Minnesota Rule 5223.0450
Minnesota shoulder and rotator cuff PPD rating
Rule 5223.0450 rates the shoulder and upper arm under exclusive categories (AC separation grades, the dislocation ladder, distal clavicle resection, chronic bicipital tendon rupture, resection arthroplasty at 36 percent, painful organic syndrome), combinable categories (implant arthroplasty at 18 percent, the rotator cuff categories, acromioplasty for dates of injury on or after August 9, 2010, the unratable fracture catch-all), and loss of measured motion under subpart 4. The rotator cuff grammar changed on August 9, 2010: before, the demonstrated tear pays regardless of healing; after, only a tear persisting despite treatment pays. The whole part is capped at the amputation value for the arm at the shoulder.
Rotator cuff tears on this schedule
A rotator cuff tear is rated under Minnesota Rule 5223.0450, not as a generic shoulder injury and not under the AMA Guides. The grammar changed on August 9, 2010. For earlier dates of injury, a demonstrated tear can pay even if it later heals. For later dates, the schedule pays the tear that persists despite treatment.
The categories on this page also cover acromioplasty, implant arthroplasty, dislocation, and AC separation. Motion loss is a separate subpart 4 rating. Use the percents below, then convert them to dollars in the PPD calculator.
Rule text from the Minnesota Revisor of Statutes, retrieved 2026-08-02.
This is my working reading of Minnesota Rule chapter 5223. I keep checking it against the official rule text and published decisions. If a category, percent, or combination looks wrong, email hello@mncompbuddy.com and say what you found. A mismatch is a reason to look again, not a reason to treat this tool or a doctor rating as automatically correct.
The percents on this page are the condition categories. This part also rates measured motion loss under subpart 4 (62 clauses). Those numbers live in the guided calculator. A total here is not the whole rating when the records also show lost motion.
How the rule decides
Each group below is a set of alternatives: the facts select at most one category from each group. Add-ons attach to their base category as the rule directs and are added, not statutorily combined.
Choose one: shoulder ac
Requires: Acromioclavicular separation, by grade (as defined at 5223.0310, subps. 2 to 4): grade 1.
R. 5223.0450, subp. 2.A(1)
Requires: Acromioclavicular separation, by grade (as defined at 5223.0310, subps. 2 to 4): grade 2.
R. 5223.0450, subp. 2.A(2)
Requires: Acromioclavicular separation, by grade (as defined at 5223.0310, subps. 2 to 4): grade 3.
R. 5223.0450, subp. 2.A(3)
Choose one: shoulder dislocation
Requires: Anterior or posterior shoulder dislocation, documented by examination, imaging study, or invasive investigation: first episode, or occurring less than three times in six months.
R. 5223.0450, subp. 2.B(1)
Requires: Anterior or posterior shoulder dislocation, documented by examination, imaging study, or invasive investigation: occurring at least three times in six months, no surgical repair.
R. 5223.0450, subp. 2.B(2)
Requires: Anterior or posterior shoulder dislocation, documented by examination, imaging study, or invasive investigation: recurring after attempted surgical repair.
R. 5223.0450, subp. 2.B(3)
Requires: Anterior or posterior shoulder dislocation, documented by examination, imaging study, or invasive investigation: surgically repaired with no recurrence (rated on measured motion under subpart 4).
R. 5223.0450, subp. 2.B(4) (rated under subp. 4)
Choose one: shoulder clavicle resection
Requires: Resection of the distal end of the clavicle.
R. 5223.0450, subp. 2.C
Choose one: shoulder biceps
Requires: Chronic bicipital tendon rupture.
R. 5223.0450, subp. 2.D
Choose one: shoulder arthroplasty
Requires: Arthroplasty of the glenohumeral joint: resection arthroplasty (joint surface removed, no implant).
R. 5223.0450, subp. 2.E
Requires: Arthroplasty of the glenohumeral joint: implant arthroplasty (replacement).
R. 5223.0450, subp. 3.B
Choose one: shoulder pain syndrome
Requires: Painful organic syndrome (as defined at 5223.0310, subp. 40), substantiated by consistent, reproducible clinical or imaging findings, with persistent limitation of active motion; and not: passive range of motion of the shoulder is limited.
R. 5223.0450, subp. 2.F
Choose one: shoulder rotator cuff
Requires: Rotator cuff tear demonstrated by medical imaging study, by thickness: partial thickness.
R. 5223.0450, subp. 3.A(1)
Requires: Rotator cuff tear demonstrated by medical imaging study, by thickness: full thickness.
R. 5223.0450, subp. 3.A(2)
Requires: Rotator cuff tear demonstrated by medical imaging study, by thickness: partial thickness or full thickness; and not: the tear persists despite treatment (false means healed, or surgically repaired with no persistent tear).
R. 5223.0450, subp. 3.E(1)
Requires: Rotator cuff tear demonstrated by medical imaging study, by thickness: partial thickness; and The tear persists despite treatment (false means healed, or surgically repaired with no persistent tear).
R. 5223.0450, subp. 3.E(2)
Requires: Rotator cuff tear demonstrated by medical imaging study, by thickness: full thickness; and The tear persists despite treatment (false means healed, or surgically repaired with no persistent tear).
R. 5223.0450, subp. 3.E(3)
Choose one: shoulder acromioplasty
Requires: Acromioplasty performed.
R. 5223.0450, subp. 3.D
Choose one: shoulder fracture other
Requires: Fracture or dislocation involving the scapula, clavicle, or humerus not otherwise ratable under this part or 5223.0460.
R. 5223.0450, subp. 3.C
Choose one: shoulder unlisted motion loss
Requires: either A shoulder condition no category of subparts 2 or 3 represents, rated only on measured loss of motion under subpart 4, or Painful organic syndrome (as defined at 5223.0310, subp. 40), substantiated by consistent, reproducible clinical or imaging findings, with persistent limitation of active motion; and Passive range of motion of the shoulder is limited.
R. 5223.0450, subp. 1 (rated only under subp. 4)
What the records must show
These are the facts the rule turns on. If one is unknown, the affected categories stay open questions with the document that would settle them; an unknown never counts as a no.
Proof: x-ray report; exam notes grading the separation
Proof: imaging or reduction records for each episode; operative report
Proof: operative report
Proof: exam notes or imaging documenting the rupture
Proof: operative report
Proof: operative report
Proof: MRI, ultrasound, or arthrogram report
Proof: post-treatment imaging; operative and follow-up records
Proof: exam notes; imaging reports
Proof: exam notes with passive range of motion measurements
Proof: x-ray or CT report
Proof: diagnosis records; range of motion measurements
Worked examples with receipts
Each example runs through the same engine the calculator uses. The category total, the components, and the citations are computed, not typed in. These receipts are category percents only. They do not include subpart 4 motion.
Full thickness rotator cuff tear persisting despite treatment, date of injury after the 2010 rewrite
category total
Date of injury 2024-01-01
- Rotator cuff tear demonstrated by medical imaging study, by thickness: full thickness
- The tear persists despite treatment (false means healed, or surgically repaired with no persistent tear): yes
- Rotator Cuff Tear: Full Thickness Persists (DOI ≥ 2010-08-09): 6%
- Category total: 6%Does not include subpart 4 motion
Repaired cuff with no persistent tear: the express 0 of 3.E(1)
category total
Date of injury 2024-01-01
- Rotator cuff tear demonstrated by medical imaging study, by thickness: full thickness
- The tear persists despite treatment (false means healed, or surgically repaired with no persistent tear): no
- Rotator Cuff Tear: Healed/Repaired, No Persistent Tear (DOI ≥ 2010-08-09): 0%
- Category total: 0%Does not include subpart 4 motion
The same repaired full thickness tear with a 2009 injury still pays 6 under the old 3.A(2)
category total
Date of injury 2009-06-01
- Rotator cuff tear demonstrated by medical imaging study, by thickness: full thickness
- The tear persists despite treatment (false means healed, or surgically repaired with no persistent tear): no
- Chronic Rotator Cuff Tear: Full Thickness (DOI ≤ 2010-08-08): 6%
- Category total: 6%Does not include subpart 4 motion
Implant arthroplasty (18); the distal clavicle resection is lesser-included and does not add
category total
Date of injury 2024-01-01
- Arthroplasty of the glenohumeral joint: implant arthroplasty (replacement)
- Resection of the distal end of the clavicle: yes
- Shoulder Arthroplasty: Implant (Total/Reverse): 18%
- Category total: 18%Does not include subpart 4 motion
Dislocation recurring after attempted surgical repair
category total
Date of injury 2024-01-01
- Anterior or posterior shoulder dislocation, documented by examination, imaging study, or invasive investigation: recurring after attempted surgical repair
- Recurring Dislocation After Surgical Repair: 10%
- Category total: 10%Does not include subpart 4 motion
Related rules
These cross-links come from the compiled graph. Read the official rule text for the full statutory language.
See also rule 5223.0460
Elbow and forearm permanency rule 5223.0460Subp. 3.C excludes fractures ratable under the elbow part (distal humerus fractures rate there).
Common questions
What does a rotator cuff tear rate?
It depends on the date of injury. On or after August 9, 2010: a tear that persists despite treatment pays two percent (partial thickness) or six percent (full thickness), and a healed or successfully repaired tear pays an express zero. Before that date: the tear demonstrated by imaging pays two or six percent whether or not it was repaired. All cuff categories are combinable with the measured motion loss.
My rotator cuff surgery was successful. Why would the rating be zero?
For dates of injury on or after August 9, 2010, subpart 3.E(1) expressly rates a healed or surgically repaired tear with no persistent tear at zero percent. Any lasting loss of motion still rates under subpart 4 and is combined with the zero.
How are shoulder dislocations rated?
A first episode (or fewer than three in six months) is three percent. Dislocations recurring at least three times in six months without repair, or recurring after an attempted repair, are ten percent. A dislocation repaired surgically with no recurrence is rated only on the measured motion under subpart 4.
What is the difference between the two shoulder replacement categories?
An implant arthroplasty (a replacement) is 18 percent, combinable with the measured motion loss. A resection arthroplasty, where the joint surface is removed without an implant, is 36 percent exclusive: it stands alone. They describe one impairing condition, so only one rates.
Does an acromioplasty change the rating?
For dates of injury on or after August 9, 2010, acromioplasty is an express zero percent combinable category, so it anchors the measured motion rating without adding a percent of its own. Before that date the rule had no acromioplasty category and the surgery is rated on motion alone.
Interpretive notes
- Subpart 4 (loss of function) is delegated to the ROM module across the shoulder arcs.
- The August 9, 2010 amendment did two things here: it added the acromioplasty category (3.D) and rewrote the rotator cuff grammar from "the demonstrated tear pays" (3.A) to "only a persisting tear pays" (3.E). The graph carries both eras; the date of injury selects between them.
- Grade definitions for AC separation live at 5223.0310, subparts 2 to 4, and are recorded as definition cross-references on the ladder nodes.
What to do next
Turn a category percent into dollars, combine multiple ratings, or see permanency inside a full settlement value.
- Minnesota PPD calculator
Turn a rating percentage into dollars using the statutory tier for your date of injury.
- PPD combination calculator
Two or more ratings combine with a formula that yields less than the sum.
- Settlement exposure calculator
See permanency next to wage loss and medical when you weigh a settlement.
- All PPD rules by body part
Browse the other Minnesota Rule 5223 categories that may apply to your claim.
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