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38 CFR Part 4 — 38 CFR § 4.71a

Four digits of one hand, amputation of, thumb, index, long and ring — VA Diagnostic Code 5127

Musculoskeletal

Diagnostic code

5127

38 CFR § 4.71a lists Diagnostic Code 5127 under “Four digits of one hand, amputation of:”. The row is “Thumb, index, long and ring.” There is no comma before “and.” The row does not end with a period. The Major column is 70. The Minor column is 60. Footnote 1 is on both numbers. A centered bold line above DC 5126 reads “multiple finger amputations” in that lowercase spelling. Appendix B indexes “Thumb, index, long and ring.” and does end with a period.

Reviewed 2026-10-05. Text checked against the eCFR versioner full-text XML for 2026-10-01 on 2026-10-05. Title 38 was up to date as of 2026-10-01 and last amended on 2026-08-27. The § 4.71a source note prints 29 FR 6718, May 22, 1964, as amended at 34 FR 5062, Mar. 11, 1969; 40 FR 42536, Sept. 15, 1975; 41 FR 11294, Mar. 18, 1976; 43 FR 45350, Oct. 2, 1978; 51 FR 6411, Feb. 24, 1986; 61 FR 20439, May 7, 1996; 67 FR 48785, July 26, 2002; 67 FR 54349, Aug. 22, 2002; 68 FR 51456, Aug. 27, 2003; 69 FR 32450, June 10, 2004; 80 FR 42041, July 16, 2015; 85 FR 76460, Nov. 30, 2020, 85 FR 85523, Dec. 29, 2020, 86 FR 8142, Feb. 4, 2021. The § 4.69 source note prints 62 FR 30239, June 3, 1997. The 2026-10-01 XML for § 4.68 prints no source note. The § 4.63 source note prints 29 FR 6718, May 22, 1964, as amended at 43 FR 45349, Oct. 2, 1978.

The rating criteria at each level

5127 Thumb, index, long and ring — Major and Minor columns

Rating %: 70 major, 60 minor

Criteria (verbatim). Thumb, index, long and ring

The heading is “Four digits of one hand, amputation of:”. The colon is on the heading. The row itself does not repeat “amputation of.”

DC 5126, five digits of one hand, is also 70 major and 60 minor, with footnote 1. DC 5128, DC 5129, and DC 5130 print that same 70 and 60, with footnote 1. DC 5131, index, long, ring and little, is 60 major and 50 minor, and it does not print footnote 1.

Footnote 1 reads: Entitled to special monthly compensation. It does not say “Also,” does not name § 3.350, and does not name an SMC level.

Paragraph (a) under the multiple-finger rows says: “The ratings for multiple finger amputations apply to amputations at the proximal interphalangeal joints or through proximal phalanges.” Paragraph (d) says: “Amputation or resection of metacarpal bones (more than one-half the bone lost) in multiple fingers injuries will require a rating of 10 percent added to (not combined with) the ratings, multiple finger amputations, subject to the amputation rule applied to the forearm.” The phrase “multiple fingers injuries” is the wording in paragraph (d).

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 5126 is five digits, 70 major and 60 minor. DC 5128 swaps the ring finger for the little finger and prints the same 70 and 60. DC 5131 has no thumb. It prints 60 and 50, without footnote 1. DC 5139 is three digits, index, long and little, at 50 and 40, also without footnote 1.

Paragraph (b) rates amputation through middle phalanges as prescribed for unfavorable ankylosis of the fingers. Paragraph (c) rates amputations at distal joints, or through distal phalanges, other than negligible losses, as prescribed for favorable ankylosis of the fingers. Paragraph (e) rates combinations of levels, or amputation with ankylosis or limitation of motion, on the grade of disability most representative of the levels or combinations. With an even number of fingers involved, and adjacent grades of disability, select the higher of the two grades. Paragraph (f) holds loss of use of the hand to exist when no effective function remains other than that which would be equally well served by an amputation stump with a suitable prosthetic appliance.

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. Paragraph (d) points the added 10 percent at “the amputation rule applied to the forearm.” The § 4.68 example still names diagnostic code 5165, not DC 5127. 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.

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 5127 footnote does not cite § 3.350. This page does not state a payment amount. 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 name DC 5127. 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 5127, eCFR full-text XML for 2026-10-01.

What the words mean in your records

No comma before “and”

The row reads “Thumb, index, long and ring.” Appendix B uses the same words and adds a period. It does not insert a comma before “and.”

Same numbers as five digits

DC 5126 and the four-digit rows that include the thumb print 70 major and 60 minor. The first four-digit row without the thumb, DC 5131, prints 60 and 50.

Paragraph (d) says “added to (not combined with)”

That sentence is about metacarpal resection of more than one-half the bone in multiple-finger injuries. It adds 10 percent. It does not say the 10 percent is combined under § 4.25.

Evidence that speaks to each level

70 major, 60 minor

What the rater needs to see. Amputation of the thumb, index, long and ring of one hand, at the level paragraph (a) names, in the major or minor column.

Where that usually lives. The amputation record, including which fingers and whether the amputation is at the proximal interphalangeal joints or through the proximal phalanges.

Footnote 1, and paragraph (d) when it applies

What the rater needs to see. Footnote 1 says entitled to special monthly compensation. Paragraph (d) is the added 10 percent for metacarpal loss of more than one-half the bone in multiple-finger injuries.

Where that usually lives. The same operative record. This page does not state a payment amount.

VA’s public DBQ list, checked October 5, 2026, names “Amputations” under Musculoskeletal. The file is Amputations.

The exam form

DC 5127 prints 70 major and 60 minor, with footnote 1. Paragraphs (a) through (f) sit under the multiple-finger rows. This page does not say the form replaces that text.

Related codes and how they interact

The little-finger swap is still 70 and 60.

DC 5128 is thumb, index, long and little. It prints the same 70 major and 60 minor, and the same footnote 1. Dropping the thumb, at DC 5131, changes both the numbers and the footnote.

Secondary conditions and presumptions

Section 3.309 does not name this four-finger combination. DC 5127 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.

Short answers

How does VA rate amputation of the thumb, index, long and ring fingers?

Under 38 CFR § 4.71a, Diagnostic Code 5127 is 70 for the major side and 60 for the minor side, with footnote 1. Education only. VA decides on the evidence.

Is five-finger amputation a higher pair of numbers?

DC 5126 prints the same 70 major and 60 minor, and the same footnote 1. The schedule does not print a higher pair for five digits than for this four-digit row.

FAQ

What are the ratings for amputation of the thumb, index, long and ring?

70 in the Major column and 60 in the Minor column. Footnote 1 says “Entitled to special monthly compensation.” It does not say “Also.” Education only. This page does not state a payment amount.

Does the row include a comma before “and”?

No. The 2026-10-01 row is “Thumb, index, long and ring.” Appendix B adds a period and does not add that comma.

When do the multiple-finger notes apply?

Paragraph (a) limits those ratings to amputations at the proximal interphalangeal joints or through proximal phalanges. Middle-phalanx amputation follows unfavorable ankylosis. Distal amputation, other than negligible losses, follows favorable ankylosis. Paragraph (d) adds 10 percent, and does not combine it, for specified metacarpal loss.

Next steps

Education only. Not legal or medical advice. My Claim Packet is not a VA-accredited representative and does not file claims. VA decides every claim on its own evidence.

Other codes in this body system

Nearby catalog entries in Musculoskeletal, ordered by diagnostic code number. All Musculoskeletal codes

Also: DC code lookup (tools) lists the same index in a compact layout.

Source: 38 CFR Part 4, Diagnostic Code 5127 • va.gov

⚠️ Important Disclaimer

This page provides general educational information based on public VA regulations and VA.gov resources. It is not legal or medical advice, and My Claim Packet is not a VA-accredited representative. Any worksheets or draft documents produced by the tools must be reviewed for accuracy and are not filed with VA for you. Ratings and service connection are decided case-by-case from the individual record. Consult a VA-accredited VSO, claims agent, attorney, or qualified clinician for help with your situation, and verify current rules using the linked official source.

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