Four digits of one hand, favorable ankylosis of — VA Diagnostic Code 5221

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 5217 is four digits of one hand, unfavorable ankylosis of. Thumb and any three fingers is 60 major and 50 minor. Index, long, ring, and little fingers is 50 major and 40 minor. DC 5217 then prints the amputation note. DC 5221’s matching lines are 50 and 40, then 40 and 30, and DC 5221 does not print that note. DC 5220 is five digits of one hand, favorable ankylosis of, one row at 50 major and 40 minor. DC 5131 is amputation of the index, long, ring and little fingers, at 60 major and 50 minor, without a comma after “ring” in that amputation title. DC 5126 is amputation of five digits, 70 major and 60 minor, with footnote 1.

Paragraph (2) applies when two or more digits of the same hand are affected by any combination of amputation, ankylosis, or limitation of motion that is not otherwise specified in the rating schedule. DC 5221 specifies two combinations. Paragraph (2) does not end with a period. Paragraph (5) says that if there is limitation of motion of two or more digits, evaluate each digit separately and combine the evaluations. 38 CFR § 4.71 says motion of the thumb and fingers should be described by appropriate reference to the joints, and it points to Plate III.

DC 5222 includes the line “Long, ring and little fingers,” at 20 major and 20 minor. That line has no comma after “ring.” The DC 5221 line is “Index, long, ring, and little fingers,” and it does print the comma after “ring.” 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. The example is the 40 percent evaluation, diagnostic code 5165. The example does not name DC 5221. 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 “ankylosis.” DC 5221 is a rating-schedule line.

Source: 38 CFR § 4.71a, Diagnostic Code 5221, eCFR full-text XML for 2026-10-01.