38 CFR Part 4 — 38 CFR § 4.71a

Index finger, ankylosis of — VA Diagnostic Code 5225

Musculoskeletal

Diagnostic code

5225

Start free worksheet Get the Founding Pass — $9.99/month

38 CFR § 4.71a lists Diagnostic Code 5225 under “III. Ankylosis of Individual Digits.” The title row is “Index finger, ankylosis of:”. The rating cells on that title are empty. The next row is “Unfavorable or favorable,” 10 in the Major column and 10 in the Minor column. It is one row, not a separate unfavorable line and a separate favorable line. The Note under it is one sentence. Appendix B indexes this code as “Index finger.” under “Ankylosis of Individual Digits:”. That index line does not say “ankylosis of.”

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

5225 Index finger, ankylosis of — Major and Minor columns

Rating %: —

Criteria (verbatim). Index finger, ankylosis of:

Rating %: 10 major, 10 minor

Criteria (verbatim). Unfavorable or favorable

Rating %	Criteria (verbatim)
—	Index finger, ankylosis of:
10 major, 10 minor	Unfavorable or favorable

The Note reads: “Also consider whether evaluation as amputation is warranted and whether an additional evaluation is warranted for resulting limitation of motion of other digits or interference with overall function of the hand.” The multiple-digit ankylosis notes stop after “whether evaluation as amputation is warranted.” This individual-digit note adds the second clause about limitation of motion of other digits or interference with overall function of the hand.

DC 5224, the thumb, splits unfavorable at 20 and favorable at 10. DC 5225 does not split. DC 5226, the long finger, uses the same “Unfavorable or favorable” line at 10 and 10. DC 5227, ring or little finger, uses that line at 0 and 0.

Paragraph (3)(i) of “Evaluation of Ankylosis or Limitation of Motion of Single or Multiple Digits of the Hand” says: “If both the metacarpophalangeal and proximal interphalangeal joints of a digit are ankylosed, and either is in extension or full flexion, or there is rotation or angulation of a bone, evaluate as amputation without metacarpal resection, at proximal interphalangeal joint or proximal thereto” That sentence does not end with a period. It routes that finding to amputation. It does not leave it on the 10 line.

Paragraph (3)(ii) says that if both the metacarpophalangeal and proximal interphalangeal joints of a digit are ankylosed, evaluate as unfavorable ankylosis, even if each joint is individually fixed in a favorable position. Paragraphs (3)(iii) and (3)(iv) use a gap of more than two inches (5.1 cm.), or of two inches (5.1 cm.) or less, between the fingertip and the proximal transverse crease of the palm, with the finger flexed to the extent possible.

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 5153 is index-finger amputation. With metacarpal resection (more than one-half the bone lost) it is 30 major and 20 minor. Without metacarpal resection, at the proximal interphalangeal joint or proximal thereto, it is 20 major and 20 minor. Through the middle phalanx or at the distal joint it is 10 major and 10 minor. Paragraph (3)(i) names the middle of those three lines: amputation without metacarpal resection, at the proximal interphalangeal joint or proximal thereto. The DC 5225 Note is the sentence that says to consider whether evaluation as amputation is warranted.

Paragraph (1) says that for the index, long, ring, and little fingers (digits II, III, IV, and V), zero degrees of flexion represents the fingers fully extended, making a straight line with the rest of the hand. The position of function of the hand is with the wrist dorsiflexed 20 to 30 degrees, the metacarpophalangeal and proximal interphalangeal joints flexed to 30 degrees, and the thumb (digit I) abducted and rotated so that the thumb pad faces the finger pads. Only joints in these positions are considered to be in favorable position. On DC 5225, both “Unfavorable” and “favorable” are printed at 10.

DC 5226 is the long finger, at the same 10 and 10. DC 5224 is the thumb, and it does split the numbers. DC 5227 is ring or little finger ankylosis, at 0 and 0. DC 5230 is limitation of motion of the ring or little finger, and that row is also 0 and 0. 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 10 line is the compensable line this code prints. It does not print a 0 line of its own. 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.” 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 5225, eCFR full-text XML for 2026-10-01.

What the words mean in your records

One line for both words

“Unfavorable or favorable” is a single row at 10 and 10. The thumb code above it uses two rows.

The Note has two “whether” clauses

The first is evaluation as amputation. The second is an additional evaluation for resulting limitation of motion of other digits or interference with overall function of the hand.

Paragraph (3)(i) leaves the 10 line

When both named joints are ankylosed, and either is in extension or full flexion, or there is rotation or angulation of a bone, the instruction is to evaluate as amputation without metacarpal resection, at the proximal interphalangeal joint or proximal thereto. On DC 5153 that line is 20 and 20.

Evidence that speaks to each level

10 major, 10 minor

What the rater needs to see. Ankylosis of the index finger that the schedule leaves on “Unfavorable or favorable.” Both columns are 10.

Where that usually lives. The finger examination, including which joints are ankylosed and the position.

The amputation route in paragraph (3)(i)

What the rater needs to see. Both the metacarpophalangeal and proximal interphalangeal joints ankylosed, and either in extension or full flexion, or rotation or angulation of a bone. That sentence points to amputation without metacarpal resection.

Where that usually lives. The same examination. DC 5153 prints 20 major and 20 minor for that amputation level, and 30 major and 20 minor when metacarpal resection is more than one-half the bone lost.

Level	What the rater needs to see	Where that usually lives
10 major, 10 minor	Ankylosis of the index finger that the schedule leaves on “Unfavorable or favorable.” Both columns are 10.	The finger examination, including which joints are ankylosed and the position.
The amputation route in paragraph (3)(i)	Both the metacarpophalangeal and proximal interphalangeal joints ankylosed, and either in extension or full flexion, or rotation or angulation of a bone. That sentence points to amputation without metacarpal resection.	The same examination. DC 5153 prints 20 major and 20 minor for that amputation level, and 30 major and 20 minor when metacarpal resection is more than one-half the bone lost.

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

The exam form

DC 5225 prints one 10 line for unfavorable or favorable ankylosis. Paragraph (3) and the Note are in the same section. This page does not say the form replaces that text.

Related codes and how they interact

Amputation of this finger is DC 5153.

That code prints 30 and 20, 20 and 20, and 10 and 10, depending on the level. The DC 5225 Note says to consider whether evaluation as amputation is warranted. Paragraph (3)(i) names one of those amputation levels.

Secondary conditions and presumptions

The 2026-10-01 text of 38 CFR § 3.309 does not contain “ankylosis.” Section 3.309(a) lists “Arthritis.” It does not assign that word to DC 5225.

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 ankylosis of the index finger?

Under 38 CFR § 4.71a, Diagnostic Code 5225 rates unfavorable or favorable ankylosis at 10 percent major and 10 percent minor. Paragraph (3)(i) sends a described pattern to an amputation evaluation instead. Education only. VA decides on the evidence.

Is favorable ankylosis a lower number than unfavorable on this finger?

Not on DC 5225. Both words are on one row at 10 and 10. DC 5224, the thumb, prints unfavorable at 20 and favorable at 10.

FAQ

What are the ratings for index-finger ankylosis?

Unfavorable or favorable is 10 in the Major column and 10 in the Minor column. The thumb code splits those words. This code does not. Education only.

When does the schedule leave this code for an amputation rating?

Paragraph (3)(i) says to evaluate as amputation without metacarpal resection, at the proximal interphalangeal joint or proximal thereto, when both named joints are ankylosed and either is in extension or full flexion, or there is rotation or angulation of a bone. On DC 5153 that level is 20 major and 20 minor. The Note also says to consider whether evaluation as amputation is warranted.

What else does the Note say to consider?

Whether an additional evaluation is warranted for resulting limitation of motion of other digits or interference with overall function of the hand. That clause is in the individual-digit note. It is not in the shorter multiple-digit note.

Next steps

Read the decision for DC 5225, whether it stayed on the 10 line, and whether it used an amputation code instead.
The free worksheet is a place to write the code, the findings, and the records you already have. It does not file a claim or protect a filing date. An accredited representative is at find a VSO.
Other musculoskeletal codes are on the musculoskeletal diagnostic-code index. The category page is musculoskeletal conditions.

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 5225 • 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.