---
title: "DC 5213 - Supination and pronation, impairment of:"
diagnostic_code: "5213"
body_system: "Musculoskeletal System"
cfr_section: "§ 4.71a"
canonical: "https://veteranai.co/va-rating-schedule/musculoskeletal/5213-supination-and-pronation-impairment-of"
source: "https://www.ecfr.gov/current/title-38/section-4.71a"
updated: "2026-07-21T19:48:18.936137Z"
---

# DC 5213 - Supination and pronation, impairment of:

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

## Rating criteria

| Rating | Rating (non-dominant) | Criteria |
| --- | --- | --- |
| 40% | 30% | Loss of (bone fusion): The hand fixed in supination or hyperpronation |
| 30% | 20% | Loss of (bone fusion): The hand fixed in full pronation |
| 20% | 20% | Loss of (bone fusion): The hand fixed near the middle of the arc or moderate pronation |
| 30% | 20% | Limitation of pronation: Motion lost beyond middle of arc |
| 20% | 20% | Limitation of pronation: Motion lost beyond last quarter of arc, the hand does not approach full pronation |
| 10% | 10% | Limitation of supination: To 30° or less |

## Notes

- Note: In all the forearm and wrist injuries, codes 5205 through 5213, multiple impaired finger movements due to tendon tie-up, muscle or nerve injury, are to be separately rated and combined not to exceed rating for loss of use of hand.

# Impairment of Supination and Pronation (VA Diagnostic Code 5213)

*Musculoskeletal System — 38 CFR § 4.71a*

## Understanding This Condition

Supination and pronation are the rotating movements of your forearm — turning your palm up (supination) and turning your palm down (pronation). When an injury or condition limits these motions, everyday tasks that depend on rotating the forearm and hand can become difficult.

Under Diagnostic Code 5213, the VA rates impairment of supination and pronation. Ratings can differ depending on whether the affected arm is your **dominant** ("major") or **non-dominant** ("minor") extremity — the same level of impairment may be rated slightly differently for each.

## Available Rating Levels

The VA assigns a percentage based on the type and severity of the impairment. This code covers two broad situations: **loss of motion due to bone fusion** (where the hand is fixed in a position) and **limitation of pronation or supination**.

### Loss (Bone Fusion) — Hand Fixed in Position

| Rating (Dominant) | Rating (Non-Dominant) | What It Describes |
|---|---|---|
| 40% | 30% | Hand fixed in supination or hyperpronation |
| 30% | 20% | Hand fixed in full pronation |
| 20% | 20% | Hand fixed near the middle of the arc or in moderate pronation |

### Limitation of Pronation

| Rating (Dominant) | Rating (Non-Dominant) | What It Describes |
|---|---|---|
| 30% | 20% | Motion lost beyond the middle of the arc |
| 20% | 20% | Motion lost beyond the last quarter of the arc; the hand does not approach full pronation |

### Limitation of Supination

| Rating (Dominant) | Rating (Non-Dominant) | What It Describes |
|---|---|---|
| 10% | 10% | Supination limited to 30° or less |

## What the VA Looks For

When rating impairment of supination and pronation, the VA considers:

- **Whether the hand is fixed in a position** due to bone fusion, and if so, which position (supination, hyperpronation, full pronation, or near the middle of the arc / moderate pronation).
- **How much rotating motion is lost** — for example, whether pronation is lost beyond the middle of the arc or beyond the last quarter of the arc, or whether supination is limited to 30° or less.
- **Which arm is affected** — dominant (major) versus non-dominant (minor) — because this can change the assigned percentage.

**Please note:** For all forearm and wrist injuries under codes 5205 through 5213, multiple impaired finger movements caused by tendon tie-up, muscle, or nerve injury are to be separately rated and combined — but not to exceed the rating for loss of use of the hand.

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*This information is drawn from the VA rating schedule under 38 CFR § 4.71a for educational purposes. It describes how the condition is categorized and does not predict any individual rating outcome.*

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