Musculoskeletal System§ 4.71aUpdated
Rating criteria

VA Diagnostic Code 5221Four digits of one hand, favorable ankylosis of

Rated from 40% to 50% under § 4.71a. Here is what the VA requires at each level.

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  1. 50%40% non-dominant

    Thumb and any three fingers

  2. 40%30% non-dominant

    Index, long, ring, and little fingers

Favorable Ankylosis of Four Digits of One Hand (VA Diagnostic Code 5221)

Understanding This Condition

Diagnostic Code 5221 covers favorable ankylosis of four digits of one hand. Ankylosis is the stiffening or fixation of a joint, meaning the affected digits can no longer move freely. "Favorable" ankylosis refers to a joint that is fixed in a more functional position compared to unfavorable ankylosis.

This condition falls under the Musculoskeletal System and is rated under § 4.71a of the VA rating schedule.

Available Rating Levels

The VA assigns a disability rating based on which combination of four digits is affected. Ratings differ depending on whether the affected hand is your dominant (major) or non-dominant (minor) extremity.

Rating (Dominant Hand)Rating (Non-Dominant Hand)Digits Affected
50%40%Thumb and any three fingers
40%30%Index, long, ring, and little fingers

What the VA Looks For

When evaluating this condition, the VA considers:

  • Which four digits of the hand are affected by favorable ankylosis — specifically, whether the combination includes the thumb and any three fingers, or the index, long, ring, and little fingers.
  • Whether the affected hand is your dominant or non-dominant (major or minor) extremity, as this directly affects the assigned rating percentage.

Each situation is evaluated individually according to the criteria set out in the VA rating schedule.

These criteria are a rendering of § 4.71a, diagnostic code 5221. 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 5221 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.

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