The Forearm and Hand Muscles

Topics:

Group VII
Group VIII
Group IX
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.

Note: Hand and arm conditions may have higher ratings for the dominant hand. If you are right-handed, then your right hand/arm is dominant. If you are left-handed, then your left hand/arm is dominant. For the ambidextrous, the rating for the dominant hand will apply regardless of which hand is injured.

Double Note: If any forearm, wrist, or hand condition causes multiple fingers to have limited or impaired motion, then the fingers can be rated as a separate condition and combined with the forearm, wrist, or hand condition. Any combination, however, cannot total more than 70% for the dominant hand and 60% for the non-dominant hand.

All muscle conditions are either rated on the Slight to Severe Scale (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 wrist, it can either be rated on the muscle injury itself (the Slight to Severe Scale) or on the limited motion of the wrist. 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: 5307-5215. 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 wrist).

The muscles in the forearm and hand are divided into three groups.

 


Group VII

Code 5307: This group controls the flexion of the wrist and fingers. They allow the hand to bend downward at the wrist and the fingers to curl into a fist. This muscle group is important for grasping and holding.

Wrist and finger flexion

Muscles/tendons: flexor carpi ulnaris, flexor carpi radialis, flexor digitorum profundus, flexor digitorum superficialis, flexor pollicis longus, pronator teres, brachioradialis, palmaris longus, flexor pollicis brevis, flexor tendon digitorum.

the muscles of the hand and forearm

This group is rated on the Slight to Severe Scale or on limited motion of the wrist, code 5215, or limited motion of the fingers, codes 5228-5230.

Ratings for the Slight to Severe scale: Dominant hand ratings: slight = 0%, moderate = 10%, moderately severe = 30%, and severe = 40%. Non-dominant hand: slight = 0%, moderate = 10%, moderately severe = 20%, and severe = 30%.

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Group VIII

Code 5308: This group bends the wrist backwards and straightens the fingers. They allow the hand and fingers to point up and back at the wrist. They also move the thumb directly away from the palm of the hand (abduction).

extension of the wrist and fingers                 Abduction and Adduction of the Thumb

Muscles/tendons: supinator, extensor digiti minimi, extensor carpi ulnaris, extensor carpi radialis brevis, extensor pollicis longus, extensor indicis, extensor digitorum, extensor carpi radialis longus, extensor pollicis brevis.

Muscles of the Forearm

This group is rated on the Slight to Severe Scale or on limited motion of the wrist, code 5215, or on limited motion of the thumb, code 5228.

Ratings for the Slight to Severe Scale: Dominant hand ratings: slight = 0%, moderate = 10%, moderately severe = 20%, and severe = 30%. Non-dominant hand: slight = 0%, moderate = 10%, moderately severe = 20%, and severe = 20%.

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Group IX

Abduction and Adduction of the Thumb

Code 5309: This group is comprised of all the small muscles in the hand. They allow the thumb to move toward the fingers in a pincher movement (adduction) and control the small precise motions of the fingers. Because they are so small, they are almost never injured without tendons or bones also being injured. Any condition that includes injury to the muscles of the hand is rated on the range of motion of the affected fingers.

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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 forearm and hand cannot be combined to be more than 70% for the entire dominant hand and 60% for the entire non-dominant hand. Likewise, any ratings for the forearm (below the elbow) cannot be combined to be more than 80% for the dominant arm and 70% for the non-dominant arm.

Special Monthly Compensation: If your condition makes it impossible grasp with your fingers or hold things in your hand, you may qualify for the VA’s Special Monthly Compensation.

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

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

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

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 Hand page and The Elbow and Forearm page.

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