- Diagnostic Code
- 5228
- CFR Section
- §4.71a — Musculoskeletal
Rating Tiers
20%
With 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
10%
With a gap of one to two inches (2.5 to 5.1 cm.) between the thumb pad and the fingers, with the thumb attempting to oppose the fingers
0%
With a gap of less than one inch (2.5 cm.) between the thumb pad and the fingers, with the thumb attempting to oppose the fingers
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.