YOUR CONDITION, EXPLAINED
Supination and Pronation, Impairment (Forearm Rotation) VA disability rating & claim guide
The VA rates Supination and Pronation, Impairment (Forearm Rotation) under diagnostic code 5213, in 38 CFR § 4.71a (musculoskeletal system), and the schedule provides four evaluation levels for it: 40%, 30%, 20% and 10%.
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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 Supination and Pronation, Impairment (Forearm Rotation)
This code covers loss of the forearm's rotation - turning the palm up (supination) and down (pronation). VA rates it by whether the rotation is lost to bone fusion and, if so, the position the hand is fixed in, or whether pronation or supination is only partly limited, and by which arm is dominant.
Diagnostic code 5213 rates impairment of supination and pronation - rotation of the forearm - in two columns for the major (dominant) and the minor (non-dominant) extremity, and it is organised in three groups rather than one severity scale. Where rotation is lost through bone fusion, the hand fixed in supination or hyperpronation is 40 percent major and 30 percent minor; the hand fixed in full pronation is 30 and 20; and the hand fixed near the middle of the arc or in moderate pronation is 20 in both columns. Where pronation is merely limited, motion lost beyond the middle of the arc is 30 percent major and 20 percent minor, and motion lost beyond the last quarter of the arc, the hand not approaching full pronation, is 20 percent in both columns. Limitation of supination has a single row: supination to 30 degrees or less, 10 percent in both columns. A note closing codes 5205 through 5213 adds that multiple impaired finger movements due to tendon tie-up, muscle or nerve injury are rated separately and combined, not to exceed the rating for loss of use of the hand.
- Diagnostic code
- 5213
- Rating schedule
- 38 CFR § 4.71a
- Schedule levels
- 40%, 30%, 20% and 10%
How does the VA choose a rating level?
Which level applies is set by the criteria the evidence meets, not by the diagnosis. Where there is a question as to which of two evaluations applies, 38 CFR § 4.7 assigns the higher one if the disability picture more nearly approximates the criteria required for that rating.
This code prints no 0% row. Under 38 CFR § 4.31, a 0% evaluation is assigned where the requirements for a compensable evaluation are not met.
EXPLORE THE PERCENTAGES
Supination and Pronation, Impairment (Forearm Rotation) VA rating criteria (DC 5213)
Choose a percentage to see what that level means. Open the full comparison to read all the criteria in one place.
These are published rating criteria. Selecting a level does not predict your VA decision.
IN THE REGULATION’S OWN WORDS
What 38 CFR also says about Supination and Pronation, Impairment (Forearm Rotation)
The notes 38 CFR Part 4 prints with these criteria, quoted. They govern how the evaluation is made without being a rating level themselves.
- “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.”DC 5213
BUILD YOUR EVIDENCE, ONE PIECE AT A TIME
Evidence for your Supination and Pronation, Impairment (Forearm Rotation) 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 Supination and Pronation, Impairment (Forearm Rotation)?
VA's page says: “You can use these forms to submit medical evidence from your health care providers.”
Source: VA: Public Disability Benefits Questionnaires (DBQs), read September 18, 2026.
THE EVERYDAY PICTURE
What the Supination and Pronation, Impairment (Forearm Rotation) examination has to record
The criteria above are read off an examination, and three sections of Part 4 govern what that examination has to contain. None of them is a diagnostic code, so none of them appears in the 5213 table, and all three apply to it. 38 CFR § 4.40: “Weakness is as important as limitation of motion, and a part which becomes painful on use must be regarded as seriously disabled.”
38 CFR § 4.45 lists what an examination of a joint is directed to consider:
- Less movement than normal (due to ankylosis, limitation or blocking, adhesions, tendon-tie-up, contracted scars, etc.).
- More movement than normal (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc.).
- Weakened movement (due to muscle injury, disease or injury of peripheral nerves, divided or lengthened tendons, etc.).
- Excess fatigability.
- Incoordination, impaired ability to execute skilled movements smoothly.
- Pain on movement, swelling, deformity or atrophy of disuse.
38 CFR § 4.59: “It is the intention to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint.” So a joint that is painful on use is not a finding of nothing, even where the measured motion is close to normal.
The same section says how the joint is to be tested: “The joints involved should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint.” An examination that records one measurement, taken once, sitting down, has not done what the section asks, and that is worth reading the exam report for.
SMALL DETAILS. BETTER PREPARATION.
Preparing your Supination and Pronation, Impairment (Forearm Rotation) 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 claim3 tips
- 01
Specify dominant hand in the claim
- 02
Include full range of motion report
- 03
Submit orthopedic consultation with imaging
C&P exam pitfalls to keep in mind3 tips
- 01
Incomplete range of motion exam
- 02
Lack of radiographic evidence
- 03
Not distinguishing between major and minor limb
Common filing mistakes3 tips
- 01
Not providing imaging proof
- 02
Claiming limitation without documented exam results
- 03
Leaving out dominant hand status
When symptoms may first appear2 tips
- 01
Often develops after elbow dislocation or fracture
- 02
Can progress from untreated joint inflammation
THE BROADER PICTURE
Supination and Pronation, Impairment (Forearm Rotation) by the numbers
- Approval outlook
- Moderate – strong with imaging and mobility testing.
- Veterans service-connected
- ~8,200 veterans
- Typical rating awarded
- ~10%
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 Supination and Pronation, Impairment (Forearm Rotation)
Is Supination and Pronation, Impairment (Forearm Rotation) a VA-rated disability?
Yes. The VA rates Supination and Pronation, Impairment (Forearm Rotation) under VASRD diagnostic code 5213 (Musculoskeletal System). This code covers loss of the forearm's rotation - turning the palm up (supination) and down (pronation). VA rates it by whether the rotation is lost to bone fusion and, if so, the position the hand is fixed in, or whether pronation or supination is only partly limited, and by which arm is dominant.
What VA disability rating can I get for Supination and Pronation, Impairment (Forearm Rotation)?
Possible VA ratings for Supination and Pronation, Impairment (Forearm Rotation) are 40%, 30%, 20%, 10%, 0%. The 0% level comes from 38 CFR 4.31, which assigns it wherever no compensable level is met. Examples: 40%: Loss of supination and pronation through bone fusion, with the hand fixed in supination or hyperpronation - major (dominant) extremity; 30%: Loss through bone fusion with the hand fixed in supination or hyperpronation - minor (non-dominant) extremity; loss through bone fusion with the hand fixed in full pronation - major (dominant) extremity; or limitation of pronation with motion lost beyond the middle of the arc - major (dominant) extremity; 20%: Loss through bone fusion with the hand fixed in full pronation - minor (non-dominant) extremity; loss through bone fusion with the hand fixed near the middle of the arc or in moderate pronation - either extremity; limitation of pronation with motion lost beyond the middle of the arc - minor (non-dominant) extremity; or limitation of pronation with motion lost beyond the last quarter of the arc, the hand not approaching full pronation - either extremity.
What's the typical VA rating awarded for Supination and Pronation, Impairment (Forearm Rotation)?
Vetrify estimates the typical rating awarded for Supination and Pronation, Impairment (Forearm Rotation) at around 10%, based on VA claims data and the rating schedule. An estimated 8,200 veterans are service-connected for Supination and Pronation, Impairment (Forearm Rotation). Estimated approval outlook: Moderate – strong with imaging and mobility testing.
What evidence helps prove Supination and Pronation, Impairment (Forearm Rotation) for VA disability?
Strong evidence for a Supination and Pronation, Impairment (Forearm Rotation) claim includes: Goniometer measurements of supination and pronation recorded separately, since the schedule rates the two directions under different rows; Imaging establishing whether rotation is lost through bone fusion, which is what separates the fusion rows from limitation of pronation alone; A record of the position the hand is fixed in - supination, hyperpronation, full pronation, or near the middle of the arc - because in the fusion rows the position, not the degree of loss, sets the evaluation; Documentation of which arm is dominant, since every row above 10 percent pays more in the major extremity.
Which DBQ is used for Supination and Pronation, Impairment (Forearm Rotation)?
VA's Elbow & Forearm Disability Benefits Questionnaire (DBQ) is on its public list of DBQs. VA's page says: "You can use these forms to submit medical evidence from your health care providers."
What mistakes should veterans avoid when claiming Supination and Pronation, Impairment (Forearm Rotation)?
Common pitfalls when filing for Supination and Pronation, Impairment (Forearm Rotation): Not providing imaging proof; Claiming limitation without documented exam results; Leaving out dominant hand status.
What conditions can be secondary to Supination and Pronation, Impairment (Forearm Rotation)?
Conditions that can be service-connected as secondary to Supination and Pronation, Impairment (Forearm Rotation), when a medical opinion links them, include: Elbow 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 5213)
- 38 CFR § 4.7, higher of two evaluations
- 38 CFR § 4.31, zero percent evaluations
- 38 CFR § 4.40, functional loss
- 38 CFR § 4.45, the joints
- 38 CFR § 4.59, painful motion
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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