Muscle Group XVIII VA Disability Rating
Diagnostic Code 5318 · 38 CFR §4.73
What Is It?
Muscle Group XVIII includes the pelvic girdle muscles responsible for outward rotation of the thigh and stabilization of the hip joint. This group includes the piriformis, obturator, gemelli, and quadratus femoris muscles. These deep hip rotators stabilize the hip during all standing and walking activities and allow you to turn your leg outward. They sit beneath the gluteal muscles and are critical for smooth gait mechanics. Military injuries from deep penetrating wounds to the buttock area can damage these muscles.
Rating Criteria
| Rating | Criteria |
|---|---|
| 30% | Severe injury with major loss of hip stabilization. |
| 20% | Moderately severe injury with significant hip instability during walking. |
| 10% | Moderate injury with some loss of hip rotation stability. |
| 0% | Slight injury with minimal functional impact. |
Evidence Needed
- Service records documenting the deep buttock or hip muscle injury
- Treatment records for the deep tissue injury
- Hip rotation strength testing (external rotation)
- Gait assessment showing instability if present
- Statements about hip instability, difficulty with rotation movements, and walking problems
C&P Exam Tips
- Have external hip rotation tested specifically
- Describe any hip instability or feeling of the hip slipping during walking
- Report difficulty with movements requiring leg rotation like getting in and out of a car
- Mention any piriformis-related sciatica symptoms if present
- Describe the original wound location and depth
How to File
File under DC 5318 with evidence of the deep hip rotator muscle injury. If piriformis syndrome is causing sciatic nerve irritation, that should be documented and may warrant a separate nerve-related claim.
Common Mistakes
Not having external rotation tested since these deep muscles are often overlooked in standard exams Missing piriformis syndrome which can mimic sciatica and should be separately documented Failing to describe the depth of the original wound which helps establish that deep muscles were involved Not connecting hip instability during walking to the deep rotator muscle damage
Frequently Asked Questions
What is piriformis syndrome?
Piriformis syndrome occurs when the piriformis muscle in the buttock spasms or becomes inflamed and compresses the sciatic nerve that runs beneath it. This causes pain, tingling, and numbness down the back of the leg similar to sciatica. If the piriformis was damaged by a service-connected injury, this syndrome can be claimed as a secondary condition.
How are deep hip rotator injuries diagnosed?
Because these muscles sit deep beneath the gluteal muscles, they cannot be seen or easily felt on examination. Diagnosis relies on specific rotation strength testing, MRI imaging, and the clinical history of a wound that penetrated deeply enough to reach these muscles.