YOUR CONDITION, EXPLAINED
Loss of Use of Both Hands VA disability rating & claim guide
The VA rates Loss of Use of Both Hands under diagnostic code 5109, in 38 CFR § 4.71a (musculoskeletal system), and the schedule provides a single evaluation under it: 100%.
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A CLEARER PATH FORWARD
Make sense of your next step.
01Understand the rating02Know what to gather03Plan your preparationTHE ESSENTIALS
How the VA rates Loss of Use of Both Hands
Both hands have lost all effective function. In 38 CFR 4.71a this is DC 5109, "Loss of use of both hands" — one row in the combinations-of-disabilities table, paying a single evaluation of 100 percent. It is functional loss with the hands still present; anatomical loss of both hands is a separate entry, DC 5106.
DC 5109 is a single row in 38 CFR 4.71a's "combinations of disabilities" table: "Loss of use of both hands" at 100 percent. There is no lower tier under this code. The loss-of-use standard is stated in 4.71a's notes to the amputation ratings, note (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." Both hands must meet that standard — one hand alone is DC 5125, "Hand, loss of use of," at 70 percent for the dominant (major) extremity and 60 percent for the non-dominant (minor). Where the cause is complete traumatic paralysis, DC 5244 directs: "Quadriplegia: Rate separately under diagnostic codes 5109 and 5110 and combine evaluations in accordance with § 4.25."
- Diagnostic code
- 5109
- Rating schedule
- 38 CFR § 4.71a
- Schedule levels
- 100%
How does the VA choose a rating level?
There is no higher or lower step inside this code: a rating decision either finds its criteria met or it does not. Where they are not met, 38 CFR § 4.31 assigns a 0% evaluation: service connection granted, at a level that does not pay.
EXPLORE THE PERCENTAGES
Loss of Use of Both Hands VA rating criteria (DC 5109)
This condition has one published rating level. Read the criteria, then explore the details and monthly pay.
These are published rating criteria. Selecting a level does not predict your VA decision.
BUILD YOUR EVIDENCE, ONE PIECE AT A TIME
Evidence for your Loss of Use of Both Hands claim
A long list feels easier when you have a place to start. Use this checklist to see what you have and what still needs gathering.
Check off what you’ve gathered. Progress stays on this page until you leave or refresh.
THE EXAM FORM
Which DBQ is used for Loss of Use of Both Hands?
VA publishes its questionnaires by body system; find the one for this condition on VA's list.
Source: VA: Public Disability Benefits Questionnaires (DBQs), read September 18, 2026.
SMALL DETAILS. BETTER PREPARATION.
Preparing your Loss of Use of Both Hands claim
Start with the practical tips, then explore the common oversights. You don’t need to work through everything at once.
Practical tips for your claim2 tips
- 01
Have documentation from two types of specialists (such as neurology and occupational therapy), since this combination of perspectives strengthens a claim for total bilateral loss.
- 02
Include assistive device usage, since reliance on adaptive equipment for both hands is strong supporting evidence.
C&P exam pitfalls to keep in mind2 tips
- 01
Partial use of one or both hands being claimed as total loss.
- 02
Inconsistent testing results between exams.
Common filing mistakes2 tips
- 01
Not distinguishing this claim from an amputation-based claim.
- 02
Lack of supporting functional tests for both hands.
When symptoms may first appear1 tips
- 01
This condition can result from nerve degeneration, paralysis, or significant trauma affecting both hands.
THE BROADER PICTURE
Loss of Use of Both Hands by the numbers
- Approval outlook
- Very High if documented by specialist.
- Veterans service-connected
- ~85 veterans
- Typical rating awarded
- ~100%
Vetrify editorial estimates informed by VA published claims data (VBA Annual Benefits Report) and the VA rating schedule, not official VA statistics.
LET’S CLEAR A FEW THINGS UP
Common questions about Loss of Use of Both Hands
Is Loss of Use of Both Hands a VA-rated disability?
Yes. The VA rates Loss of Use of Both Hands under VASRD diagnostic code 5109 (Musculoskeletal System). Both hands have lost all effective function. In 38 CFR 4.71a this is DC 5109, "Loss of use of both hands" — one row in the combinations-of-disabilities table, paying a single evaluation of 100 percent. It is functional loss with the hands still present; anatomical loss of both hands is a separate entry, DC 5106.
What VA disability rating can I get for Loss of Use of Both Hands?
Possible VA ratings for Loss of Use of Both Hands are 100%, 0%. The 0% level comes from 38 CFR 4.31, which assigns it wherever no compensable level is met. Examples: 100%: Loss of use of both hands.
What's the typical VA rating awarded for Loss of Use of Both Hands?
Vetrify estimates the typical rating awarded for Loss of Use of Both Hands at around 100%, based on VA claims data and the rating schedule. An estimated 85 veterans are service-connected for Loss of Use of Both Hands. Estimated approval outlook: Very High if documented by specialist.
What evidence helps prove Loss of Use of Both Hands for VA disability?
Strong evidence for a Loss of Use of Both Hands claim includes: Occupational therapy evaluations; Neurologist or orthopedic reports confirming the extent of the loss.
What mistakes should veterans avoid when claiming Loss of Use of Both Hands?
Common pitfalls when filing for Loss of Use of Both Hands: Not distinguishing this claim from an amputation-based claim; Lack of supporting functional tests for both hands.
What conditions can be secondary to Loss of Use of Both Hands?
Conditions that can be service-connected as secondary to Loss of Use of Both Hands, when a medical opinion links them, include: Depression; Shoulder Tendonitis. A secondary condition gets its own rating, which VA combines with the veteran's other ratings under 38 CFR 4.25.
Official sources
- 38 CFR § 4.71a, Schedule of ratings, musculoskeletal system (Diagnostic Code 5109)
- 38 CFR § 4.31, zero percent evaluations
Criteria in quotation marks are the regulation’s own words; everything else on this page is Vetrify’s summary of it. The eCFR text is authoritative. See how Vetrify derives its numbers.
How these figures are checked: our methodology and the open dataset.
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