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38 CFR Part 4 — 38 CFR § 4.71a

Three digits of one hand, amputation of, thumb, ring and little — VA Diagnostic Code 5137

Musculoskeletal

Diagnostic code

5137

38 CFR § 4.71a lists Diagnostic Code 5137 under “Three digits of one hand, amputation of:”. The row is “Thumb, ring and little”. There is no comma before “and.” The row does not end with a period. The Major column is 60. The Minor column is 50. Those cells do not carry footnote 1. Appendix B to Part 4 indexes “Thumb, ring and little.” and does end with a period. The appendix heading is “Three digits of one hand:” It drops “amputation of”. The catalog slug is dc-5137-thumb-ring-and-little.

Reviewed 2026-10-05. Text checked against the eCFR versioner full-text XML for 2026-10-01 on 2026-10-05. Title 38 was last amended on 2026-08-27. On 2026-10-05 the titles list reports up to date as of 2026-10-02. 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

5137 Thumb, ring and little — Major and Minor columns

Rating %: 60 major, 50 minor

Criteria (verbatim). Thumb, ring and little

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

Footnote 1, “Entitled to special monthly compensation,” is printed on DC 5126 through DC 5130. It is not printed on DC 5137. The note under the single-finger rows says: The single finger amputation ratings are the only applicable ratings for amputations of whole or part of single fingers. DC 5137 is a three-digit row, not a single-finger row.

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).

This is the last three-digit row that includes the thumb. The next numbered row, DC 5138, drops the thumb and prints 50 major and 40 minor.

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 5134 still includes the index finger. DC 5138 is index, long and ring, with no thumb, at 50 and 40. DC 5135 and DC 5136 sit between DC 5134 and DC 5137 in the schedule, print 60 and 50, and stay pending-hidden.

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 finger amputations at various levels, or of finger amputations with ankylosis or limitation of motion of the fingers, on the basis of the grade of disability; i.e., amputation, unfavorable ankylosis, 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 5137. 38 CFR § 4.63 defines loss of use of a hand or a foot for special monthly compensation. Section 4.63 does not name these fingers and does not name DC 5137. 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 paragraph (c) says ischemic heart disease or other cardiovascular disease developing in a veteran who has a service-connected amputation of one lower extremity at or above the knee, or service-connected amputations of both lower extremities at or above the ankles, shall be held to be the proximate result of the service-connected amputation or amputations. That paragraph does not assign DC 5137, and it does not say finger. This page does not add DC 5137 to that row. 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 5137, eCFR full-text XML for 2026-10-01.

What the words mean in your records

No index finger, same 60 and 50

Thumb, ring and little is still 60 major and 50 minor. Dropping the index finger does not change that pair while the thumb remains.

The next row drops the thumb

DC 5138 is 50 and 40. That is the first three-digit row in this heading with no thumb.

Evidence that speaks to each level

60 major, 50 minor

What the rater needs to see. Amputation of the thumb, ring and little 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.

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

The exam form

DC 5137 prints 60 major and 50 minor, without 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

Without the thumb, the pair changes.

DC 5138 is index, long and ring, at 50 major and 40 minor. DC 5137 keeps the thumb and prints 60 and 50.

Secondary conditions and presumptions

The 2026-10-01 text of 38 CFR § 3.309 paragraph (c) says ischemic heart disease or other cardiovascular disease developing in a veteran who has a service-connected amputation of one lower extremity at or above the knee, or service-connected amputations of both lower extremities at or above the ankles, shall be held to be the proximate result of the service-connected amputation or amputations. That paragraph does not assign DC 5137, and it does not say finger. This page does not add DC 5137 to that row.

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, ring and little fingers?

Under 38 CFR § 4.71a, Diagnostic Code 5137 is 60 for the major side and 50 for the minor side. Footnote 1 is not on those cells. Education only. VA decides on the evidence.

Which three-digit row is the first without the thumb?

DC 5138, index, long and ring, at 50 major and 40 minor.

FAQ

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

60 in the Major column and 50 in the Minor column. Those cells do not carry footnote 1. Education only. This page does not state a payment amount.

Does dropping the index finger lower the pair?

Not on this row. DC 5137 still includes the thumb and still prints 60 and 50. The drop to 50 and 40 is DC 5138, which has no thumb.

Does § 3.309 assign DC 5137?

No. Section 3.309(c) is about cardiovascular disease after a service-connected amputation of a lower extremity. It does not assign DC 5137.

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 5137 • 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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