Muscle Group V — VA Diagnostic Code 5305

Note (2) of § 4.73: Ratings of slight, moderate, moderately severe, or severe for diagnostic codes 5301 through 5323 will be determined based upon the criteria contained in § 4.56.

The column headers for this table are Dominant and Nondominant. They are not Major and Minor. Moderate is 10 in both columns. Slight is 0 in both columns. Severe and Moderately Severe differ by column.

Section 4.56(c) says the cardinal signs and symptoms of muscle disability are loss of power, weakness, lowered threshold of fatigue, fatigue-pain, impairment of coordination and uncertainty of movement.

Section 4.56(d) says that under diagnostic codes 5301 through 5323, disabilities resulting from muscle injuries shall be classified as slight, moderate, moderately severe or severe as follows. There is no comma before “or severe.”

Slight, type of injury: simple wound of muscle without debridement or infection. History and complaint: service department record of superficial wound with brief treatment and return to duty; healing with good functional results; no cardinal signs or symptoms. Objective findings: minimal scar; no evidence of fascial defect, atrophy, or impaired tonus; no impairment of function or metallic fragments retained in muscle tissue.

Moderate, type of injury: through and through or deep penetrating wound of short track from a single bullet, small shell or shrapnel fragment, without explosive effect of high velocity missile, residuals of debridement, or prolonged infection. History and complaint includes a record of consistent complaint of one or more of the cardinal signs and symptoms, particularly lowered threshold of fatigue after average use, affecting the particular functions controlled by the injured muscles. Objective findings include entrance and (if present) exit scars, small or linear, indicating short track of missile through muscle tissue, and some loss of deep fascia or muscle substance or impairment of muscle tonus and loss of power or lowered threshold of fatigue when compared to the sound side.

Moderately severe, type of injury: through and through or deep penetrating wound by small high velocity missile or large low-velocity missile, with debridement, prolonged infection, or sloughing of soft parts, and intermuscular scarring. History and complaint includes hospitalization for a prolonged period for treatment of wound, consistent complaint of cardinal signs and symptoms, and, if present, evidence of inability to keep up with work requirements. Objective findings include entrance and (if present) exit scars indicating track of missile through one or more muscle groups; indications on palpation of loss of deep fascia, muscle substance, or normal firm resistance of muscles compared with sound side; and tests of strength and endurance compared with sound side that demonstrate positive evidence of impairment.

Severe, type of injury: through and through or deep penetrating wound due to high-velocity missile, or large or multiple low velocity missiles, or with shattering bone fracture or open comminuted fracture with extensive debridement, prolonged infection, or sloughing of soft parts, intermuscular binding and scarring. The history-and-complaint paragraph says the cardinal signs and symptoms are worse than those shown for moderately severe muscle injuries. Objective findings include ragged, depressed and adherent scars indicating wide damage to muscle groups in missile track; loss of deep fascia or muscle substance, or soft flabby muscles in the wound area; muscles that swell and harden abnormally in contraction; and tests of strength, endurance, or coordinated movements compared with the uninjured side that indicate severe impairment of function.

DC 5305 prints 40 and 30, 30 and 20, 10 and 10, and 0 and 0. Section 4.56 is the classification for those four words. This page does not say the muscle form replaces either text.

Section 3.309 does not contain “elbow supination.” This page does not add DC 5305 to a presumptive row.

A separate question, when a presumption does not decide it, is a medical question on the facts under 38 CFR § 3.310. Paragraph (a) covers disability proximately due to or the result of a service-connected disease or injury. Paragraph (b) covers increase in severity and requires a medical baseline.