Two digits of one hand, amputation of, thumb and index — VA Diagnostic Code 5142

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 5143 swaps the index finger for the long finger and keeps 50 and 40. DC 5141 is the last three-digit row, long, ring and little, at 40 and 30. DC 5133 adds the ring finger to the thumb and index and prints 60 and 50.

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 5142. 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 5142. 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 5142, and it does not say finger. This page does not add DC 5142 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 5142, eCFR full-text XML for 2026-10-01.