Musculoskeletal System§ 4.71aUpdated
Rating criteria

VA Diagnostic Code 5218Three digits of one hand, unfavorable ankylosis of

Rated from 30% to 50% under § 4.71a. Here is what the VA requires at each level.

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What each rating requires

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  1. 50%40% non-dominant

    Thumb and any two fingers

  2. 40%30% non-dominant

    Index, long, and ring; index, long, and little; or index, ring, and little fingers

  3. 30%20% non-dominant

    Long, ring, and little fingers

From the schedule

Notes on this code

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

  • Note: Also consider whether evaluation as amputation is warranted.

Unfavorable Ankylosis of Three Digits of One Hand (Diagnostic Code 5218)

Musculoskeletal System · 38 CFR § 4.71a

Understanding This Condition

Ankylosis refers to the stiffening or fixation of a joint, meaning the affected digits can no longer move freely. Under Diagnostic Code 5218, the VA addresses unfavorable ankylosis of three digits of one hand — a condition affecting hand function when three fingers (or a thumb and two fingers) become fixed in position.

Because hand use often depends on which hand is affected, the VA distinguishes between the dominant (major) hand and the non-dominant (minor) hand. Ratings for the non-dominant hand are listed separately below.

Available Rating Levels

The following rating levels apply under Diagnostic Code 5218:

Rating (Dominant Hand)Rating (Non-Dominant Hand)Which Digits Are Affected
50%40%Thumb and any two fingers
40%30%Index, long, and ring; index, long, and little; or index, ring, and little fingers
30%20%Long, ring, and little fingers

What the VA Looks For

When evaluating this condition, the VA considers:

  • Which three digits are affected, since the combination of digits determines the applicable rating level.
  • Whether the affected hand is the dominant or non-dominant extremity, as this changes the assigned percentage.
  • Whether the ankylosis is unfavorable, which is the specific type of joint fixation addressed by this diagnostic code.

Additional Consideration

Note: The VA will also consider whether an evaluation as amputation is warranted, depending on the circumstances of the condition.


This information is drawn directly from the VA rating schedule under 38 CFR § 4.71a, Diagnostic Code 5218. Individual ratings depend on the specifics of your condition as evaluated by the VA.

These criteria are a rendering of § 4.71a, diagnostic code 5218. 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 5218 and attach the evidence for the level you are asking for. Other Musculoskeletal System codes may cover your secondary conditions.

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