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Shoulder Clavicle Coranoid Process Fracture



So there is a mess of things going on with my shoulder. I got 20% for A/C separation and a 0% Long thoracic nerve paralysis that I am about to appeal since I have a winged scapula and limited ROM.

After viewing X-rays from last year I noticed there was a bone the size and shape of a nickel floating below my scapula and clavicle as well as another small fragment. This happened after a reconstructive surgery removal of the outer third of left clavicle with graft. That's why my clavicle looks all jacked up.

The report of the scapula states:

There is a 1.2 cm well-coricated boney density between the coracoid and distal clavicle. This may represent non-acute fracture off the tip of the coracoid process. Smaller bony densities also seen located just about the coracoid process.

It's my fault for missing the ortho exam and waiting so long to go back.


1) Apparently it is a rare break and not many cases I have seen. Would this count as a Code 5203: "If either the clavicle or scapula bones are broken and do not heal back together, it is rated 20% for either arm if there is loose or uncontrolled movement or 10% for either arm if there is not any loose movement. If they are broken and heal, but not correctly, then it is rated 10% for either arm." ?

2) Will this affect my previous 20% shoulder a/c separation? I heard a 'shoulder injury' is just one bucket and it might only select one or the other.

3) Will the VA deny or wait for the ortho surgeon to remove/replace it then try to claim it was repaired?

4) I am trying to appeal my nerve damage based on ROM. Will the ROM come into account when rating the broken bone as well, or since they might grant it for the nerve damage it will not be taken into account for the bone?


I don't want to get in trouble to screw anything up if it looks like I am trying to double dip for ROM. Worried they might deny or reduce if they cannot determine which problem is causing the ROM shoulder abduction.

Any advice would be appreciated and sorry for the essay.


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1.  You would be better at interpreting your symptoms than I am.  Are they broken and did not heal back together?  I dont know.  You do.

2.  Pyramiding prevents duplication, so you may well be right there.  You get rated for loss of rom, and pain in the joint, not in each bone of the joint.  

3.  The VA loves to deny.  Its their favorite thing after delays.  Remember, tho, you get compensated for CHRONIC conditions, not acute conditions that resolve themselves.  

If your condition is repaired by a surgeon, and the pain is reduced and or loss of ROM restored, yes, you could be subject to a reduction if you no longer meet the criteria for a higher rating.  

4.  If your broken bone causes nerve damage you can apply for nerve damage secondary to the fracture.  But, pyramading prevents you from getting compensated for loss of rom from nerve damage AND loss of rom from broken bones that didnt heal.  You will only get ONE loss of ROM for a joint and ONE pain for a joint.  

However, your injury "may" affect your job, and that could help with a higher rating if you have limited or no use of that shoulder/arm.  


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Now if you are a Veteran and you are an MD   then maybe you can opine on your own conditions? I am unsure on this? 

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