Musculoskeletal System§ 4.71aUpdated
Rating criteria

VA Diagnostic Code 5144Thumb and ring

A single 50% rating under § 4.71a. Here is what the VA requires for it.

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  1. 50%40% non-dominant

    Thumb and ring

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 and Ring Finger (Diagnostic Code 5144)

Body System: Musculoskeletal System Regulation: 38 CFR § 4.71a — Diagnostic Code 5144


Understanding This Condition

Diagnostic Code 5144 addresses the amputation of two specific fingers on the same hand: the thumb and the ring finger. Because these amputations affect more than one finger, the VA rates them under a framework designed specifically for multiple finger amputations.

The VA recognizes that the impact of a finger amputation depends on where the amputation occurs along the finger, and whether the dominant (major) or non-dominant (minor) hand is affected.


Available Rating Levels

Under Diagnostic Code 5144, the rating for amputation of the thumb and ring finger is:

ConditionDominant (Major) HandNon-Dominant (Minor) Hand
Thumb and ring50%40%

The rating depends on whether the affected hand is your dominant or non-dominant extremity.


What the VA Looks For

When rating amputations of the thumb and ring finger, the VA applies several specific rules:

  • Level of amputation matters. The multiple finger amputation ratings 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.

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

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

  • Combinations of amputations at different levels, or amputations combined with ankylosis or limitation of motion, are rated based on the grade of disability (amputation or unfavorable ankylosis) that most closely represents the overall level of impairment. When an even number of fingers is involved with adjacent grades of disability, the VA selects the higher of the two grades.

  • Loss of use of the hand is considered to exist when no effective function remains other than what would be equally 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 medical facts of each case.

These criteria are a rendering of § 4.71a, diagnostic code 5144. 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 5144 and attach the evidence for the level you are asking for. Other Musculoskeletal System codes may cover your secondary conditions.

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