Evidence Checklist: Shoulder Impingement Syndrome

Orthopedic evaluation with impingement testing and range of motionCritical

Examination documenting positive impingement signs (Neer, Hawkins-Kennedy), painful arc, shoulder range of motion in degrees, and subacromial tenderness.

Nexus opinion linking shoulder impingement to service ("at least as likely as not")Critical

A medical opinion connecting your shoulder impingement to repetitive overhead military duties, heavy lifting, or a specific in-service injury.

MRI shoulder documenting bursal thickening, partial tear, or acromion morphologyCritical

MRI findings of subacromial bursal thickening, partial-thickness rotator cuff tears, or acromial morphology (Type II/III) that contributes to mechanical impingement.

Documentation of dominant vs. non-dominant armCritical

Medical records specifying which shoulder is affected and which arm is dominant, as the major extremity receives a higher rating.

Treatment records (physical therapy, subacromial injections, surgery)

Records documenting subacromial corticosteroid injections, physical therapy focused on rotator cuff strengthening, and any surgical procedures (subacromial decompression, acromioplasty).

Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

Completed DBQ Shoulder and Arm ConditionsCritical

Standardized form capturing shoulder range of motion, impingement findings, pain, and functional limitations.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.