Musculoskeletal System§ 4.71aUpdated
Rating criteria

VA Diagnostic Code 5129Thumb, index, ring and little

A single 70% rating under § 4.71a. Here is what the VA requires for it.

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  1. 70%60% non-dominant

    Thumb, index, ring and little

From the schedule

Notes on this code

These notes are part of the regulation. They change how the levels above are applied.

  • (a) The ratings for multiple finger amputations apply to amputations at the proximal interphalangeal joints or through proximal phalanges.
  • (b) Amputation through middle phalanges will be rated as prescribed for unfavorable ankylosis of the fingers.
  • (c) Amputations at distal joints, or through distal phalanges, other than negligible losses, will be rated as prescribed for favorable ankylosis of the fingers.
  • (d) Amputation or resection of metacarpal bones (more than one-half the bone lost) in multiple fingers injuries will require a rating of 10 percent added to (not combined with) the ratings, multiple finger amputations, subject to the amputation rule applied to the forearm.
  • (e) Combinations of finger amputations at various levels, or finger amputations with ankylosis or limitation of motion of the fingers will be rated on the basis of the grade of disability; i.e., amputation, unfavorable ankylosis, most representative of the levels or combinations. With an even number of fingers involved, and adjacent grades of disability, select the higher of the two grades.
  • (f) Loss of use of the hand will be held to exist when no effective function remains other than that which would be equally well served by an amputation stump with a suitable prosthetic appliance.
  • 1 Entitled to special monthly compensation.

VA Disability Rating: Multiple Finger Amputation — Thumb, Index, Ring, and Little Fingers

Diagnostic Code 5129 · 38 CFR § 4.71a · Musculoskeletal System

Understanding This Condition

This rating covers the amputation of multiple fingers on one hand — specifically the thumb, index, ring, and little fingers. When several fingers are lost, the impact on hand function can be significant, affecting the ability to grip, hold, and perform everyday tasks.

The VA rates this condition under Diagnostic Code 5129, which is part of the schedule addressing multiple finger amputations in § 4.71a.

Available Rating Level

Under this diagnostic code, the rating depends on which hand is affected:

RatingDescriptionExtremity
70%Thumb, index, ring, and little fingersDominant (major) extremity
60%Thumb, index, ring, and little fingersNon-dominant (minor) extremity

Note: This rating carries entitlement to special monthly compensation.

What the VA Looks For When Rating This Condition

The VA applies specific rules to determine how amputations of the fingers are evaluated:

  • Level of amputation matters. The ratings for multiple finger amputations apply to amputations at the proximal interphalangeal joints or through the proximal phalanges.

  • Amputation through the middle phalanges is rated as prescribed for unfavorable ankylosis of the fingers.

  • Amputations at the distal joints, or through the distal phalanges (other than negligible losses) are rated as prescribed for favorable ankylosis of the fingers.

  • Metacarpal bone loss. If more than one-half of the metacarpal bone is lost or resected in multiple finger injuries, a rating of 10 percent is added to (not combined with) the multiple finger amputation ratings, subject to the amputation rule applied to the forearm.

  • Combinations of amputations and other impairments. Combinations of finger amputations at various levels, or finger amputations along with ankylosis or limitation of motion, are rated based on the grade of disability — amputation or unfavorable ankylosis — that is most representative of the levels or combinations involved. When an even number of fingers is involved with adjacent grades of disability, the higher of the two grades is selected.

  • Loss of use of the hand is recognized when no effective function remains other than what would be equally well served by an amputation stump with a suitable prosthetic appliance.

These criteria are a rendering of § 4.71a, diagnostic code 5129. The official version is the one that governs your rating.

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What next

How to claim this

Knowing the criteria is the first half. Getting your file to show them is the second.

  1. Find your level in the stack

    Read each rung against what your medical records already say. The level your records document today is the one the VA can support today.

  2. Name the gap

    Look at the rung above yours and write down exactly what it asks for that your file does not show yet — a diagnosis, a measurement, a prescribed brace, a doctor’s opinion linking it to service.

  3. Claim it by code

    File under diagnostic code 5129 and attach the evidence for the level you are asking for. Other Musculoskeletal System codes may cover your secondary conditions.

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