Long finger, ankylosis — VA Diagnostic Code 5226

The 10 and 10 are printed for both words, “Unfavorable or favorable.” Paragraph (3)(ii), (iii), and (iv) still distinguish unfavorable ankylosis from favorable ankylosis. On DC 5226 those two results use the same numbers. The (i), (ii), (iii), and (iv) cells do not end with a period. Paragraph (3)(i) is a different instruction: evaluate as amputation without metacarpal resection, at the proximal interphalangeal joint or proximal thereto. DC 5154 is “Long finger, amputation of:”. It prints 20 major and 20 minor for “With metacarpal resection (more than one-half the bone lost)” and 10 major and 10 minor for “Without metacarpal resection, at proximal interphalangeal joint or proximal thereto.” It does not print a “through middle phalanx” line. The amputation note says the single finger amputation ratings are the only applicable ratings for amputations of whole or part of single fingers. Paragraph (3)(i) names the without-metacarpal-resection evaluation. It does not name the 20 percent metacarpal-resection line.

DC 5226 is one digit. DC 5219 is “Two digits of one hand, unfavorable ankylosis of:”. Its line “Index and long; index and ring; or index and little fingers” is 30 major and 20 minor. Its line “Long and ring; long and little; or ring and little fingers” is 20 major and 20 minor. DC 5223 is the favorable-ankylosis code for two digits. Those same pairs are 20 major and 20 minor, and 10 major and 10 minor. DC 5222 is “Three digits of one hand, favorable ankylosis of:”. Its line “Long, ring and little fingers” has no comma after “ring,” and it is 20 major and 20 minor. Paragraph (5) says that if there is limitation of motion of two or more digits, evaluate each digit separately and combine the evaluations. That cell does not end with a period.

DC 5225 is “Index finger, ankylosis of:”. Unfavorable or favorable is also 10 major and 10 minor. DC 5227 is ring or little finger, ankylosis of. Unfavorable or favorable there is 0 major and 0 minor. DC 5229 is “Index or long finger, limitation of motion:”. A gap of one inch (2.5 cm.) or more between the fingertip and the proximal transverse crease of the palm, with the finger flexed to the extent possible, or extension limited by more than 30 degrees, is 10 major and 10 minor. The lesser gap, with extension limited by no more than 30 degrees, is 0 major and 0 minor. 38 CFR § 4.71 says motion of the thumb and fingers should be described by appropriate reference to the joints (See Plate III). 38 CFR § 4.69 determines the dominant hand. It does not use the words “Major” and “Minor.” Those are the column headings. 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 § 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 in that section names diagnostic code 5165 and disabilities below the knee. It does not name DC 5226.

Source: 38 CFR § 4.71a, Diagnostic Code 5226, eCFR full-text XML for 2026-10-01.