5 VA Secondary Conditions to Shoulder Pain and How to Prove Service Connection

For many veterans, lingering shoulder pain isn’t just an isolated injury; it can trigger a chain of related health issues that affect daily life and overall well-being. 

VA secondary conditions to shoulder pain, such as back pain, neck strain, limited use of hands or fingers, nerve problems, and mental health challenges, may qualify you for additional disability benefits. 

This post explains five common secondary conditions, how to establish service connection, file a claim, and strengthen your case with a credible nexus letter.

Key Takeaways

• VA secondary conditions to shoulder pain may qualify you for additional compensation and benefits. 

• The VA rates secondary conditions to shoulder pain based on severity, functional limitations, and documented medical evidence, often under multiple diagnostic codes. 

• Establishing a link between your shoulder pain and secondary conditions, supported by medical evidence, is critical for claim approval.

• A Nexus Letter linking your shoulder pain to related secondary conditions is one of the strongest forms of evidence for claim approval.

Shoulder Pain in Veterans

Shoulder pain is a prevalent issue among veterans, often stemming from the physical demands of military service, including repetitive overhead motions, heavy lifting, and exposure to traumatic events. 

This can lead to long-term discomfort and functional limitations, significantly impacting daily activities and quality of life. 

For example, a 2023 study revealed that nearly 1 in 20 active-duty military service members sought nonoperative care for shoulder and upper-arm dysfunction during fiscal year 2014. 

However, shoulder injuries don’t just affect your arm; they can lead to other health issues over time.  

When a service-connected shoulder condition causes or worsens another medical problem, that condition may qualify as a secondary service-connected disability. 

How the VA Rates Shoulder Pain

The VA typically rates shoulder pain under one of two schedules: the musculoskeletal system or muscle injuries. 

VA shoulder ratings typically range from 0% to 40% for most shoulder conditions, although severe limitations of motion can be rated up to 100%. 

Most ratings are based on range of motion, how far you can lift, rotate, or extend your arm before pain occurs, and may be higher if your dominant arm is affected. 

Note: Typically, only one rating is given per shoulder. 

5 VA Secondary Conditions to Shoulder Pain

Back Pain

Shoulder pain can alter your posture and movement patterns, placing extra stress on the back, and eventually leading to secondary back pain. 

The VA evaluates back pain under the General Rating Formula for Diseases and Injuries of the Spine, assigning ratings from 10% to 100% based on range of motion, painful motion, ankylosis, and functional limitations. 

Even if your spine still moves normally, painful motion alone can qualify you for a minimum compensable rating, usually starting at 10%. 

Neck Pain

Veterans with shoulder injuries from service often develop neck pain over time as altered posture and movement put extra strain on the cervical spine. 

A 2024 study found that neck pain is highly prevalent among military personnel, with a one-year prevalence rate as high as 83% and a lifetime prevalence of up to 78%. 

The VA recognizes neck pain as potentially secondary to shoulder conditions and evaluates it under the General Rating Formula for Diseases and Injuries of the Spine.  

VA ratings for neck pain secondary to shoulder pain are based on pain severity, limited range of motion, painful movement, and the presence of ankylosis, with ratings ranging from 0% to 100%. 

Mental Health Conditions

Chronic shoulder pain can affect more than just your mobility; it can also impact your mental well-being, contributing to stress, anxiety, or depression. 

Ongoing discomfort and limitations in daily life often lead to frustration, social withdrawal, and emotional fatigue. 

If your service-connected shoulder pain aggravates or causes a mental health condition, you could qualify for VA disability benefits. 

The VA rates mental health conditions secondary to shoulder pain under the General Rating Formula for Mental Disorders, with potential ratings from 0% to 100%, depending on the severity of symptoms and the degree of occupational and social impairment. 

Limited Use of Hands or Fingers

Shoulder pain can interfere with the muscles and nerves that control your arms, making tasks that require fine motor skills or grip strength more difficult.  

Over time, this can impact your ability to perform daily activities and reduce overall hand function. 

The VA assigns ratings for limited use of the hands or fingers based on loss of motion, strength, or functional ability, taking into account whether the affected hand is your dominant or non-dominant hand. 

The VA rates limited use of hands or fingers under the Schedule of Ratings for the Musculoskeletal System. 

Nerve Conditions

Chronic shoulder pain can sometimes put pressure on nearby nerves or cause irritation, particularly when injury or inflammation affects the area. 

This can lead to symptoms such as numbness, tingling, weakness, or pain radiating down the arm to the hand. 

The VA evaluates nerve conditions under the Schedule of Ratings for Neurological Conditions and Convulsive Disorders, depending on which nerve is affected, whether it involves your dominant or non-dominant arm, and the severity of the impairment, from mild incomplete paralysis to complete paralysis. 

How to Service Connect Secondary Conditions to Shoulder Pain

To establish secondary service connection, you’ll need two key elements:  

• A current diagnosis: Medical documentation of your secondary condition from a qualified provider.  
• A medical nexus: Evidence showing that your secondary condition was caused or aggravated by your service-connected shoulder pain.  

—> A detailed nexus letter from an independent medical provider is often the most effective way to demonstrate this link. 

Nexus Letter for Secondary Conditions to Shoulder Pain

A nexus letter for secondary conditions is highly recommended. While the VA doesn’t require one, it may be the difference between an approval and a denial.  

To prove secondary service connection, you must prove your secondary disability is “proximately due to’ or “aggravated by” another service-connected disability. 

A nexus letter provides the VA with a detailed medical opinion from a qualified provider that connects your secondary condition to your service-connected knee pain. Learn More: How to Get a Nexus Letter

How to File a VA Claim for Secondary Conditions

You can file a VA claim for secondary conditions to shoulder pain in one of the following ways: 

• Online 

• By mail    

• Via fax  

• In person at a VA regional office 

Note: If you don’t file online, you’ll need to download and complete VA Form 21-526EZ. 

Conclusion

Chronic shoulder pain doesn’t always stay isolated—it can trigger other physical and mental health problems that affect your mobility, sleep, and overall well-being.

If your service-connected shoulder condition has caused or aggravated another issue, you may be eligible for additional VA disability compensation through secondary service connection.

The key to winning these claims lies in credible medical evidence, especially a credible nexus letter from a qualified provider that clearly explains how your shoulder injury led to your secondary condition.

Medical Evidence Wins VA Claims

Did you know that a lack of medical evidence is the #1 reason VA disability claims are denied?  

Medical evidence is a crucial piece of the puzzle that VA raters consider when reviewing a disability claim. Telemedica provides solutions for veterans looking to bolster their claims through high-quality medical evidence that wins claims!  

Schedule your 20-minute consultation call and learn how to get the supporting medical evidence you need to strengthen your claim.

FAQs | Frequently Asked Questions

What are common VA secondary conditions to shoulder pain?

Several health issues can develop secondary to shoulder pain, including neck pain, back pain, nerve conditions, limited use of the hands or fingers, and mental health conditions. 

What is the average VA rating for shoulder pain?

VA disability ratings for shoulder pain typically range from 10% to 40%, depending on factors like range of motion, painful motion, muscle, or joint damage, and whether the affected shoulder is on the dominant or non-dominant arm. However, higher VA ratings may be granted for more serious conditions. 

Is neck pain secondary to shoulder pain?

Yes. Shoulder injuries can change posture and movement patterns, placing extra stress on the cervical spine, and potentially leading to chronic neck pain. 

Can shoulder pain cause depression or anxiety?

Yes, chronic pain and limited mobility from shoulder injuries can contribute to stress, depression, or anxiety, which the VA can recognize as secondary mental health conditions. 

Do I need a nexus letter for VA secondary conditions to shoulder pain?

While not required, a nexus letter provides a medical opinion connecting your secondary condition to your service-connected shoulder pain and can be crucial in securing claim approval. 

Do secondary conditions increase VA ratings?

Yes, if a secondary condition is proven to be caused or aggravated by a service-connected shoulder injury, it may increase your overall combined VA rating. >>View the VA Disability Calculator