38 CFR Part 4 — 38 CFR § 4.71a

Skull, loss of part of, both inner and outer tables — VA Diagnostic Code 5296

Musculoskeletal

Diagnostic code

5296

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

38 CFR § 4.71a lists Diagnostic Code 5296 as “Skull, loss of part of, both inner and outer tables.” With brain hernia the rating is 80. Without brain hernia the lines are 50, 30, and 10, by area. Appendix B to Part 4 indexes the code only as “Loss of part of.” The rating-table title is the longer one.

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 rating criteria at each level

5296 Skull, loss of part of, both inner and outer tables

Rating %: 80

Criteria (verbatim). With brain hernia

Rating %: —

Criteria (verbatim). Without brain hernia:

Rating %: 50

Criteria (verbatim). Area larger than size of a 50-cent piece or 1.140 in² (7.355 cm²)

Rating %: 30

Criteria (verbatim). Area intermediate

Rating %: 10

Criteria (verbatim). Area smaller than the size of a 25-cent piece or 0.716 in² (4.619 cm²)

Rating %	Criteria (verbatim)
80	With brain hernia
—	Without brain hernia:
50	Area larger than size of a 50-cent piece or 1.140 in² (7.355 cm²)
30	Area intermediate
10	Area smaller than the size of a 25-cent piece or 0.716 in² (4.619 cm²)

Note: Rate separately for intracranial complications.

The 50 percent line says “larger than size of a 50-cent piece,” without the word “the” before “size.” The 10 percent line says “smaller than the size of a 25-cent piece.” The 2 in in² and cm² is a superscript in the regulation. The 30 percent line says only “Area intermediate.”

The note says to rate intracranial complications separately. It does not name a diagnostic code. Residuals of traumatic brain injury have a public page, the TBI guide. That guide is not a line of DC 5296. 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 § 4.31 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. DC 5296 does not print a 0 percent line. The lowest area line is 10 percent.

Source: 38 CFR § 4.71a, Diagnostic Code 5296, eCFR full-text XML for 2026-10-01.

What the words mean in your records

Both tables

The schedule title requires loss of part of both the inner and the outer tables. The 80 percent line adds brain hernia. The area lines are under “Without brain hernia.”

Area intermediate

That is the entire 30 percent cell. The 50 percent cell is larger than a 50-cent piece or 1.140 in² (7.355 cm²). The 10 percent cell is smaller than a 25-cent piece or 0.716 in² (4.619 cm²).

The index is shorter

Appendix B says “Loss of part of.” It does not repeat “skull” or “both inner and outer tables” on that index line. The criteria are the § 4.71a row.

Evidence that speaks to each level

80, with brain hernia

What the rater needs to see. Loss of part of both inner and outer tables, and brain hernia.

Where that usually lives. The operative or imaging record that shows both.

50, 30, or 10, without brain hernia

What the rater needs to see. The area compared with the 50-cent piece, the intermediate area, or the 25-cent piece, including the square-inch and square-centimeter figures the outer lines print.

Where that usually lives. The measurement in the surgical or imaging record.

Level	What the rater needs to see	Where that usually lives
80, with brain hernia	Loss of part of both inner and outer tables, and brain hernia.	The operative or imaging record that shows both.
50, 30, or 10, without brain hernia	The area compared with the 50-cent piece, the intermediate area, or the 25-cent piece, including the square-inch and square-centimeter figures the outer lines print.	The measurement in the surgical or imaging record.

VA’s public DBQ list, checked October 5, 2026, names “Bones and Other Skeletal Conditions” under Musculoskeletal. The file is Bones and Other Skeletal Conditions.

The exam form

DC 5296 prints the hernia and area lines and the intracranial note. This page does not say the form replaces those lines.

Related codes and how they interact

Intracranial complications are a separate rating.

The note does not assign them to a numbered code. The TBI guide is a different public page.

Secondary conditions and presumptions

The 2026-10-01 text of 38 CFR § 3.309 does not contain “skull.” DC 5296 is not a named chronic-disease row.

Short answers

What is the VA rating for skull loss?

Under 38 CFR § 4.71a, Diagnostic Code 5296 is 80 percent with brain hernia, and 50, 30, or 10 percent without brain hernia, by the area lines. Education only. VA decides on the evidence.

Does DC 5296 include a 0 percent area?

No. The smallest printed area is 10 percent. Section 4.31 is the zero-percent rule for a code that does not print one.

FAQ

How does VA rate loss of part of the skull under DC 5296?

With brain hernia, the rating is 80 percent. Without brain hernia, an area larger than a 50-cent piece or 1.140 in² (7.355 cm²) is 50, an intermediate area is 30, and an area smaller than a 25-cent piece or 0.716 in² (4.619 cm²) is 10. The title is loss of part of both inner and outer tables. Education only.

What does the note add?

Rate separately for intracranial complications. The note does not name the diagnostic code for those complications.

Why is the index title shorter?

Appendix B says “Loss of part of.” The § 4.71a row says “Skull, loss of part of, both inner and outer tables.” The percentages are on the rating-table row.

Next steps

Read the decision for DC 5296, whether brain hernia was found, and the area used.
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.

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 5296 • 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.