The Hand

Topics:

Loss of Use/Amputation of the Hand
Amputation of the Fingers
Loss of Use of the Fingers
Limitation of Motion of the Fingers
Other Hand Conditions
DBQ for Hand 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.

Triple Note: For FINGER conditions, if multiple fingers are affected by any combination of amputation, no motion, limited motion or loss of use, then they will be rated together on whatever best describes the disability. So, if the thumb is amputated, the ring finger cannot move and the little finger has been amputated, then amputation of all three fingers would BEST describe this condition since the majority fall under that category.

Quadruple Note: All finger ratings are for ONLY one hand. If there are two fingers frozen or amputated on one hand and one on the other, they are rated separately per hand, not just three total fingers.

Final Note: This note is to apologize for the excessive amount of notes on this page.

 


Loss of Use/Amputation of the Hand

Code 5125: If any hand condition is so severe that the hand cannot be used at all or has been amputated, then it is rated 70% for the dominant hand and 60% for the non-dominant hand.

Code 5106: If both hands are amputated, then it is rated 100%.

Code 5109: If both hands cannot function at all, it is rated 100%.

If both a hand and a foot have been amputated or cannot be used at all, they are rated just once (there cannot be two ratings, one for the foot and one for the hand—just one rating for both) under one of the following codes.

Amputation of Hand

Loss of Use of Hand

Amputation of Foot

Loss of Use of Foot

Code

Rating

x

 

 

x

5104

100%

 

x

x

 

5105

100%

x

 

x

 

5108

100%

 

x

 

x

5111

100%


Your condition may also qualify for additional compensation by the VA. Please see the Special Monthly Compensation page for more information.

Return to Top

 


Amputation of the Fingers

the joints of the hand

A table is going to work best for explaining the very elaborate and confusing rating process for amputation of the fingers. The problem is there are four different sections (“grades”) where the fingers can be amputated, and each is rated differently. Also, different ratings are given for different combinations of fingers.

So, how to use the charts below. First choose the table that has the appropriate number of finger amputations. Next, find the row within the table with Xs indicating the appropriate fingers amputated. If you have three fingers—thumb, index, and little—then look at the chart for three fingers and find the row that marks those three fingers.

Next, determine what grade of amputation applies. See the image above. Each grade marks a place where the finger is amputated, so find which grade applies to your fingers. If multiple fingers have been amputated at different locations, the average grade applies. So, if the thumb is amputated at grade 2, the index at grade 3, and the little at grade 2, then the overall average grade is 2. If the thumb is grade 4, the index grade 3, and the little grade 2, then the overall average grade would be 3. If there are an even number of fingers amputated and there is a tie, the higher rating will be given. Got it? We hope so.

Single Finger Amputations
Two Finger Amputations
Three Finger Amputations
Four Finger Amputations
Five Finger Amputations


Single Finger Amputations

Thumb

Index

Long

Ring

Little

Grade 1

Grade 2

Grade 3

Grade 4

Code

Ratings

Dominant

Non-dominant

x

 

 

 

 

 

 

 

x

5152

40%

30%

x

 

 

 

 

 

 

x

 

5152

30%

20%

x

 

 

 

 

 

x

 

 

5152

20%

20%

 

x

 

 

 

 

 

 

x

5153

30%

20%

 

x

 

 

 

 

 

x

 

5153

20%

20%

 

x

 

 

 

 

x

 

 

5153

10%

10%

 

x

 

 

 

x

 

 

 

5225

10%

10%

 

 

x

 

 

 

 

 

x

5154

20%

20%

 

 

x

 

 

 

 

x

 

5154

10%

10%

 

 

x

 

 

 

x

 

 

5226

10%

10%

 

 

x

 

 

x

 

 

 

5226

10%

10%

 

 

 

x

 

 

 

 

x

5155

20%

20%

 

 

 

x

 

 

 

x

 

5155

10%

10%

 

 

 

x

 

 

x

 

 

5227

0%

0%

 

 

 

x

 

x

 

 

 

5227

0%

0%

 

 

 

 

x

 

 

 

x

5156

20%

20%

 

 

 

 

x

 

 

x

 

5156

10%

10%

 

 

 

 

x

 

x

 

 

5227

0%

0%

 

 

 

 

x

x

 

 

 

5227

0%

0%

 

Return to Top                Return to Amputations

Two Finger Amputations

Thumb

Index

Long

Ring

Little

Grade 1

Grade 2

Grade 3

Grade 4

Code

Ratings

Dominant

Non-dominant

x

x

 

 

 

 

 

 

x

5142

60%

50%

x

x

 

 

 

 

 

x

 

5142

50%

40%

x

x

 

 

 

 

x

 

 

5219

40%

30%

x

x

 

 

 

x

 

 

 

5223

30%

20%

x

 

x

 

 

 

 

 

x

5143

60%

50%

x

 

x

 

 

 

 

x

 

5143

50%

40%

x

 

x

 

 

 

x

 

 

5219

40%

30%

x

 

x

 

 

x

 

 

 

5223

30%

20%

x

 

 

x

 

 

 

 

x

5144

60%

50%

x

 

 

x

 

 

 

x

 

5144

50%

40%

x

 

 

x

 

 

x

 

 

5219

40%

30%

x

 

 

x

 

x

 

 

 

5223

30%

20%

x

 

 

 

x

 

 

 

x

5145

60%

50%

x

 

 

 

x

 

 

x

 

5145

50%

40%

x

 

 

 

x

 

x

 

 

5219

40%

30%

x

 

 

 

x

x

 

 

 

5223

30%

20%

 

x

x

 

 

 

 

 

x

5146

50%

40%

 

x

x

 

 

 

 

x

 

5146

40%

30%

 

x

x

 

 

 

x

 

 

5219

30%

20%

 

x

x

 

 

x

 

 

 

5223

20%

20%

 

x

 

x

 

 

 

 

x

5147

50%

40%

 

x

 

x

 

 

 

x

 

5147

40%

30%

 

x

 

x

 

 

x

 

 

5219

30%

20%

 

x

 

x

 

x

 

 

 

5223

20%

20%

 

x

 

 

x

 

 

 

x

5148

50%

40%

 

x

 

 

x

 

 

x

 

5148

40%

30%

 

x

 

 

x

 

x

 

 

5219

30%

20%

 

x

 

 

x

x

 

 

 

5223

20%

20%

 

 

x

x

 

 

 

 

x

5149

40%

30%

 

 

x

x

 

 

 

x

 

5149

30%

20%

 

 

x

x

 

 

x

 

 

5219

20%

20%

 

 

x

x

 

x

 

 

 

5223

10%

10%

 

 

x

 

x

 

 

 

x

5150

40%

30%

 

 

x

 

x

 

 

x

 

5150

30%

20%

 

 

x

 

x

 

x

 

 

5219

20%

20%

 

 

x

 

x

x

 

 

 

5223

10%

10%

 

 

 

x

x

 

 

 

x

5151

40%

30%

 

 

 

x

x

 

 

x

 

5151

30%

20%

 

 

 

x

x

 

x

 

 

5219

20%

20%

 

 

 

x

x

x

 

 

 

5223

10%

10%

 

Return to Top                Return to Amputations

Three Finger Amputations

Thumb

Index

Long

Ring

Little

Grade 1

Grade 2

Grade 3

Grade 4

Code

Ratings

Dominant

Non-dominant

x

x

x

 

 

 

 

 

x

5132

70%

60%

x

x

x

 

 

 

 

x

 

5132

60%

50%

x

x

x

 

 

 

x

 

 

5218

50%

40%

x

x

x

 

 

x

 

 

 

5222

40%

30%

x

x

 

x

 

 

 

 

x

5133

70%

60%

x

x

 

x

 

 

 

x

 

5133

60%

50%

x

x

 

x

 

 

x

 

 

5218

50%

40%

x

x

 

x

 

x

 

 

 

5222

40%

30%

x

x

 

 

x

 

 

 

x

5134

70%

60%

x

x

 

 

x

 

 

x

 

5134

60%

50%

x

x

 

 

x

 

x

 

 

5218

50%

40%

x

x

 

 

x

x

 

 

 

5222

40%

30%

x

 

x

x

 

 

 

 

x

5135

70%

60%

x

 

x

x

 

 

 

x

 

5135

60%

50%

x

 

x

x

 

 

x

 

 

5218

50%

40%

x

 

x

x

 

x

 

 

 

5222

40%

30%

x

 

x

 

x

 

 

 

x

5136

70%

60%

x

 

x

 

x

 

 

x

 

5136

60%

50%

x

 

x

 

x

 

x

 

 

5218

50%

40%

x

 

x

 

x

x

 

 

 

5222

40%

30%

x

 

 

x

x

 

 

 

x

5137

70%

60%

x

 

 

x

x

 

 

x

 

5137

60%

50%

x

 

 

x

x

 

x

 

 

5218

50%

40%

x

 

 

x

x

x

 

 

 

5222

40%

30%

 

x

x

x

 

 

 

 

x

5138

60%

50%

 

x

x

x

 

 

 

x

 

5138

50%

40%

 

x

x

x

 

 

x

 

 

5218

40%

30%

 

x

x

x

 

x

 

 

 

5222

30%

20%

 

x

x

 

x

 

 

 

x

5139

60%

50%

 

x

x

 

x

 

 

x

 

5139

50%

40%

 

x

x

 

x

 

x

 

 

5218

40%

30%

 

x

x

 

x

x

 

 

 

5222

30%

20%

 

x

 

x

x

 

 

 

x

5140

60%

50%

 

x

 

x

x

 

 

x

 

5140

50%

40%

 

x

 

x

x

 

x

 

 

5218

40%

30%

 

x

 

x

x

x

 

 

 

5222

30%

20%

 

 

x

x

x

 

 

 

x

5141

50%

40%

 

 

x

x

x

 

 

x

 

5141

40%

30%

 

 

x

x

x

 

x

 

 

5218

30%

20%

 

 

x

x

x

x

 

 

 

5222

20%

20%

 

Return to Top                Return to Amputations

Four Finger Amputations

Thumb

Index

Long

Ring

Little

Grade 1

Grade 2

Grade 3

Grade 4

Code

Ratings

Dominant

Non-dominant

x

x

x

x

 

 

 

 

x

5127

80%

70%

x

x

x

x

 

 

 

x

 

5127

70%

60%

x

x

x

x

 

 

x

 

 

5217

60%

50%

x

x

x

x

 

x

 

 

 

5221

50%

40%

x

x

x

 

x

 

 

 

x

5128

80%

70%

x

x

x

 

x

 

 

x

 

5128

70%

60%

x

x

x

 

x

 

x

 

 

5217

60%

50%

x

x

x

 

x

x

 

 

 

5221

50%

40%

x

x

 

x

x

 

 

 

x

5129

80%

70%

x

x

 

x

x

 

 

x

 

5129

70%

60%

x

x

 

x

x

 

x

 

 

5217

60%

50%

x

x

 

x

x

x

 

 

 

5221

50%

40%

x

 

x

x

x

 

 

 

x

5130

80%

70%

x

 

x

x

x

 

 

x

 

5130

70%

60%

x

 

x

x

x

 

x

 

 

5217

60%

50%

x

 

x

x

x

x

 

 

 

5221

50%

40%

 

x

x

x

x

 

 

 

x

5131

70%

60%

 

x

x

x

x

 

 

x

 

5131

60%

50%

 

x

x

x

x

 

x

 

 

5217

50%

40%

 

x

x

x

x

x

 

 

 

5221

40%

30%

 

Return to Top                Return to Amputations

Five Finger Amputations

Thumb

Index

Long

Ring

Little

Grade 1

Grade 2

Grade 3

Grade 4

Code

Ratings

Dominant

Non-dominant

x

x

x

x

x

 

 

 

x

5126

80%

70%

x

x

x

x

x

 

 

x

 

5126

70%

60%

x

x

x

x

x

 

x

 

5216

60%

50%

x

x

x

x

x

x

 

 

 

5220

50%

40%


Return to Top               Return to Amputations

 


Loss of Use of the Fingers

A condition will be rated here if one or more knuckles are frozen in place and cannot move at all.the military disability ratings of the hand

Please look carefully at the image here. This image shows the best position for the hand to be in. The second and third knuckles are at 30° and the thumb is out facing the palm with a gap of 2 inches or less between the thumb and palm. This is considered the FAVORABLE position. If a finger is not in this position, it is considered UNFAVORABLE. There is one exception. If only the second or third knuckle is frozen on a finger (not including the thumb) and there is a gap of more than 2 inches between the finger and palm when making a fist, then this is considered an unfavorable position. If the gap is 2 inches or less, then it is favorable.

This second image shows the joints in each finger, numbered 1-3. There are a few special conditions where having more than one joint per finger frozen will change the rating. If the joints are not separately marked in the table, then only the fingers affected matter.

the military disability ratings of the hand

The ratings for frozen joints is detailed in the following tables:

One Finger with Frozen Joints
Two Fingers with Frozen Joints
Three Fingers with Frozen Joints
Four Fingers with Frozen Joints
Five Fingers with Frozen Joints


One Finger with Frozen Joints

Thumb

Index

Long

Ring

Little

Joint 1

Joint 2

Joint 3

Favorable

Unfavorable

Code

Ratings

Dominant

Non-dominant

x

 

 

 

 

any single joint or combination except the Joint 1 and Joint 3 combination below

x

 

5224

10%

10%

x

 

 

 

 

any single joint or combination except the Joint 1 and Joint 3 combination below

 

x

5224

20%

20%

x

 

 

 

 

x

 

x

 

x

5152

30%

20%

x

 

 

 

 

x

 

x

x

 

5224

20%

20%

 

x

 

 

 

any single joint or combination except the Joint 2 and Joint 3 combination below

both rate the same

5225

10%

10%

 

x

 

 

 

 

x

x

 

x

5153

20%

20%

 

x

 

 

 

 

x

x

x

 

5225

10%

10%

 

 

x

 

 

any single joint or combination except the Joint 2 and Joint 3 combination below

both rate the same

5226

10%

10%

 

 

x

 

 

 

x

x

 

x

5154

10%

10%

 

 

x

 

 

 

x

x

x

 

5226

10%

10%

 

 

 

x

 

any single joint or combination except the Joint 2 and Joint 3 combination below

both rate the same

5227

0%

0%

 

 

 

x

 

 

x

x

 

x

5155

10%

10%

 

 

 

x

 

 

x

x

x

 

5227

0%

0%

 

 

 

 

x

any single joint or combination except the Joint 2 and Joint 3 combination below

both rate the same

5227

0%

0%

 

 

 

 

x

 

x

x

 

x

5156

10%

10%

 

 

 

 

x

 

x

x

x

 

5227

0%

0%

 

Return to Top            Return to Frozen Joints

Two Fingers with Frozen Joints

Thumb

Index

Long

Ring

Little

Favorable

Unfavorable

Code

Ratings

Dominant

Non-dominant

x

x

 

 

 

x

 

5223

30%

20%

x

x

 

 

 

 

x

5219

40%

30%

x

 

x

 

 

x

 

5223

30%

20%

x

 

x

 

 

 

x

5219

40%

30%

x

 

 

x

 

x

 

5223

30%

20%

x

 

 

x

 

 

x

5219

40%

30%

x

 

 

 

x

x

 

5223

30%

20%

x

 

 

 

x

 

x

5219

40%

30%

 

x

x

 

 

x

 

5223

20%

20%

 

x

x

 

 

 

x

5219

30%

20%

 

x

 

x

 

x

 

5223

20%

20%

 

x

 

x

 

 

x

5219

30%

20%

 

x

 

 

x

x

 

5223

20%

20%

 

x

 

 

x

 

x

5219

30%

20%

 

 

x

x

 

x

 

5223

10%

10%

 

 

x

x

 

 

x

5219

20%

20%

 

 

x

 

x

x

 

5223

10%

10%

 

 

x

 

x

 

x

5219

20%

20%

 

 

 

x

x

x

 

5223

10%

10%

 

 

 

x

x

 

x

5219

20%

20%

 

Return to Top            Return to Frozen Joints

Three Fingers with Frozen Joints

Thumb

Index

Long

Ring

Little

Favorable

Unfavorable

Code

Ratings

Dominant

Non-dominant

x

x

x

 

 

x

 

5222

40%

30%

x

x

x

 

 

 

x

5218

50%

40%

x

x

 

x

 

x

 

5222

40%

30%

x

x

 

x

 

 

x

5218

50%

40%

x

x

 

 

x

x

 

5222

40%

30%

x

x

 

 

x

 

x

5218

50%

40%

x

 

x

x

 

x

 

5222

40%

30%

x

 

x

x

 

 

x

5218

50%

40%

x

 

x

 

x

x

 

5222

40%

30%

x

 

x

 

x

 

x

5218

50%

40%

x

 

 

x

x

x

 

5222

30%

20%

x

 

 

x

x

 

x

5218

50%

40%

 

x

x

x

 

x

 

5222

30%

20%

 

x

x

x

 

 

x

5218

40%

30%

 

x

x

 

x

x

 

5222

30%

29%

 

x

x

 

x

 

x

5218

40%

30%

 

x

 

x

x

x

 

5222

30%

20%

 

x

 

x

x

 

x

5218

40%

30%

 

 

x

x

x

x

 

5222

20%

20%

 

 

x

x

x

 

x

5218

30%

20%

 

Return to Top            Return to Frozen Joints

Four Fingers with Frozen Joints

Thumb

Index

Long

Ring

Little

Favorable

Unfavorable

Code

Ratings

Dominant

Non-dominant

x

x

x

x

 

x

 

5221

50%

40%

x

x

x

x

 

 

x

5217

60%

50%

x

x

x

 

x

x

 

5221

50%

40%

x

x

x

 

x

 

x

5217

60%

50%

x

 

x

x

x

x

 

5221

50%

40%

x

 

x

x

x

 

x

5217

60%

50%

 

x

x

x

x

x

 

5221

40%

30%

 

x

x

x

x

 

x

5217

50%

40%

 

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Five Fingers with Frozen Joints

Thumb

Index

Long

Ring

Little

Favorable

Unfavorable

Code

Ratings

Dominant

Non-dominant

x

x

x

x

x

x

 

5220

50%

40%

x

x

x

x

x

 

x

5220

60%

50%

 

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Limitation of Motion of the Fingers

For multiple fingers, rate each finger separately and then combine the ratings.the military disability ratings of the hand

Code 5228: If the thumb’s motion is limited so that it cannot get closer than 2 inches from the fingers (in a grasping motion—thumb trying to pin something between it and the fingers), then it is rated 20%. If it can get between 1 and 2 inches from the fingers, then it is rated 10%. If it can get less than 1 inch from the fingers, it is rated 0%. the military disability ratings of the hand

Code 5229: If the index or long finger can’t get more than 1 inch to the transverse crease in the palm of the hand, then it is rated 10%. If it can get within 1 inch of the crease, then it is rated 0%.

Code 5230: If the ring or little finger has any limitation of motion, it is rated 0%.

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Other Hand Conditions

Diseases that affect the hand can be found on the Diseases of the Musculoskeletal System page and cancer in the hand can be found on the Cancer and Tumors of the Musculoskeletal System page. All other hand injuries or conditions will either be rated on limitation of motion or on the condition itself. So, if you have bursitis that affects the hand, it is rated under code 5019 for bursitis. If the condition is a broken bone that didn’t heal properly, then rate it on limitation of motion.

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DBQ for Hand Conditions

Here is the Disability Benefits Questionnaire (DBQ) used for hand conditions: Hand DBQ.

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Principles that Apply

The Amputation Rule: Any ratings for the hand cannot be combined to be more than 70% for the dominant hand and 60% for the non-dominant hand.

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

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

Pyramiding: A single condition can only be rated once! However, if a nerve condition exists that is additional to the hand condition (not simply caused by it), then it can also be rated. Fingers have special treatment: If multiple fingers are limited in their functioning capacity as a result of a forearm, wrist, or hand injury, they can be rated in addition to that injury.

The Joints: When rating arthritis in the hands, all finger joints are considered minor joints.

Probative Value: If two exams record the condition differently, the exam with the most thorough data and performed by the most qualified physician 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. All ranges of motion should be measured with a goniometer. 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 muscle conditions, see The Forearm and Hand Muscles page.

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