Rotator Cuff ART Claims Guide

Almost every rotator cuff claim arrives the same way: the shoulder had been hurting for months, the insurer looked at it once and replied that the injury is degenerative, a matter of age. That answer is met with the rule book. If your job requires repetitive or forced shoulder movement, rotator cuff tendinitis is on Argentina's official schedule of occupational diseases and work causation is presumed.

1. The three scenarios your shoulder can fall into

The rotator cuff is the group of four tendons — supraspinatus, infraspinatus, subscapularis and teres minor — that stabilises the joint and lets you raise your arm. For the insurer, though, what matters is not the anatomy but how you got there, because that decides which procedure applies.

If there was a fall, a direct blow or a single sudden strain — lifting more than expected, catching a load that shifted — you are in Section 6(1) of Law 24,557: "any sudden and violent event occurring by reason of or on the occasion of work". No schedule is needed. The event and its connection to work are enough.

If the injury built up over years with no single episode, the ground is occupational disease. And Decree 658/96 is explicit. Under the agent "Forced postures and repetitive gestures at work I (Upper limb)", in the periarticular conditions section, the schedule lists two shoulder conditions verbatim: simple painful shoulder (rotator cuff tendinitis) and frozen shoulder following an unresolved painful shoulder. The associated activity is equally clear: "work requiring repetitive or forced shoulder movement".

If your job means raising your arms, pushing, pulling or working above shoulder height — warehousing, construction, assembly lines, loading and unloading, hairdressing, painting, maintenance — the statute already presumes the tendinitis came from work. You do not have to rebuild causation from scratch.

2. Scheduled tendinitis or a tear: which procedure applies

Here is the technical point that decides many files. The schedule names tendinitis, the inflammation of the tendon. It does not name a structural tear of the cuff, which is the injury that usually ends in surgery. If your MRI reports a tear and there is no fall to explain it, the insurer has an argument for denying cover on the basis that the condition is not scheduled.

When that happens the door does not close: the claim moves to Section 6(2)(b) of Law 24,557. You file a reasoned petition before the Jurisdictional Medical Board, with factual, medical and legal support, seeking recognition that work was the direct and immediate cause of the condition, excluding factors unrelated to work or attributable to you.

There is a rule in Section 6(2)(c) worth knowing because it is rarely invoked: where the insurer argues the disease is unscheduled and the Jurisdictional Medical Board considers it does fall within subsection (b), the Board notifies the insurer and from that moment until the matter is finally resolved the insurer must provide all benefits. The Jurisdictional Board must immediately refer the matter to the Central Medical Board, which has 30 days to confirm or overturn. In other words: while the argument runs, you must still be treated.

Telling tendinitis from a tear in the first filing is not a technicality. Claiming down the wrong route costs you months.

3. How impairment is measured under the 2026 table

Decree 549/2025 (Official Gazette, 6 August 2025) replaced Annex I of Decree 659/96 with a new Labour Impairment Assessment Table, in force since February 2026 — 180 calendar days after publication — and applicable "to any assessment or determination of labour impairment not yet issued, regardless of the administrative or judicial stage it is at".

The evidential standard also tightened, and it favours you if you arrive prepared. The schedule requires that "any joint restriction reducing the range of movement must be supported by an anatomical substrate justifying that pathological finding". In plain terms: the MRI or ultrasound showing the tendinopathy or the tear is not decoration, it is the condition for the restriction to count at all.

On the other side, pain on its own generates no percentage. The text is blunt: "pain, given its subjective and variable character, shall not be included in the labour impairment weighting tables". What is compensated is documented functional loss, not the complaint. That is why the medical report has to translate the pain into measurable restriction backed by imaging.

Two further chapter rules come into play where there is more than one sequela. If the involvement is in the same limb and the same side, the impairments are added arithmetically. If they are in a different topographic region or on the other side, they are weighted by residual capacity. And the sum of hand, wrist, forearm, elbow, arm and shoulder girdle sequelae on one side cannot exceed 66%, the value assigned to interscapulothoracic amputation.

The weighting factors of Section 8(3) of Law 24,557 — age, type of activity and redeployment prospects — are then applied to the table percentage. Those factor percentages are added into a single value, and that value is the percentage by which the table impairment is increased, not points bolted on from outside. If the factors take a partial impairment to 66% or above, the maximum recognised is 65.99%.

4. What you collect

There is no fixed amount "for a rotator cuff". There is a formula, and what changes from case to case is the percentage. Section 14(2)(a) of Law 24,557 — which governs impairments of 50% or less, the usual range for a shoulder — reads:

53 × monthly Base Income × impairment percentage × (65 ÷ your age at the date of first disabling manifestation)

Base Income is the monthly average of all wages accrued in the year before the first disabling manifestation, indexed month by month by the RIPTE wage index (Section 12(1)). From that date until the payment is made available it accrues interest equal to the RIPTE variation (Section 12(2)). The full walkthrough is in how workers' compensation is calculated.

The 20% single-payment supplement under Section 3 of Law 26,773 is added to the result, where the harm occurred at the workplace or while you were at the employer's disposal.

A statutory floor applies too, updated every six months by the SRT using RIPTE. For the period from 1 September 2026 to 28 February 2027, SRT Resolution 39/2026 set that the Section 14(2) award may not fall below ARS 114,354,110 multiplied by the permanent labour impairment percentage. If the formula gives less, you collect the floor. Current figures are kept in what workers' comp pays for a rotator cuff injury.

If the insurer fails to make payment available on time, Section 12(3) of Law 24,557 applies the Banco de la Nación Argentina 30-day general lending rate, capitalised every six months.

5. The procedure and the real deadlines

Going through the SRT's Jurisdictional Medical Board is the mandatory administrative stage, exclusive of any other intervention (Section 1, Law 27,348). The Supreme Court upheld that requirement in the Pogonza ruling. The only exception is unregistered workers of uninsured employers: for them the same Section 1 leaves the judicial route open.

1. Legal representation paid by the insurer. The final paragraph of Section 1 of Law 27,348 places legal representation fees and the worker's other expenses on the insurer. Section 2 adds that all evidence produced at any stage is free for the worker, and bans contingency-fee agreements in these proceedings. The exception: a party-appointed medical expert is paid by whoever proposes them.
2. If the insurer denied the claim. The contingency-rejection procedure opens with proof of identity, the notice of the accident or disease, and the insurer's reasoned rejection (Section 1, SRT Resolution 298/17). Where the argument is unscheduled disease, add the reasoned petition with factual, medical and legal support. The detail is in workers' comp claim rejections.
3. If the insurer does not request the impairment determination. Once temporary disability ends, it has twenty days to ask for it. If that window passes, you can start the divergence procedure yourself, in person at the Board's registry or by post (Section 3, SRT Resolution 298/17). It is not a limitation period running against you: it is the insurer's deadline.
4. Sixty days for the report. The Medical Board has 60 administrative working days from the first properly completed filing (Section 3, Law 27,348), extendable once by up to 30 working days where evidence is still outstanding (Section 7, SRT Resolution 298/17). The deadlines are peremptory: once they lapse, the judicial route under Section 2 opens.
5. Service and review. The report is served on the parties and the employer within ten days. From there you have three days to seek correction of clerical or formal errors, or revocation where the reasoning contradicts the conclusion or a submission went unanswered. A hearing before the Settlement Approval Service follows.
6. Payment. Section 4 of Law 26,773 requires the insurer to notify you formally, within fifteen days of being served with the approval or the impairment determination, of the amounts due, itemised by head of claim and stated to be available for collection.

Since March 2026 Section 4 bis of Law 27,348, inserted by Law 27,802, is also in force. It obliges adhering jurisdictions to apply the Impairment Assessment Table strictly at every stage, to establish or reinforce forensic medical bodies specialised in workplace risks, and to implement the digital environments the SRT provides to assist doctors and experts in the calculation. For rotator cuff cases, where the spread between examiners was enormous, the change is noticeable.

6. Answering the "it's degenerative" argument

It is the insurers' standard defence and it is not medically absurd: degenerative tendinopathy exists and increases with age. What is not acceptable is using that possibility as an automatic answer when the job fits the schedule.

The reply is built from three pieces. The first is legal: if your role requires repetitive or forced shoulder movement, Decree 658/96 already presumes work causation and the burden of displacing it shifts to the insurer. The second is factual: job description, time in the post, witnesses, production records, anything that documents the exposure. The third is medical: the MRI or ultrasound showing the anatomical substrate, plus a report translating that finding into functional restriction.

If the rating still comes out below what is reasonable, the Supreme Court has settled doctrine on caps that dilute compensation — the Lucca de Hoz and Ascua rulings — and on the right to collect compensation in full, without improper deductions, in Obregón.

And where the real problem is an employer who never adapted the workstation to reduce repetitive strain, full civil compensation is available under the Aquino ruling, with the possibility of extending liability to the insurer itself where it failed in its prevention duties, as in Torrillo. But Section 4 of Law 26,773 is clear: the election is exclusive, the systems are not cumulative, and merely collecting money or filing suit means you have already chosen. That decision is made before you collect, not after.

7. Mistakes that sink the claim

• Putting up with it for months without giving notice. Every month of pain with no written record is a month the insurer uses to dispute causation. Give notice as soon as symptoms appear, even if you expect them to pass.
• Claiming under the schedule when the diagnosis is a tear. If the MRI reports a structural tear and there was no accident, framing the claim solely under Decree 658/96 weakens it. It goes by the unscheduled disease route, with the petition properly built.
• Attending the examination with no imaging. Without a documented anatomical substrate, the joint restriction is not counted. That is an express rule of the current schedule.
• Presenting pain as if it were the damage. Pain is not in the weighting tables. What counts is documented functional restriction.
• Not documenting what your job actually involves. The job description, the witnesses and the personnel file are what sustain causation, above all in the unscheduled disease procedure.
• Assuming no surgery means no compensation. Tendinitis treated with physiotherapy alone can still leave a permanent sequela rated under Table 5 on Muscle and Tendon Injuries.
• Letting the three days after the report lapse. It is the fastest and cheapest chance to correct an error or a contradiction before you have to appeal.

Frequently asked questions about rotator cuff claims