Inside the exam room
1. You will be asked which wrist is affected and which hand you use most. Explain injury, surgery, braces, and trouble typing, lifting, using tools, or pushing up from a chair.
2. You will be asked to bend the wrist backward, toward the palm, toward the thumb, and toward the little finger. Tell the examiner about pain, unsafe movement, or a wrist that cannot move.
3. You may be asked to repeat movements if safe. Explain what changes during typing or gripping, on worse days, and with prescribed support.
The examiner measures joint movement with a goniometer (angle-measuring tool).
How VA rates wrist condition
Explain limits on gripping, lifting, and moving the wrist. The examiner checks bending in each direction and whether the wrist is fixed in position. VA rates wrist fixed in position (ankylosis) under 38 CFR § 4.71a, DC 5214 and limitation of motion under DC 5215. A joint or spine fixed in position (ankylosis) percentages differ for the major/dominant and minor wrist.
Plate I: bending the wrist backward (dorsiflexion) 0–70°, bending the wrist toward the palm (palmar flexion) 0–80°, bending toward the little-finger side (ulnar deviation) 0–45°, bending toward the thumb side (radial deviation) 0–20°.
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 |
|---|---|
| 10% | DC 5215: bending the wrist backward (dorsiflexion) less than 15° or bending the wrist toward the palm (palmar flexion) limited in line with forearm, either wrist |
| 20–50% | DC 5214: a wrist fixed in position, classified as favorable through unfavorable ankylosis, based on the position and whether it affects the hand you use most |
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.
- Wrist bending the wrist backward (dorsiflexion) less than 15 degrees10%DC 5215
- Bending the wrist toward the palm (palmar flexion) limited in line with the forearm10%DC 5215
- Favorable wrist fixed in position (ankylosis) at 20 to 30 degrees bending the wrist backward (dorsiflexion), dominant hand30%DC 5214
- Unfavorable wrist fixed in position (ankylosis), dominant hand50%DC 5214
What may happen in the exam room
- Angle-measuring tool (goniometer) movement in four directions
- The examiner checks you moving the wrist, moves it for you, and asks you to repeat movements
- They check your grip and ability to handle small objects
- They check whether the wrist is stuck in one position (ankylosis), swollen, scarred, or has signs of a nerve problem
What the measurements tell you
- Bending the wrist backward (dorsiflexion) and bending the wrist toward the palm (palmar flexion)
- Bending toward the thumb side and the little-finger side
- Where pain begins and what changes after doing the movement several times
- Whether the affected wrist is on the side you use most
Questions the examiner may cover
- Which wrist and which hand is dominant?
- How do symptoms affect lifting, typing, tools, or push-off?
- Do braces or splints help?
- What happens after repetitive use?
Questions to expect
How far does the wrist bend, and is it fixed?
Explain: Identify the side and dominant hand, pain onset, typing or lifting limits, flares and any recorded fixation.
Rating connection: DC 5215 limited motion and DC 5214 ankylosis are distinct pathways; fixed-wrist position and handedness can matter.
What happens after repeated use?
Explain: Describe time, tasks, rests and treatment response. The examiner records movement and functional loss.
Rating connection: Painful motion and repeated-use findings are considered with the applicable joint rule; pain is not an added percentage on top of it.
Your answer outline
My [side] wrist is affected, and I am [right/left]-handed. During [task or movement], I feel [actual symptom]. After [time or repetition], I [change in activity]. [Brace, treatment, or adjustment] has [actual effect].
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 motion that first causes pain.
- Explain grip and weight-bearing limits.
- Describe flare how often it happens and how long it lasts.
Common mistakes to avoid
- Forcing movement despite the examiner’s safety instructions
- Omitting the dominant side
- Failing to separate wrist symptoms from hand or nerve symptoms
Records to get ready before the exam
- Wrist Conditions DBQ
- Imaging and orthopedic records
- Brace prescription
- Therapy ROM and grip measurements
Preparation notes
- Bring the brace you normally use.
- Describe actual daily limits without forcing movement.
Pain, repeated use, and worse periods
Painful motion: Report where pain begins, 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 5214-5215. 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
Other health problems to ask about
Use these notes to ask your provider about problems you already have. Your records must explain the connection. VA decides whether the condition is linked to service.
If the wrist injury or its treatment left a scar, bring the treatment records. Show where it hurts or keeps breaking open. The examiner should record effects that are separate from the wrist movement problem.
Sources: VA wrist exam form · VA scar rating rules
A wrist fracture, arthritis, or swelling can put pressure on the median nerve. If carpal tunnel syndrome is diagnosed, bring the wrist and nerve records. Ask your provider whether the wrist problem caused it or made it worse. The same symptoms cannot be counted twice.
Sources: NIH: carpal tunnel syndrome
Choose the related health problems you want to discuss. Your preparation packet will include the notes you select and the full condition guides available for them.