Arm, amputation of, above insertion of deltoid — VA Diagnostic Code 5121

38 CFR § 4.69 says handedness for the purpose of a dominant rating will be determined by the evidence of record, or by testing on VA examination. Only one hand shall be considered dominant. The injured hand, or the most severely injured hand, of an ambidextrous individual will be considered the dominant hand for rating purposes. Section 4.69 does not use the words “Major” and “Minor.” Those are the column headings.

DC 5122 is the next row: “Below insertion of deltoid,” 80 major and 70 minor, with the same footnote 1. DC 5120 disarticulation is 90 major and 90 minor. The DC 5121 major number matches that 90. The minor number is 80, not 90. DC 5123 is forearm amputation above insertion of the pronator teres, 80 major and 70 minor. DC 5125 is loss of use of the hand, 70 major and 60 minor.

38 CFR § 4.68 says the combined rating for disabilities of an extremity shall not exceed the rating for the amputation at the elective level, were amputation to be performed. For example, the combined evaluations for disabilities below the knee shall not exceed the 40 percent evaluation, diagnostic code 5165. This 40 percent rating may be further combined with evaluation for disabilities above the knee but not to exceed the above the knee amputation elective level. Painful neuroma of a stump after amputation shall be assigned the evaluation for the elective site of reamputation. The example names diagnostic code 5165. It does not name DC 5121. 38 CFR § 4.63 defines loss of use of a hand or a foot for special monthly compensation. Section 4.63 does not name the deltoid and does not name DC 5121.

38 CFR § 3.350(a) says special monthly compensation under 38 U.S.C. 1114(k) is payable for each anatomical loss or loss of use of one hand, one foot, and the other losses that sentence lists. The DC 5121 footnote does not cite § 3.350. This page does not state a payment amount. 38 CFR § 4.7 assigns the higher rating when the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 CFR § 4.6 requires each element affecting the evidence to be studied so that decisions will be equitable and just.

The code prints no 0 percent line. 38 CFR § 4.31 says that in every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. The 2026-10-01 text of 38 CFR § 3.309 does not contain “deltoid.” DC 5121 is a rating-schedule line. A separate question, when a presumption does not decide it, is a medical question on the facts under 38 CFR § 3.310. Paragraph (a) covers disability proximately due to or the result of a service-connected disease or injury. Paragraph (b) covers increase in severity and requires a medical baseline.

Source: 38 CFR § 4.71a, Diagnostic Code 5121, eCFR full-text XML for 2026-10-01.