YOUR CONDITION, EXPLAINED
Unfavorable Ankylosis of Two Digits of One Hand VA disability rating & claim guide
The VA rates Unfavorable Ankylosis of Two Digits of One Hand under diagnostic code 5219, in 38 CFR § 4.71a (musculoskeletal system), and the schedule provides three evaluation levels for it: 40%, 30% and 20%.
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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 Unfavorable Ankylosis of Two Digits of One Hand
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.
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.
- Diagnostic code
- 5219
- Rating schedule
- 38 CFR § 4.71a
- Schedule levels
- 40%, 30% and 20%
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
Unfavorable Ankylosis of Two Digits of One Hand VA rating criteria (DC 5219)
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 Unfavorable Ankylosis of Two Digits of One Hand
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: Also consider whether evaluation as amputation is warranted.”DC 5219
BUILD YOUR EVIDENCE, ONE PIECE AT A TIME
Evidence for your Unfavorable Ankylosis of Two Digits of One Hand 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 Unfavorable Ankylosis of Two Digits of One Hand?
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 Unfavorable Ankylosis of Two Digits of One Hand 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 5219 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 Unfavorable Ankylosis of Two Digits of One Hand 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
Document finger coordination and grip loss
- 02
Use therapist or occupational evaluations
- 03
Describe real-life challenges like typing or tool use
C&P exam pitfalls to keep in mind3 tips
- 01
Failing to document which fingers are affected
- 02
No proof of functional limitation
- 03
Underreported pain or stiffness
Common filing mistakes3 tips
- 01
Not specifying fingers involved
- 02
Lack of combined impact evaluation
- 03
Only submitting X-rays without function tests
When symptoms may first appear2 tips
- 01
Common after severe hand trauma or multiple fractures
- 02
May follow repetitive overuse or systemic disease
THE BROADER PICTURE
Unfavorable Ankylosis of Two Digits of One Hand by the numbers
- 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.
LET’S CLEAR A FEW THINGS UP
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 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.
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%, 0%. The 0% level comes from 38 CFR 4.31, which assigns it wherever no compensable level is met. Examples: 40%: Unfavorable ankylosis of the thumb and any finger of the dominant (major) hand; 30%: Unfavorable ankylosis of the thumb and any finger of the non-dominant (minor) hand; or of the index finger together with the long, ring or little finger of the dominant (major) hand; 20%: Unfavorable ankylosis of the index finger together with the long, ring or little finger of the non-dominant (minor) hand; or of any two of the long, ring and little fingers, on either hand.
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 rows differ between the major and minor columns; Grip, pinch and dexterity testing showing the combined effect on the hand.
Which DBQ is used for Unfavorable Ankylosis of Two Digits of One Hand?
VA's Hand and Finger 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 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 can be secondary to Unfavorable Ankylosis of Two Digits of One Hand?
Conditions that can be service-connected as secondary to Unfavorable Ankylosis of Two Digits of One Hand, when a medical opinion links them, include: Hand Osteoarthritis. 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 5219)
- 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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