---
title: "DC 5142 - Thumb and index"
diagnostic_code: "5142"
body_system: "Musculoskeletal System"
cfr_section: "§ 4.71a"
canonical: "https://veteranai.co/va-rating-schedule/musculoskeletal/5142-thumb-and-index"
source: "https://www.ecfr.gov/current/title-38/section-4.71a"
updated: "2026-07-21T19:31:48.277773Z"
---

# DC 5142 - Thumb and index

Rated under § 4.71a. Body system: Musculoskeletal System.

## Rating criteria

| Rating | Rating (non-dominant) | Criteria |
| --- | --- | --- |
| 50% | 40% | Thumb and index |

## Notes

- (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.

# Thumb and Index Finger Amputation (VA Diagnostic Code 5142)

**Body System:** Musculoskeletal System
**Regulation:** 38 CFR § 4.71a

## Understanding This Condition

Diagnostic Code 5142 addresses the amputation of the thumb and index finger. Because the thumb and index finger play a central role in grip, pinch, and everyday hand function, the loss of these fingers is evaluated under the VA's musculoskeletal rating schedule.

The VA recognizes that the impact of an amputation depends on which hand is affected. Ratings distinguish between the **dominant (major)** extremity and the **non-dominant (minor)** extremity.

## Available Rating Levels

| Rating | Description | Non-Dominant Extremity |
|--------|-------------|------------------------|
| 50% | Amputation of the thumb and index finger | 40% |

## What the VA Looks For

When rating amputations of the fingers, the VA follows specific rules set out in § 4.71a:

- **Level of amputation.** Ratings for multiple finger amputations apply to amputations at the proximal interphalangeal joints or through the proximal phalanges.
- **Amputations through the middle phalanges** are rated as prescribed for *unfavorable ankylosis* of the fingers.
- **Amputations at distal joints, or through the distal phalanges** — other than negligible losses — are rated as prescribed for *favorable ankylosis* of the fingers.
- **Loss of metacarpal bone.** Amputation or resection of metacarpal bones (with more than one-half the bone lost) in multiple-finger injuries requires that 10 percent be *added to* (not combined with) the ratings for multiple finger amputations, subject to the amputation rule applied to the forearm.
- **Combinations of amputation levels.** When finger amputations occur at various levels, or when amputations are combined with ankylosis or limitation of motion, the VA rates based on the grade of disability (amputation or unfavorable ankylosis) most representative of the levels involved. 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.** 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.

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*This overview is based on the VA rating schedule for Diagnostic Code 5142 under 38 CFR § 4.71a. Individual evaluations depend on the specific medical findings in each case.*

Source: https://www.ecfr.gov/current/title-38/section-4.71a