Four digits of one hand, favorable ankylosis of
The VA rates Four digits of one hand, favorable ankylosis of under Diagnostic Code 5221, with separate ratings for the dominant and non-dominant arm: 40% to 50% for the dominant arm and 30% to 40% for the non-dominant arm. The applicable level depends on the full criteria below and the evidence for the condition.
Rating schedule · DC 5221 at a glance
- Dominant arm
- 40% to 50%
- Non-dominant arm
- 30% to 40%
- CFR section
- § 4.71a
- Body system
- Musculoskeletal System
- Secondary conditions
- 0
Major column of the published table
Minor column of the published table
Where this code is published
None mapped
What are the VA rating criteria for Four digits of one hand, favorable ankylosis of?
DC 5221 is rated separately for your dominant arm and your non-dominant arm. 38 CFR § 4.69 decides which arm is dominant.
Source: 38 CFR § 4.71a, eCFR as of .
Other notes printed in this table
These notes appear in the same table in 38 CFR, and their text does not name DC 5221.
- (1) For the index, long, ring, and little fingers (digits II, III, IV, and V), zero degrees of flexion represents the fingers fully extended, making a straight line with the rest of the hand. The position of function of the hand is with the wrist dorsiflexed 20 to 30 degrees, the metacarpophalangeal and proximal interphalangeal joints flexed to 30 degrees, and the thumb (digit I) abducted and rotated so that the thumb pad faces the finger pads. Only joints in these positions are considered to be in favorable position. For digits II through V, the metacarpophalangeal joint has a range of zero to 90 degrees of flexion, the proximal interphalangeal joint has a range of zero to 100 degrees of flexion, and the distal (terminal) interphalangeal joint has a range of zero to 70 or 80 degrees of flexion
- (2) When two or more digits of the same hand are affected by any combination of amputation, ankylosis, or limitation of motion that is not otherwise specified in the rating schedule, the evaluation level assigned will be that which best represents the overall disability (i.e., amputation, unfavorable or favorable ankylosis, or limitation of motion), assigning the higher level of evaluation when the level of disability is equally balanced between one level and the next higher level
- (3) Evaluation of ankylosis of the index, long, ring, and little fingers:
- (i) If both the metacarpophalangeal and proximal interphalangeal joints of a digit are ankylosed, and either is in extension or full flexion, or there is rotation or angulation of a bone, evaluate as amputation without metacarpal resection, at proximal interphalangeal joint or proximal thereto
- (ii) If both the metacarpophalangeal and proximal interphalangeal joints of a digit are ankylosed, evaluate as unfavorable ankylosis, even if each joint is individually fixed in a favorable position
- (iii) If only the metacarpophalangeal or proximal interphalangeal joint is ankylosed, and there is a gap of more than two inches (5.1 cm.) between the fingertip(s) and the proximal transverse crease of the palm, with the finger(s) flexed to the extent possible, evaluate as unfavorable ankylosis
- (iv) If only the metacarpophalangeal or proximal interphalangeal joint is ankylosed, and there is a gap of two inches (5.1 cm.) or less between the fingertip(s) and the proximal transverse crease of the palm, with the finger(s) flexed to the extent possible, evaluate as favorable ankylosis
- (4) Evaluation of ankylosis of the thumb:
- (i) If both the carpometacarpal and interphalangeal joints are ankylosed, and either is in extension or full flexion, or there is rotation or angulation of a bone, evaluate as amputation at metacarpophalangeal joint or through proximal phalanx
- (ii) If both the carpometacarpal and interphalangeal joints are ankylosed, evaluate as unfavorable ankylosis, even if each joint is individually fixed in a favorable position
- (iii) If only the carpometacarpal or interphalangeal joint is ankylosed, and there is a gap of more than two inches (5.1 cm.) between the thumb pad and the fingers, with the thumb attempting to oppose the fingers, evaluate as unfavorable ankylosis
- (iv) If only the carpometacarpal or interphalangeal joint is ankylosed, and there is a gap of two inches (5.1 cm.) or less between the thumb pad and the fingers, with the thumb attempting to oppose the fingers, evaluate as favorable ankylosis
- (5) If there is limitation of motion of two or more digits, evaluate each digit separately and combine the evaluations
What other musculoskeletal conditions does the VA rate?
These diagnostic codes sit next to Four digits of one hand, favorable ankylosis of in 38 CFR Part 4. The rating schedule is ordered anatomically, so neighbouring codes usually cover the same joint, organ, or system, and a claim often involves more than one of them.
- 5216Five digits of one hand, unfavorable ankylosis of
- 5217Four digits of one hand, unfavorable ankylosis of
- 5218Three digits of one hand, unfavorable ankylosis of
- 5219Two digits of one hand, unfavorable ankylosis of
- 5220Five digits of one hand, favorable ankylosis of
- 5222Three digits of one hand, favorable ankylosis of
- 5223Two digits of one hand, favorable ankylosis of
- 5224Thumb, ankylosis of
- 5225Index finger, ankylosis of
- 5226Long finger, ankylosis of
What to do with a Four digits of one hand, favorable ankylosis of rating
The tools, regulations and guides that pick up where the criteria above leave off.
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Common Questions About Four digits of one hand, favorable ankylosis of VA Ratings
What is the VA rating range for Four digits of one hand, favorable ankylosis of?
Dominant arm: 40% to 50%; non-dominant arm: 30% to 40%, under DC 5221, 38 CFR § 4.71a. The applicable column depends on which arm is dominant under 38 CFR § 4.69.
Which 38 CFR diagnostic code does the VA use for Four digits of one hand, favorable ankylosis of?
The VA rates Four digits of one hand, favorable ankylosis of under Diagnostic Code (DC) 5221, published in 38 CFR § 4.71a. The diagnostic code establishes the specific rating tiers and severity criteria the VA examiner applies.
What is the difference between a 40% and a 50% dominant-arm rating for Four digits of one hand, favorable ankylosis of?
These figures are the dominant-arm column of DC 5221. A 40% dominant-arm rating is published for: Index, long, ring, and little fingers. A 50% dominant-arm rating is published for: Thumb and any three fingers. The non-dominant arm is rated on its own column, 30% to 40%.
Can Four digits of one hand, favorable ankylosis of qualify for TDIU?
Using the dominant-arm maximum: DC 5221 publishes up to 50% for the dominant arm and up to 40% for the non-dominant arm. That alone does not meet the single-disability TDIU threshold of 60%. With other service-connected disabilities combining to 70% or more, one of them at 40% or more, TDIU under 38 CFR § 4.16(a) may apply, and extraschedular TDIU under § 4.16(b) is available if the condition alone prevents work regardless of rating.
What evidence supports a higher rating for Four digits of one hand, favorable ankylosis of?
The key evidence for Four digits of one hand, favorable ankylosis of is documentation of how the condition affects daily functioning. For musculoskeletal conditions, range of motion measurements (active, passive, weight-bearing, and non-weight-bearing per Correia v. McDonald) and flare-up documentation are critical. A nexus letter from a qualified medical professional linking the current severity to service is essential for contested claims.
What happens at the C&P exam for Four digits of one hand, favorable ankylosis of?
The C&P examiner uses a Musculoskeletal System DBQ and evaluates your condition against the DC 5221 rating criteria. Expect range of motion testing in multiple positions. Under Correia v. McDonald, the examiner must test active, passive, weight-bearing, and non-weight-bearing range of motion. Report your worst flare-up symptoms. If you cannot attend during a flare, request the exam be rescheduled.
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