(a) A muscle injury rating will not be combined with a peripheral nerve paralysis rating of the same body part, unless the injuries affect entirely different functions.
(b) For rating purposes, the skeletal muscles of the body are divided into 23 muscle groups in 5 anatomical regions: 6 muscle groups for the shoulder girdle and arm (diagnostic codes 5301 through 5306); 3 muscle groups for the forearm and hand (diagnostic codes 5307 through 5309); 3 muscle groups for the foot and leg (diagnostic codes 5310 through 5312); 6 muscle groups for the pelvic girdle and thigh (diagnostic codes 5313 through 5318); and 5 muscle groups for the torso and neck (diagnostic codes 5319 through 5323).
(c) There will be no rating assigned for muscle groups which act upon an ankylosed joint, with the following exceptions:
(1) In the case of an ankylosed knee, if muscle group XIII is disabled, it will be rated, but at the next lower level than that which would otherwise be assigned.
(2) In the case of an ankylosed shoulder, if muscle groups I and II are severely disabled, the evaluation of the shoulder joint under diagnostic code 5200 will be elevated to the level for unfavorable ankylosis, if not already assigned, but the muscle groups themselves will not be rated.
(d) The combined evaluation of muscle groups acting upon a single unankylosed joint must be lower than the evaluation for unfavorable ankylosis of that joint, except in the case of muscle groups I and II acting upon the shoulder.
(e) For compensable muscle group injuries which are in the same anatomical region but do not act on the same joint, the evaluation for the most severely injured muscle group will be increased by one level and used as the combined evaluation for the affected muscle groups.
(f) For muscle group injuries in different anatomical regions which do not act upon ankylosed joints, each muscle group injury shall be separately rated and the ratings combined under the provisions of § 4.25.
(Authority: 38 U.S.C. 1155)
[62 FR 30237, June 3, 1997]
Notes of Decisions
Francisco v. Brown, 7 Vet. App. 55 (Vet. App. 1994).
“The appellant also argues that the Board erred because it did not consider combining the rating under 38 C.F.R. § 4.55 (c) (1993) for the injury to muscle group III, intrinsic muscles of the shoulder girdle, with a rating for injury to muscle group I, extrinsic muscles of the…”
C Harles Jones v. Anthony J. Principi, 18 Vet. App. 248 (Vet. App. 2004).
· cites it 4× “On June 3, 1997, VA substantially revised its rating schedule with respect to musculoskeletal injuries by amending, inter alia, 38 C.F.R. § 4.55 (Principles of combined ratings for muscle injuries) and 38 C.”
Reald v. Shinseki, 651 F.3d 1296 (Fed. Cir. 2011).
· cites it 2× “Moreover, 38 C.F.R. § 4.55 specifically limits the relevance of Muscle Groups to the rating context, thus precluding a definition of disability based on the identification of the Muscle Group involved.”
Myler v. Derwinski, 1 Vet. App. 571 (Vet. App. 1991).
· cites it 4× “Consistent with the clinical findings and the provisions of 38 C.F.R. § 4.55 and 4.72 regarding principles of combined ratings, we conclude the injuries to muscle groups XIII and XIV were moderate and should be combined to one rating for a moderately severe injury.”
Dinsay v. Brown, 9 Vet. App. 79 (Vet. App. 1996).
“55 (a) and (b), multiple injuries to the veteran’s shoulder and arm may be combined for rating purposes to increase the level of severity of injury, but any such combination may not exceed the maximum entitlement provided for by the schedular criteria.”
Bierman v. Brown, 6 Vet. App. 125 (Vet. App. 1994).
· cites it 2× “, 38 C.F.R. §§ 4.55 (g) (1993) (“Muscle injury ratings will not be combined with peripheral nerve paralysis ratings for the same part, unless affecting entirely different functions.”
Nat'l Org. of Vets.' Advocates, Inc. v. Sec'y Affairs, 927 F.3d 1263 (Fed. Cir. 2019).
“For example, in the case of muscle injuries, 38 C.F.R. § 4.55 (e) provides that "[f]or compensable muscle group injuries which are in the same anatomical region but do not act on the same joint, the evaluation for the most severely injured muscle group will be increased by one…”
09-46 242 (Board of Vet. App. 2018).
· cites it 4× “38 C.F.R. § 4.55 . At the outset, the Board notes that an October 2016 VA examination has identified impairment of Muscle Groups VIII and IX associated with the service-connected disability.”
191125-48058 (Board of Vet. App. 2021).
· cites it 4× “38 C.F.R. § 4.55 (a). For rating purposes, the skeletal muscles of the body are divided into 23 muscle groups in 5 anatomical regions: 6 muscle groups for the shoulder girdle and arm (diagnostic codes 5301 through 5306); 3 muscle groups for the forearm and hand (diagnostic codes…”
190618-10338 (Board of Vet. App. 2020).
· cites it 3× “See 38 C.F.R. §§ 4.55 , 4.56, 4.73. The Veteran contends that his service-connected costochondritis warrants an increased compensable evaluation, and for the reasons set forth below, the Board agrees.”
03-01 548 (Board of Vet. App. 2012).
· cites it 4× “Muscle injuries are evaluated pursuant to criteria at 38 C.F.R. §§ 4.55 , 4.56, and 4.73 (2012).”
— 38 C.F.R. § 4.55(a) — 1 case
Myler v. Derwinski, 1 Vet. App. 571 (Vet. App. 1991).
“Consistent with the clinical findings and the provisions of 38 C.F.R. § 4.55 and 4.72 regarding principles of combined ratings, we conclude the injuries to muscle groups XIII and XIV were moderate and should be combined to one rating for a moderately severe injury.”
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