The Buttock, Hip and Thigh Muscles

Topics:

Group XIII
Group XIV
Group XV
Group XVI
Group XVII
Group XVIII
DBQ for Muscle Conditions
Principles that Apply

Reminder: The VA will give a Military Disability Rating for each service-connected condition a service member has, but the DoD will only rate service-connected conditions that make a service member Unfit for Duty.

All muscle conditions are either rated on the Slight to Severe Scale detailed on another page (the links in the rating discussions will take you straight to the scale), or on the limited motion of the joint the muscle condition affects, whichever gives a higher rating. So, if there is a muscle injury near the hip, it can either be rated on the muscle injury itself (the Slight to Severe Scale) or on the limited motion of the hip. If the muscle injury is the cause of the limited motion, then only one can be rated. If, however, there is a muscle injury that does not affect a joint, and that joint has limited motion because of another condition, then both can be rated. If the muscle condition is rated as limited motion, then the final code will look like this: 5301-5251. The first four-digit code defines the condition as a muscle injury, and the second code tells how it is rated (limited motion of the hip).

The muscles in the buttocks, pelvis, and thighs are divided into six groups.

 


Group XIII

Code 5313: This group is commonly called the hamstring muscles. They are located in the back of the thigh, and control the extension of the hip and the flexion of the knee. These muscles allow the leg to move backwards from the hip, and the knee to bend and to rotate inward and outward.

The extension of the hip                              The flexion of the knee                          The inward and outward rotation of the hip

Muscles/tendons: iliotibial tract, biceps femoris, semimembranosus, semitendinosus.

The hamstring muscles

This group is either rated on the Slight to Severe Scale or on limited motion of the hip, code 5251, or knee, code 5260.

Ratings for the Slight to Severe Scale: slight = 0%, moderate = 10%, moderately severe = 30%, and severe = 40%.

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Group XIV

Code 5314: This group is mostly made up of the quadriceps muscle, the large muscle in the front thigh. It controls the straightening of the leg at the knee and the simultaneous flexion of the hip (think of a hurdler raising his leg to jump over a hurdle). These muscles allow the knee to straighten and the hip to flex.

 The extension of the knee                           The extension of the knee and the flexion of the hip

Muscles/tendons: quadriceps femoris (rectus femoris, vastus lateralis, vastus medialis, vastus intermedius), sartorius, tensor vaginae femoris.

The muslces of the thigh

This group is rated on the Slight to Severe Scale or on limited motion of the hip, code 5252, or knee, code 5261.

Ratings for the Slight to Severe Scale: slight = 0%, moderate = 10%, moderately severe = 30%, and severe = 40%.

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Group XV

Code 5315: This muscle group is located on the inside of the thigh. Its main function is to move the leg inward toward the body and across the other leg (adduction of the hip), but it also helps flex the hip and the knee.

 The adduction of the hip              The flexion of the hip                       The flexion of the knee

Muscles/tendons: adductor longus, adductor brevis, adductor magnus, and gracilis.

The muscles of the inner thigh

This group is rated on the Slight to Severe Scale or on limited motion of the hip, codes 5252-5253, or knee, code 5260.

Ratings for the Slight to Severe Scale: slight = 0%, moderate = 10%, moderately severe = 20%, and severe = 30%.

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Group XVI

Code 5316: This group controls the flexion of the hip. These muscles are located in the pelvic girdle and allow the leg to move forward.

The flexion of the hip

Muscles/tendons: psoas, iliacus, pectineus.

The muscles of the hip

This group is either rated on the Slight to Severe Scale or on limited motion of the hip, code 5252.

Ratings for the Slight to Severe Scale: slight = 0%, moderate = 10%, moderately severe = 30%, and severe = 40%.

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Group XVII

Code 5317: This group is made up of the muscles in the buttocks. Their main function is to extend the hip, but they also move the leg outward away from the body (abduction) and support the pelvis. These muscles allow the leg to move backwards and out to the side away from the body. They also work with the muscles in Group XIV to keep the hips stable when standing and walking.

The extension of the hip                   The abduction of the hip   

Muscles/tendons: gluteus maximus, gluteus medius, and gluteus minimus.

The muscles of the buttocks

This group is either rated on the Slight to Severe Scale or on limited motion of the hip, code 5251 or 5253.

Ratings for the Slight to Severe Scale: slight = 0%, moderate = 20%, moderately severe = 40%, and severe = 50%.

If you have lost the use of BOTH buttocks, you may also qualify for additional compensation by the VA. Please see the Special Monthly Compensation page for more information.

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Group XVIII

Code 5318: This group controls the outward rotation of the thigh. They allow the leg and foot to turn out away from the body instead of pointing straight ahead.

The outward rotation of the hip and thigh

Muscles/tendons: piriformis, gemellus, obturator, quadratus femoris.

The small muscles of the hip

This group is either rated on the Slight to Severe Scale or on limited motion of the hip, code 5253.

Ratings for the Slight to Severe Scale: slight = 0%, moderate = 10%, moderately severe = 20%, and severe = 30%.

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DBQ for Muscle Conditions

Here is the Disability Benefits Questionnaire (DBQ) used for muscle conditions: Muscle Injury DBQ.

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Principles that Apply

The Amputation Rule: Any ratings for the hip and leg cannot be combined to be more than 90% for the entire leg including the pelvic girdle, 80% for mid-thigh, 60% for low-thigh/knee (the knee is not able to function), and 40% for below the knee (knee is able to function).

Special Monthly Compensation: If your condition makes it impossible to push off with the foot or balance on the foot, or rise to your feet without using your arms or other assistance, you may qualify for the VA’s Special Monthly Compensation.

Combined Ratings for Muscle Injuries: A nerve rating in the butt and leg cannot be combined with a muscle rating in the butt and leg unless each condition affects completely different functions (i.e. the nerve condition affects the flexion and the muscle condition affects the extension). If more than one muscle group is injured in the butt and leg, then they must be combined as described in this principle.

Painful Motion: If pain is present with motion, then the minimum rating must be given.

Pyramiding: A single condition can only be rated once! However, if a nerve condition or other condition exists that is additional to the hip and thigh condition (not simply caused by it), then it can also be rated.

Probative Value: If two exams record the condition differently, the exam with the most thorough data and performed by the most qualified person in that specialty will be the exam the rating is based on.

A Tie Goes to the Veteran: If there are two equally strong exams with conflicting information, or if the condition can be equally rated under two different codes, then the one that gives the highest rating will be assigned. Every conflict should be resolved in favor of the higher rating.

Accurate Measurements: It is essential that the necessary information to rate your condition is recorded by the physician in your exam. With the information on this page, you should know what needs to be measured and recorded. Make sure this happens correctly to ensure that you receive a proper rating.

Hospital or Convalescent Ratings: Some conditions require periods of hospitalization or constant medical care (at-home nurse, etc.). Any condition that requires this is rated 100% during this intensive treatment. Once it ends, then the 100% rating will continue for a certain period. This period is 3 months unless another length (6 months, 1 year, etc.) is directly specified in the condition ratings. Some patients may need more time to recover than others, so the physician or Rating Authorities can lengthen this time period if they see fit.

Please see the Musculoskeletal Principles and the VASRD Principles pages for further guidance.

For non-muscle conditions, see The Knee and Leg page and The Hip and Thigh page.

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