;
outward and

inward rotation of flexed knee; acting with rectus femoris and sartorius

(see XIV, 1, 2) synchronizing simultaneous flexion of hip and knee and

extension of hip and knee by belt-over-pulley action at knee joint.
Posterior

thigh group, Hamstring complex of 2-joint muscles: (1) Biceps femoris;

\(2\) semimembranosus; (3) semitendinosus.

Severe 40

Moderately Severe 30

Moderate 10

Slight 0

**5314** Group XIV. *Function*: Extension of knee (2, 3, 4, 5);
simultaneous flexion of

hip and flexion of knee (1); tension of fascia lata and iliotibial
(Maissiat's)

band, acting with XVII (1) in postural support of body (6); acting with

hamstrings in synchronizing hip and knee (1, 2). Anterior thigh group:

\(1\) Sartorius; (2) rectus femoris; (3) vastus externus; (4) vastus
intermedius;

\(5\) vastus internus; (6) tensor vaginae femoris.

Severe 40

Moderately Severe 30

Moderate 10

Slight 0

**5315** Group XV. *Function*: Adduction of hip (1, 2, 3, 4); flexion of
hip (1, 2);

flexion of knee (4). Mesial thigh group: (1) Adductor longus;

\(2\) adductor brevis; (3) adductor magnus; (4) gracilis.

Severe 30

Moderately Severe 20

Moderate 10

Slight 0

**5316** Group XVI. *Function*: Flexion of hip (1, 2, 3). Pelvic girdle
group 1:

\(1\) Psoas; (2) iliacus; (3) pectineus.

Severe 40

Moderately Severe 30

Moderate 10

Slight 0

Rating

**5317** Group XVII. *Function*: Extension of hip (1); abduction of
thigh; elevation

of opposite side of pelvis (2, 3); tension of fascia lata and iliotibial

(Maissiat's) band, acting with XIV (6) in postural support of body

steadying pelvis upon head of femur and condyles of femur on tibia (1).

Pelvic girdle group 2: (1) Gluteus maximus; (2) gluteus medius;

\(3\) gluteus minimus.

Severe \*50

Moderately Severe 40

Moderate 20

Slight 0

**5318** Group XVIII. *Function*: Outward rotation of thigh and
stabilization of hip

joint. Pelvic girdle group 3: (1) Pyriformis; (2) gemellus (superior or

inferior); (3) obturator (external or internal); (4) quadratus femoris.

Severe 30

Moderately Severe 20

Moderate 10

Slight 0

\*If bilateral, see §3.350(a)(3) of this chapter to determine whether
the veteran may be entitled to special monthly compensation.

**[The Torso and Neck]{.smallcaps}**

Rating

**5319** Group XIX. *Function*: Support and compression of abdominal
wall and

lower thorax; flexion and lateral motions of spine; synergists in strong

downward movements of arm (1). Muscles of the abdominal wall:

\(1\) Rectus abdominis; (2) external oblique; (3) internal oblique;

\(4\) transversalis; (5) quadratus lumborum.

Severe 50

Moderately Severe 30

Moderate 10

Slight 0

**5320** Group XX. *Function*: Postural support of body; extension and
lateral

movements of spine. Spinal muscles: Sacrospinalis (erector spinae and
its

prolongations in thoracic and cervical regions).

*Cervical and thoracic region:*

Severe 40

Moderately Severe 20

Moderate 10

Slight 0

*Lumbar region:*

Severe 60

Moderately Severe 40

Moderate 20

Slight 0

**5321** Group XXI. *Function*: Respiration. Muscles of respiration:
Thoracic

muscle group.

Severe or Moderately Severe 20

Moderate 10

Slight 0

**5322** Group XXII. *Function*: Rotary and forward movements of the
head;

respiration; deglutition. Muscles of the front of the neck: (Lateral,
supra-,

and infrahyoid group.) (1) Trapezius I (clavicular insertion);

\(2\) sternocleidomastoid; (3) the "hyoid" muscles; (4) sternothyroid;

\(5\) digastric.

Severe 30

Moderately Severe 20

Moderate 10

Slight 0

Rating

**5323** Group XXIII. *Function*: Movements of the head; fixation of
shoulder

movements. Muscles of the side and back of the neck: Suboccipital;

lateral vertebral and anterior vertebral muscles.

Severe 30

Moderately Severe 20

Moderate 10

Slight 0

**[Miscellaneous]{.smallcaps}**

Rating

**5324** Diaphragm, rupture of, with herniation. Rate under diagnostic
code 7346.

**5325** Muscle injury, facial muscles. Evaluate functional impairment
as seventh

(facial) cranial nerve neuropathy (diagnostic code 8207), disfiguring

scar (diagnostic code 7800), etc. Minimum, if interfering to any extent

with mastication---10

**5326** Muscle hernia, extensive. Without other injury to the
muscle---10.

**5327** Muscle, neoplasm of, malignant (excluding soft tissue
sarcoma)---100.

Note: A rating of 100 percent shall continue beyond the cessation of any
surgery, radiation treatment, antineoplastic chemotherapy or other
therapeutic procedures. Six months after discontinuance of such
treatment, the appropriate disability rating shall be determined by
mandatory VA examination. Any change in evaluation based upon that or
any subsequent examination shall be subject to the provisions of
§3.105(e) of this chapter. If there has been no local recurrence or
metastasis, rate on residual impairment of function.

**5328** Muscle, neoplasm of, benign, postoperative. Rate on impairment
of function,

i.e., limitation of motion, or scars, diagnostic code 7805, etc.

**5329** Sarcoma, soft tissue (of muscle, fat, or fibrous connective
tissue)---100.

Note: A rating of 100 percent shall continue beyond the cessation of any
surgery, radiation treatment, antineoplastic chemotherapy or other
therapeutic procedures. Six months after discontinuance of such
treatment, the appropriate disability rating shall be determined by
mandatory VA examination. Any change in evaluation based upon that or
any subsequent examination shall be subject to the provisions of
§3.105(e) of this chapter. If there has been no local recurrence or
metastasis, rate on residual impairment of function.

(Authority: 38 U.S.C. 1155)

\[29 FR 6718, May 22, 1964, as amended at 41 FR 11296, Mar. 18, 1976; 43
FR 45352, Oct. 2, 1978; 56 FR 51653, Oct. 15, 1991; 62 FR 30239, June 3,
1997\]

**Supplement *Highlights* reference**: 20(1)

*Next Section is 4.75*