Elbow Condition C&P Exam

Inside the exam room

1. You will be asked which elbow is affected and which hand you use most. Explain injury, treatment, and trouble lifting, carrying, or turning tools.

2. You will be asked to bend and straighten your elbow and turn your palm up and down. Each movement is measured separately. Tell the examiner about pain or unsafe movement.

3. You may be asked to repeat movements if safe. Explain weakness, tiredness, hand symptoms, and what changes after activity or on worse days.

The examiner measures joint movement with a goniometer (angle-measuring tool).

How VA rates elbow condition

Explain problems bending or straightening the elbow and turning the palm up or down. The examiner measures each movement separately and records which arm is affected. VA rates elbow fixed in position (ankylosis), bending the elbow (flexion), straightening the elbow (extension), bone impairment, and turning the palm up (supination)/turning the palm down (pronation) under 38 CFR § 4.71a, DCs 5205–5213. Several percentages differ for the major/dominant and minor arm.

Plate I: bending the elbow (flexion) 0–145°; forearm turning the palm down (pronation) 0–80°; turning the palm up (supination) 0–85°.

What each rating percentage means

Match the whole description with your exam and records. A single symptom or illustration does not decide your rating.

Rating	What the rule requires
0–50%	Bending (DC 5206), dominant / other arm: 110° = 0% / 0%; 100° = 10% / 10%; 90° = 20% / 20%; 70° = 30% / 20%; 55° = 40% / 30%; 45° = 50% / 40%.
10–50%	Straightening (DC 5207), degrees short of straight, dominant / other arm: 45° or 60° = 10% / 10%; 75° = 20% / 20%; 90° = 30% / 20%; 100° = 40% / 30%; 110° = 50% / 40%.
20%	DC 5208: bending the elbow (flexion) limited to 100° and straightening the elbow (extension) to 45°
10–40%	DC 5213: loss or limitation of turning the palm up (supination)/turning the palm down (pronation)
30–60%	DC 5205: favorable through unfavorable elbow fixed in position (ankylosis), based on side

Check these details in your records

The examiner uses a condition form called a Disability Benefits Questionnaire (DBQ). Compare these items with your own records and explain what actually happens in daily life.

Forearm bending the elbow (flexion) limited to 100 degrees10%DC 5206
Forearm bending the elbow (flexion) limited to 90 degrees20%DC 5206
Forearm straightening the elbow (extension) limited to 60 degrees10%DC 5207
Bending the elbow (flexion) limited to 100 degrees and straightening the elbow (extension) limited to 45 degrees20%DC 5208
Turning the palm up (supination) limited to 30 degrees or less10%DC 5213
Favorable elbow fixed in position (ankylosis), dominant arm40%DC 5205

What may happen in the exam room

Angle-measuring tool (goniometer) bending the elbow (flexion) and straightening the elbow (extension)
Turning the palm down (pronation) and turning the palm up (supination) measurement
The examiner asks you to repeat a movement to see what changes
The examiner checks strength, tenderness, whether the joint gives way, and scars

What the measurements tell you

Where pain begins
What changes after doing the movement several times
Whether the affected arm is the one you use most
Whether finger movement is also impaired

Questions the examiner may cover

Do you usually use your right or left arm?
What lifting, carrying, pushing, or rotation is limited?
Do symptoms travel into the hand?
What changes after doing a task several times?

Questions to expect

What stops bending, straightening or palm rotation?

Explain: Name the side and dominant hand. Describe lifting, carrying and turning tools, including flare and repetition limits.

Rating connection: Flexion, extension and forearm rotation have different tables, with handedness affecting several rows.

Is fixation or a bone injury recorded?

Explain: Identify fracture, surgery, aid use and existing clinical findings.

Rating connection: Fixed joints and radius or ulna injuries use requirements separate from ordinary limited motion.

Your answer outline

My [side] elbow causes [actual symptom] when I [task]. I can manage [amount or time] before [change]. I then [adjustment or recovery]. This happens [frequency], and I am [right/left]-handed.

Mark approximate dates and counts as estimates.

My notes: ________________________

Service connection records

1. How is this connected to your service?

For a direct claim, identify your current disability, what happened in service, and evidence linking them. Being on active duty or orders alone does not prove that link.

Write the 5 Ws and how: who was there; what happened; when; where; why you were there; how the problem began. Add duty status, treatment, witnesses, and records. Mark uncertain dates as estimates.
Guard or Reserve: find your orders, dates, duty type, and any line-of-duty records. Active duty, training, and drills have different rules.
Secondary condition: it may start after service. Identify the service-connected condition and evidence that it caused or worsened this problem. A medical opinion may help explain the link.
Started before service? Record what changed during service. Presumptive condition? Check the required diagnosis and service history; qualifying claims do not require separate proof of a link.
Already service connected and seeking an increase? Focus on what has worsened and the records showing it.

If you do not know the cause, say so. Do not guess a medical connection.

Explain what changes in daily life

Describe both what you can do and what becomes difficult. Include how often it happens and how long it lasts.

Describe the angle or task where pain begins.
Explain limits turning a doorknob, using tools, lifting, or carrying.
Describe flare duration and recovery.

Common mistakes to avoid

Ignoring turning the palm down (pronation)/turning the palm up (supination) limits
Not identifying the dominant arm
Combining nerve or finger symptoms without identifying them

Records to get ready before the exam

Elbow and Forearm Conditions DBQ
Imaging and surgical records
Therapy movement and strength measurements
Brace records

Preparation notes

Tell the examiner where pain begins and where movement stops so they can record both.
Do not force movement to change the result. Follow the examiner’s instructions.

Pain, repeated use, and worse periods

Loss of ability to use the affected body part: Explain painful motion, weakness, fatigue, and what becomes harder during worse periods under 38 CFR §§ 4.40, 4.45, and 4.59.

Official rating rule and code numbers

Use this source to check the full rule and its medical terms: 38 CFR 4.71a, DCs 5205-5213. Source review recorded 2026-09-04.

Could one health problem have caused another?

A condition VA has already linked to your service may cause another health problem or make it worse. VA calls this secondary service connection. Having both conditions does not prove the link. Your records need to show a current diagnosis and explain how the first condition or its treatment affected the second.

Start with your records. Find the current diagnosis, the condition VA already linked to service, and evidence from someone qualified to explain the connection.
Ask about cause and worsening. Did the first condition or its treatment cause the new disability, or make an existing disability worse? These are different questions. The rules call them causation under 38 CFR § 3.310(a) and aggravation under § 3.310(b). If both are raised by your records, the medical opinion should address both; answering only the cause question may not be enough (El-Amin).
If treatment may be involved, collect the dates. List the medicine or surgery prescribed for the condition VA linked to service, the side effect, and the new diagnosis. Bring pharmacy records and dates when treatment started or stopped. A provider must explain the connection in your case; taking a medicine alone does not prove it.
If weight gain may be involved, ask how it fits. Weight gain or obesity can be a step between the first condition and another diagnosed disability under VAOPGCPREC 1-2017. Obesity itself does not receive a VA disability rating.
You do not need absolute certainty. VA uses the “at least as likely as not” standard and the reasonable-doubt rule under 38 CFR § 3.102. Ask a VA-accredited representative how the evidence applies to your claim.
The same symptom cannot be counted twice. This is the rule against pyramiding in 38 CFR § 4.14. Mental-health diagnoses generally share one § 4.130 rating when they affect the same work and social abilities. Trouble sleeping may be a symptom rather than a separate disability.
Check whether VA already assumes a link to service. Some conditions qualify based on where or when you served. These are called presumptive conditions. Examples can include chronic rhinitis, chronic sinusitis, hypertension after qualifying herbicide exposure, and type 2 diabetes. Sleep apnea (OSA) is not a PACT Act presumptive. Check eligibility before seeking a medical opinion about the link.
An exam form and a medical opinion do different jobs. A Disability Benefits Questionnaire (DBQ) records the diagnosis and how severe it is. It may not explain why it is linked to service, often called a nexus. A VA-accredited veterans service organization (VSO) can help you file at no charge.

If another prescribed treatment may have caused a problem, ask your health care provider to record what happened and explain the connection in your case.

Sources: 38 CFR § 3.310 · 38 CFR § 4.14 · VA-accredited representatives

C&P exam for elbow condition: what to expect and how VA rates it.