Hand and Fingers
38 CFR § 4.71a — Musculoskeletal System
Diagnostic Codes
5152–5230
Why your DC matters: The VA uses a complex set of codes (5152–5230) for the hand and fingers. Ratings can be based on amputation, fusion (ankylosis), or restricted motion. Your specific code determines which finger is affected and what functional loss is required.
⚠️ Are You Potentially Under-Rated? Self-Check
If you have finger issues and any of these apply, you may have grounds for an increase:
- ☐ Your finger is fused (ankylosis) and cannot move at all. (10% to 70% depending on the number and location)
- ☐ You have lost a portion of a finger (amputation). (10% to 70% based on which bones are missing)
- ☐ Your grip strength is significantly reduced compared to your other hand.
- ☐ You have painful motion (10% minimum per affected joint/finger, though rules on combining vary).
Note: Hand and finger ratings are some of the most complex in the CFR. Multiple fingers can be combined for higher ratings.
Official VA Rating Criteria — Hand/Fingers (Examples)
| Rating | VA Criteria (Selected Examples) | Key Evidence at This Level |
|---|---|---|
| 70%* | Loss of use of both hands; or Amputation of all five fingers on one hand. | Surgical or trauma records confirming amputation or total functional loss. |
| 30%* | Amputation of thumb and index finger (dominant). Or Ankylosis of three or more fingers (dominant). | Imaging and physical exam confirming fusion or absence of digits. |
| 10%* | Ankylosis or limitation of motion of a single finger (dominant thumb or index finger). Also: Painful motion. | Medical notes documenting pain or specific degree of fusion/restriction. |
*Ratings vary significantly based on which finger(s) are involved and whether they are on the Dominant hand. Non-Dominant ratings are usually lower.
Source: 38 CFR § 4.71a, Diagnostic Codes 5152–5230
Key Terms Defined
Ankylosis
The total loss of movement in a joint (fusion). For fingers, the VA rates this based on whether it is fused in a "position of function" or an "unfavorable position."
Loss of Use
When a finger or hand remains physically attached but is as functionally useless as if it were amputated. This can lead to a rating equal to amputation.
Dominant vs. Non-Dominant
The VA provides higher ratings for injuries to the dominant hand (usually right, unless left-handedness is documented). Ensure your records correctly reflect your handedness.
Service Connection Paths
🎯 Direct Service Connection
Hand/finger injury occurred during service (blast, crush injury, frostbite, repetitive strain). Records must show an in-service incident and current diagnosis.
🔗 Secondary Service Connection
Finger issues caused by nerve damage (like Carpal Tunnel), rheumatoid arthritis (service-connected elsewhere), or even a wrist injury causing loss of finger function.
Secondary Conditions to Pursue if You Have Service-Connected Hand Issues
Functional loss in the hand often leads to compensation elsewhere.
Wrist Strain / Tendonitis
DC 5215StrongUsing the wrist to compensate for poor finger grip/motion.
Elbow Strain (Epicondylitis)
DC 5206StrongForearm muscles overworking to assist a weakened hand/grip.
Shoulder Issues
DC 5201ModerateAltered arm mechanics when reaching or lifting due to hand impairment.
Opposite Hand Overuse
DC 5215ModerateOverusing the "good" hand due to impairment of the service-connected hand.
Already Service-Connected for These? Hand/Fingers May Qualify as a Secondary
If you have service connection for any of the following, your hand/finger condition may be claimable as a secondary.
Carpal Tunnel Syndrome
DC 8515Ulnar Nerve Neuropathy
DC 8516Radial Nerve Neuropathy
DC 8514Raynaud's Phenomenon
DC 7117Cervical Spine (Neck)
DC 5237Special Considerations
Bilateral Factor
Injuries to both hands (bilateral) receive an extra 10% weight in the combined rating calculation.
Multiple Fingers
The VA allows for combining finger ratings on a single hand up to the level of amputation for those fingers. This "multi-finger" rating is often higher than individual ratings.
Grip Strength
While not its own rating, significantly reduced grip strength is used as evidence of functional loss and can justify a higher rating for limitation of motion or "loss of use."
Evidence Map — What Unlocks Each Rating
- • Medical evidence of fusion or pain in a single key finger
- • ROM results showing restricted bending of a single digit
- • Documentation showing three or more fingers affected
- • Imaging confirming amputation or fusion of thumb + index
- • Specialist notes on loss of pinch or fine motor skills
What Leads to Lower Ratings or Denials
- Failing to specify which joint (MCP, PIP, DIP) of the finger is affected.
- Ignoring "Loss of Use" — the finger is there, but doesn't work.
- Dominance not recorded — if you are left-handed but the rater assumes right, your rating might be lower.
- Not accounting for "Functional Loss" like cold sensitivity or inability to type/write.
Next Steps
Hand claims are technical. If you believe your hand is under-rated:
- Get an Occupational Therapy (OT) evaluation for grip strength and fine motor skills
- Identify every joint of every finger that is affected (don't just say "my hand hurts")
- Consider whether your hand issues are actually a symptom of a nerve condition (Cervical Spine or Carpal Tunnel)
This is general educational information only — not legal or medical advice.
Source: 38 CFR § 4.71a, Diagnostic Codes 5152–5230 • va.gov
⚠️ Important Disclaimer
This page provides general educational information only based on public VA regulations (38 CFR) and va.gov resources. It is not legal, medical, or claims assistance. Ratings and service connections are decided case-by-case by the VA based on the individual veteran’s evidence. We do not prepare claims, generate documents, or provide personalized advice. Always consult a VA-accredited Veterans Service Organization (VSO), attorney, or your physician for help with your specific situation. Verify the latest rules on va.gov.