VASRD 5213 · Musculoskeletal System
Supination and Pronation, Impairment (Forearm Rotation) VA Disability Rating
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.
VA Rating Tiers
| Rating | Criteria |
|---|---|
| 40% | Your dominant forearm is fused with the palm locked upward, or turned down past its normal limit. |
| 30% | Any of: that same fused position on your non-dominant side, a dominant forearm fused palm-down, or a dominant forearm that cannot pronate past the middle of its arc. |
| 20% | A forearm fused near mid-rotation, or pronation that stops short of full palm-down - and the more severe rotation findings when they are on your non-dominant side. |
| 10% | You can turn your palm upward only 30 degrees or less. |
How the VA Evaluates Supination and Pronation, Impairment (Forearm Rotation)
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.
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.
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Best Evidence to Gather
- •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.
Strategy Tips
- •Specify dominant hand in the claim
- •Include full range of motion report
- •Submit orthopedic consultation with imaging
C&P Exam Pitfalls
- •Incomplete range of motion exam
- •Lack of radiographic evidence
- •Not distinguishing between major and minor limb
Common Filing Mistakes
- •Not providing imaging proof
- •Claiming limitation without documented exam results
- •Leaving out dominant hand status
Onset Patterns
- •Often develops after elbow dislocation or fracture
- •Can progress from untreated joint inflammation
Secondary Conditions
Conditions commonly linked to Supination and Pronation, Impairment (Forearm Rotation). Service-connecting a secondary condition can increase your combined rating.
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 positi…
- 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%. Examples: 40%: Your dominant forearm is fused with the palm locked upward, or turned down past its normal limit.; 30%: Any of: that same fused position on your non-dominant side, a dominant forearm fused palm-down,…
- 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 –…
- 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 sepa…
- 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 are commonly secondary to Supination and Pronation, Impairment (Forearm Rotation)?
- Conditions often service-connected as secondary to Supination and Pronation, Impairment (Forearm Rotation) include: Elbow Tendonitis, Shoulder Impingement. Filing for secondary conditions can increase a veteran's combined VA rating.
Official sources
- 38 CFR § 4.71a — Schedule of ratings — musculoskeletal system (Diagnostic Code 5213)
Rating criteria on this page are an educational summary of the cited regulation — the eCFR text is authoritative. See how Vetrify derives its numbers.
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