VASRD 5219 · Musculoskeletal System
Unfavorable Ankylosis of Two Digits of One Hand VA Disability Rating
When two digits of the same hand are ankylosed in an unfavorable position, the schedule stops rating them one finger at a time and rates the pair as a unit under DC 5219. Which two digits they are, and whether it is the dominant hand, set the evaluation: the thumb-plus-any-finger combination pays the most and a pair drawn from the long, ring and little fingers pays the least.
VA Rating Tiers
| Rating | Criteria |
|---|---|
| 40% | Your thumb and one finger on your dominant hand are both fused in an unfavorable position. |
| 30% | The same thumb-and-finger combination on your non-dominant hand, or the index finger plus one other finger on your dominant hand. |
| 20% | The index finger plus one other finger on your non-dominant hand, or any two of the middle, ring and little fingers on either hand. |
How the VA Evaluates Unfavorable Ankylosis of Two Digits of One Hand
DC 5219 has three rating rows, each with a major (dominant) and a minor (non-dominant) value. The thumb and any finger is 40 percent major and 30 percent minor. The index finger with the long, ring or little finger is 30 major and 20 minor. Long and ring, long and little, or ring and little is 20 percent in both columns. The record therefore has to establish which two digits are ankylosed, that the ankylosis is unfavorable rather than favorable - favorable ankylosis of the same two digits is DC 5223, which pays 10 percent less on every row except one: an index-finger pair on the non-dominant hand is 20 percent under both codes - and which hand is dominant. The code closes with a note: 'Also consider whether evaluation as amputation is warranted.' Where three, four or five digits of one hand are ankylosed, the evaluation moves up the table to DC 5218, 5217 or 5216.
Approval outlook
Moderate – increases if dominant hand or both middle and index involved.
Veterans service-connected
~8,800 veterans
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
- •Imaging confirming ankylosis of each digit claimed, not only of the hand generally
- •An examination that names which two digits are ankylosed and the position each is fixed in
- •Documentation of hand dominance, since two of the three rows differ between the major and minor columns
- •Grip, pinch and dexterity testing showing the combined effect on the hand
Strategy Tips
- •Document finger coordination and grip loss
- •Use therapist or occupational evaluations
- •Describe real-life challenges like typing or tool use
C&P Exam Pitfalls
- •Failing to document which fingers are affected
- •No proof of functional limitation
- •Underreported pain or stiffness
Common Filing Mistakes
- •Not specifying fingers involved
- •Lack of combined impact evaluation
- •Only submitting X-rays without function tests
Onset Patterns
- •Common after severe hand trauma or multiple fractures
- •May follow repetitive overuse or systemic disease
Secondary Conditions
Conditions commonly linked to Unfavorable Ankylosis of Two Digits of One Hand. Service-connecting a secondary condition can increase your combined rating.
Hand Osteoarthritis
Stiff fingers can stress other joints.
De Quervain’s Tenosynovitis
Strain from altered hand movement.
Common questions about Unfavorable Ankylosis of Two Digits of One Hand
- Is Unfavorable Ankylosis of Two Digits of One Hand a VA-rated disability?
- Yes. The VA rates Unfavorable Ankylosis of Two Digits of One Hand under VASRD diagnostic code 5219 (Musculoskeletal System). When two digits of the same hand are ankylosed in an unfavorable position, the schedule stops rating them one finger at a time and rates the pair as a unit under DC 5219. Which two digits they a…
- What VA disability rating can I get for Unfavorable Ankylosis of Two Digits of One Hand?
- Possible VA ratings for Unfavorable Ankylosis of Two Digits of One Hand are 40%, 30%, 20%. Examples: 40%: Your thumb and one finger on your dominant hand are both fused in an unfavorable position.; 30%: The same thumb-and-finger combination on your non-dominant hand, or the index finger plus one other finger on your d…
- What evidence helps prove Unfavorable Ankylosis of Two Digits of One Hand for VA disability?
- Strong evidence for a Unfavorable Ankylosis of Two Digits of One Hand claim includes: Imaging confirming ankylosis of each digit claimed, not only of the hand generally; An examination that names which two digits are ankylosed and the position each is fixed in; Documentation of hand dominance, since two of the three r…
- What mistakes should veterans avoid when claiming Unfavorable Ankylosis of Two Digits of One Hand?
- Common pitfalls when filing for Unfavorable Ankylosis of Two Digits of One Hand: Not specifying fingers involved; Lack of combined impact evaluation; Only submitting X-rays without function tests.
- What conditions are commonly secondary to Unfavorable Ankylosis of Two Digits of One Hand?
- Conditions often service-connected as secondary to Unfavorable Ankylosis of Two Digits of One Hand include: Hand Osteoarthritis, De Quervain’s Tenosynovitis. 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 5219)
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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