Musculoskeletal System§ 4.71aUpdated
Rating criteria

VA Diagnostic Code 5228Thumb, limitation of motion

Rated from 0% to 20% 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. 20%20% non-dominant

    With a gap of more than two inches (5.1 cm.) between the thumb pad and the fingers, with the thumb attempting to oppose the fingers

  2. 10%10% non-dominant

    With a gap of one to two inches (2.5 to 5.1 cm.) between the thumb pad and the fingers, with the thumb attempting to oppose the fingers

  3. 0%0% non-dominant

    With a gap of less than one inch (2.5 cm.) between the thumb pad and the fingers, with the thumb attempting to oppose the fingers

Thumb, Limitation of Motion (VA Diagnostic Code 5228)

Understanding This Rating

Body System: Musculoskeletal System Regulation: 38 CFR § 4.71a — Diagnostic Code 5228

Limitation of motion of the thumb affects how well the thumb can move and function — specifically, its ability to reach across the hand toward the fingers. The thumb plays a central role in gripping, pinching, and handling objects, so reduced motion can impact everyday activities.

Under this diagnostic code, the VA measures how far the thumb can move when it attempts to touch (oppose) the fingers. The rating is based on the size of the gap between the thumb pad and the fingers during this movement.

Available Rating Levels

The VA assigns one of the following disability ratings based on the measured gap. These ratings apply to both the dominant and non-dominant (minor) hand.

RatingWhat It Reflects
20%A gap of more than two inches (5.1 cm) between the thumb pad and the fingers, with the thumb attempting to oppose the fingers
10%A gap of one to two inches (2.5 to 5.1 cm) between the thumb pad and the fingers, with the thumb attempting to oppose the fingers
0%A gap of less than one inch (2.5 cm) between the thumb pad and the fingers, with the thumb attempting to oppose the fingers

For this diagnostic code, the rating percentages are the same whether the affected thumb is on the dominant or non-dominant (minor) extremity.

What the VA Looks For

When rating thumb limitation of motion under Diagnostic Code 5228, the VA focuses on:

  • The gap distance between the thumb pad and the fingers when the thumb attempts to oppose (reach toward) the fingers.
  • The measurement of that gap, expressed in inches and centimeters, which determines which of the three rating levels applies.

The larger the gap when the thumb tries to touch the fingers, the higher the assigned rating.

These criteria are a rendering of § 4.71a, diagnostic code 5228. 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 5228 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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