Musculoskeletal

DC 5146

Two digits of one hand (index and long), amputation of

Educational use only. Not legal or medical advice. Read 38 CFR §4.71a on eCFR
Diagnostic Code
5146
CFR Section
§4.71a — Musculoskeletal

Rating Tiers

40%
major

Dominant hand.

30%
minor

Non-dominant hand.

Rated Under Formula

This condition is rated using the §4.71a general rating formula.

What Raters Look For

Based on M21-1 adjudication criteria for Musculoskeletal conditions. These are the factors a VA rater evaluates when assigning a rating percentage.

M21-1 III.iv.4.A
  • •Range of motion measurements in degrees for each affected joint, recorded on examination
  • •Pain on motion — whether pain limits motion before the normal end point is reached
  • •Functional loss — specific activities the Veteran cannot perform due to the condition
  • •Flare-up history: how often they occur, how severe, and how long they last (Veteran's statement counts)
  • •Effects of repetitive motion (whether additional loss of motion occurs after repeated use)
  • •Muscle atrophy, guarding, or tenderness noted on physical exam
  • •Whether ankylosis (complete fixation) is present and in a favorable or unfavorable position
  • •Imaging findings: X-ray, MRI, or CT reports noting bone/joint changes
NoteRaters must consider functional loss from pain even if range of motion appears near-normal. A lay statement describing flare-ups carries evidentiary weight.