Musculoskeletal System§ 4.71aUpdated
Rating criteria

VA Diagnostic Code 5134Thumb, index and little

A single 60% rating under § 4.71a. Here is what the VA requires for it.

View official source

Not the right code?

The ladder

What each rating requires

The VA assigns the highest level your evidence actually supports. Read up the stack until your records stop matching.

  1. 60%50% non-dominant

    Thumb, index 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.

VA Disability Rating: Amputation of the Thumb, Index, and Little Fingers (Diagnostic Code 5134)

Under 38 CFR § 4.71a, the VA rates disabilities of the Musculoskeletal System. Diagnostic Code 5134 addresses the combined amputation of the thumb, index, and little fingers.

Understanding This Condition

This rating applies to a specific combination of multiple finger amputations involving the thumb, index finger, and little finger. Because the hand relies on the coordinated function of its fingers, the loss of these particular digits is evaluated together under a single diagnostic code.

The VA uses specific rules to determine how different amputation levels and related conditions are measured and rated.

Available Rating Levels

RatingCriteriaNon-Dominant (Minor) Extremity
60%Thumb, index and little50%

The rating differs depending on whether the affected hand is your dominant or non-dominant (minor) extremity.

What the VA Looks For

When evaluating amputations of the thumb, index, and little fingers, the VA applies the following rules:

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

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

  • Amputation at distal joints or through distal phalanges. Other than negligible losses, these are rated as prescribed for favorable ankylosis of the fingers.

  • Loss of metacarpal bones. Amputation or resection of metacarpal bones (more than one-half the bone lost) in multiple finger injuries requires a rating of 10 percent added to (not combined with) the multiple finger amputation ratings, subject to the amputation rule applied to the forearm.

  • Combinations of amputation levels. 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, unfavorable ankylosis) 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. Loss of use is considered 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.


This information is drawn directly from the VA rating schedule under 38 CFR § 4.71a. Individual ratings depend on the specific findings in your case.

These criteria are a rendering of § 4.71a, diagnostic code 5134. The official version is the one that governs your rating.

View official source
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 5134 and attach the evidence for the level you are asking for. Other Musculoskeletal System codes may cover your secondary conditions.

Find out which rating your evidence supports.

Six reads your records against these exact criteria and tells you what the VA is still missing.

Start for freeAll 159 Musculoskeletal System codes