---
title: "DC 5146 - Index and long"
diagnostic_code: "5146"
body_system: "Musculoskeletal System"
cfr_section: "§ 4.71a"
canonical: "https://veteranai.co/va-rating-schedule/musculoskeletal/5146-index-and-long"
source: "https://www.ecfr.gov/current/title-38/section-4.71a"
updated: "2026-07-21T19:33:40.974325Z"
---

# DC 5146 - Index and long

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

## Rating criteria

| Rating | Rating (non-dominant) | Criteria |
| --- | --- | --- |
| 40% | 30% | Index and long |

## 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.

# Amputation of the Index and Long Fingers (Diagnostic Code 5146)

## Understanding This Rating

Diagnostic Code 5146 addresses the amputation of the **index and long fingers**. It falls under the **Musculoskeletal System** and is evaluated under **38 CFR § 4.71a**.

This entry is part of the VA's rating schedule for multiple finger amputations. The VA recognizes that the loss of these fingers can affect the function of the hand, and ratings differ depending on whether the affected hand is your dominant (major) or non-dominant (minor) hand.

## Available Rating Levels

| Rating | Description |
|--------|-------------|
| **40%** | Index and long fingers (dominant extremity) |
| **30%** | Index and long fingers (non-dominant extremity) |

The higher rating applies when the amputation involves the dominant hand; the lower rating applies to the non-dominant hand.

## What the VA Looks For

When evaluating amputations of the index and long fingers, the VA considers the following principles:

- **Level of amputation.** The ratings for multiple finger amputations apply to amputations **at the proximal interphalangeal joints or through the proximal phalanges**.

- **Amputation through middle phalanges** is rated as prescribed for **unfavorable ankylosis** of the fingers.

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

- **Loss of metacarpal bone.** If more than one-half of a metacarpal bone is lost or resected in multiple finger injuries, an additional **10 percent** is added to (not combined with) the multiple finger amputation rating — subject to the amputation rule applied to the forearm.

- **Combinations of levels or conditions.** When finger amputations occur at various levels, or amputations are combined with ankylosis or limitation of motion, the VA rates based on the **grade of disability** (amputation or unfavorable ankylosis) that is most representative of the levels or combinations involved. Where an even number of fingers is involved and the grades of disability are adjacent, the **higher** of the two grades is selected.

- **Loss of use of the hand.** This 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 information is drawn from the VA rating schedule under 38 CFR § 4.71a and is provided for general educational purposes. Individual ratings depend on the specific facts of each case.*

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