Secondary Condition Claim · VASRD 5214

Ankylosis of the Wrist Secondary to Favorable Ankylosis of Two Digits of One Hand

A condition caused or aggravated by an already service-connected disability can be granted its own service connection as a secondary condition under 38 CFR § 3.310. Here's how that works for Ankylosis of the Wrist when it develops after Favorable Ankylosis of Two Digits of One Hand.

Why Ankylosis of the Wrist Is Linked to Favorable Ankylosis of Two Digits of One Hand

Impaired thumb use can lead to poor wrist control.

Primary condition · VASRD 5223

Favorable Ankylosis of Two Digits of One Hand

DC 5223 covers two digits of the same hand ankylosed in a favorable position, most often the thumb and one finger. It is the favorable counterpart of DC 5219 and pays 10 percent less on every row but one: which two digits are involved, and whether it is the dominant hand, set the evaluation.

Secondary condition · VASRD 5214

Ankylosis of the Wrist

Ankylosis of the wrist is a wrist fixed in one position that no longer moves. DC 5214 rates it by the position the wrist is fused in and by which hand it is - the schedule prints a major (dominant) and a minor (non-dominant) column, and the dominant wrist rates one step higher at every position. A wrist fixed in an extremely unfavorable position is not rated under this code at all: its note sends that case to DC 5125, loss of use of the hand.

Ankylosis of the Wrist VA Rating Tiers

The VA rates Ankylosis of the Wrist the same way whether it's claimed directly or as secondary to Favorable Ankylosis of Two Digits of One Hand — severity of Ankylosis of the Wrist itself determines the percentage.

RatingCriteria
50%Your dominant wrist is fused bent toward the palm, or off to one side.
40%Either your non-dominant wrist is fused in one of those bad positions, or your dominant wrist is fused somewhere other than the favorable angle.
30%Your non-dominant wrist is fused outside the favorable angle, or your dominant wrist is fused at the favorable angle.
20%Your non-dominant wrist is fused at the favorable angle - bent back 20 to 30 degrees.

Example combined rating

20% Favorable Ankylosis of Two Digits of One Hand + 40% Ankylosis of the Wrist = 52%

The VA combines ratings with Table I of 38 CFR 4.25, not simple addition — 20% and 40% combine to 52%, not 60%. These figures are illustrative; your actual rating for each condition depends on your own evaluation.

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Evidence for a Ankylosis of the Wrist Secondary Claim

  • X-rays or CT confirming bony ankylosis of the wrist
  • An examination that records the exact angle the wrist is fixed at and any ulnar or radial deviation
  • Documentation of hand dominance, since every row of DC 5214 differs between the major and minor columns
  • Occupational therapy or functional-use notes describing what the fixed wrist prevents

Common questions about Ankylosis of the Wrist secondary to Favorable Ankylosis of Two Digits of One Hand

Can Ankylosis of the Wrist be service-connected as secondary to Favorable Ankylosis of Two Digits of One Hand?
Yes. Under 38 CFR § 3.310, a condition that is caused or aggravated by an already service-connected disability can be granted secondary service connection. Impaired thumb use can lead to poor wrist control. You'll need a current Ankylosis of the Wrist diagnosis and a medical nexus opinion linking it to your service-co…
What VA rating can I get for Ankylosis of the Wrist as a secondary condition?
Ankylosis of the Wrist is rated under VASRD diagnostic code 5214 using the same criteria whether it's a direct or secondary claim: possible ratings are 50%, 40%, 30%, 20%. The rating depends on the severity of Ankylosis of the Wrist itself, not on the severity of Favorable Ankylosis of Two Digits of One Hand.
How does a secondary Ankylosis of the Wrist claim affect my combined VA rating?
The VA doesn't add ratings together. Using the official combined-ratings formula (38 CFR 4.25): a 20% rating for Favorable Ankylosis of Two Digits of One Hand combined with a 40% rating for Ankylosis of the Wrist (example figures) produces a combined rating of 52%, not 60%. Approving Ankylosis of the Wrist as secondar…
What evidence do I need to service-connect Ankylosis of the Wrist as secondary to Favorable Ankylosis of Two Digits of One Hand?
Strong evidence for the underlying Ankylosis of the Wrist diagnosis includes: X-rays or CT confirming bony ankylosis of the wrist; An examination that records the exact angle the wrist is fixed at and any ulnar or radial deviation; Documentation of hand dominance, since every row of DC 5214 differs between the major a…

Primary condition

Full Favorable Ankylosis of Two Digits of One Hand guide

Secondary condition

Full Ankylosis of the Wrist guide

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See how Favorable Ankylosis of Two Digits of One Hand and Ankylosis of the Wrist combine with the rest of your service-connected conditions using the official VA combined-ratings formula.

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