How VA rates finger and thumb conditions
VA rates single and multiple digit ankylosis and limitation under 38 CFR § 4.71a, DCs 5216–5230. Major/dominant versus minor hand matters for many ankylosis combinations, while DCs 5228–5230 use the same percentages for either hand.
For digits II–V: MCP flexion 0–90°, PIP flexion 0–100°, and DIP flexion 0–70 or 80° under the schedule notes.
Rating criteria from the tool data
| Rating | What VA looks for |
|---|---|
| 10/20% | DC 5228: thumb opposition gap of 1–2 inches or more than 2 inches |
| 0/10% | DC 5229: index/long fingertip gap or extension lag thresholds |
| 0% | DC 5230: any limitation of ring or little finger motion |
| 0–60% | DCs 5216–5227: single or multiple digit ankylosis; combinations and dominant/minor hand control the percentage |
DBQ and symptom topics to review
Review these topics against your own records and symptoms. Do not exaggerate or minimize; describe functional impact accurately.
- Thumb opposition gap of 1 to 2 inches10%DC 5228
- Thumb opposition gap greater than 2 inches20%DC 5228
- Index or long finger gap at least 1 inch, or extension limited more than 30 degrees10%DC 5229
- Any limitation of ring or little finger motion0%DC 5230; other functional effects may still require review
- Unfavorable thumb ankylosis20%DC 5224
- Unfavorable ankylosis of all five digits of the dominant hand60%DC 5216
What may happen in the exam room
- Goniometer measurement of each affected joint
- Thumb-to-finger opposition
- Fingertip-to-proximal-transverse-crease measurement
- Extension-lag measurement
- Grip, pinch, dexterity, and repetitive-use testing
Measurements and findings to understand
- Thumb pad gap in inches/centimeters
- Fingertip gap to the proximal transverse crease of the palm
- Extension lag in degrees
- Whether one or multiple digits are ankylosed
- Dominant versus nondominant hand
Questions the examiner may cover
- Which fingers and joints are affected?
- Can the thumb oppose each fingertip?
- Can the fingers reach the palm crease?
- How do symptoms affect grip and fine manipulation?
- Which hand is dominant?
Functional-impact language to think through
Use plain, truthful wording that matches your records and daily limitations. These examples are prompts for accuracy, not scripts.
- Identify the measured gap or extension limit if it is documented.
- Describe buttoning, typing, tool use, writing, and opening containers.
- Explain how repetition changes motion or grip.
Common mistakes to avoid
- Not identifying each digit
- Ignoring dominant versus nondominant hand
- Reporting grip loss without measured digit motion
Evidence to organize before the exam
- Hand and Finger Conditions DBQ
- Therapy ROM and grip measurements
- Imaging and surgical records
- Photos of fixed positioning or swelling during flares
Preparation notes
- Let the examiner measure each affected digit.
- Do not force a finger to the palm through pain.
DeLuca and flare-up notes
Functional loss: Describe painful motion, weakness, fatigue, and loss after repetition or during flare-ups under 38 CFR §§ 4.40, 4.45, and 4.59.
Official rating source
38 CFR 4.71a, DCs 5216-5230. Checked 2026-09-04. Educational preparation only; not a personal rating.