Wrist Conditions
38 CFR § 4.71a — Musculoskeletal System
Diagnostic Codes
5214–5215
Why your DC matters: The VA uses DC 5214 for ankylosis (fusion) and 5215 for limitation of motion. These codes determine how your wrist's restricted movement or fusion translates into a disability percentage.
⚠️ Are You Potentially Under-Rated? Self-Check
If you are currently rated at 0% or 10% and any of these apply, review the current criteria with your representative:
- ☐ Dorsiflexion less than 15 degrees (bending the wrist back). Normal dorsiflexion is 70 degrees.
- ☐ Palmar flexion limited in line with the forearm. Normal palmar flexion is 80 degrees.
- ☐ You have painful motion during the C&P exam (under 38 CFR § 4.59, painful motion can support the minimum compensable rating when the evidence warrants it)
If your wrist is frozen/fused (ankylosis):
- ☐ Favorable ankylosis, in 20 to 30 degrees of dorsiflexion: 30% major / 20% minor.
- ☐ Any other position, except favorable: 40% major / 30% minor.
- ☐ Unfavorable ankylosis, in any degree of palmar flexion, or with ulnar or radial deviation: 50% major / 40% minor.
- ☐ Extremely unfavorable ankylosis will be rated as loss of use of hands under diagnostic code 5125.
This is general educational information only — not legal or medical advice.
Official VA Rating Criteria — Wrist (DC 5214–5215)
| Rating | VA Criteria (Limitation of Motion) | Key Evidence at This Level |
|---|---|---|
| 20%-50%* | Ankylosis under DC 5214. The percent depends on major or minor hand and on position: favorable (20° to 30° dorsiflexion), any other position except favorable, or unfavorable. Extremely unfavorable ankylosis will be rated as loss of use of hands under diagnostic code 5125. | Surgical history, orthopedic findings, and exam notes showing the wrist is fixed/fused rather than merely painful or stiff. |
| 10% | Under DC 5215, dorsiflexion less than 15 degrees; or palmar flexion limited in line with the forearm. In practice, painful motion can also support the minimum compensable rating under 38 CFR § 4.59. | Goniometer measurements, painful-motion findings, splint/brace use, and records showing loss of function in writing, lifting, or grip tasks. |
| 0% | Service connection with noncompensable limitation and without sufficiently documented painful motion or ankylosis. | Diagnosis present, but the record does not yet show compensable mechanical loss or functional impairment. |
*The wrist is unusual: limitation of motion under DC 5215 tops out at 10%, while materially higher ratings usually require ankylosis under DC 5214. Dominant vs. non-dominant hand matters most once ankylosis is in play.
Source: 38 CFR § 4.71a, Diagnostic Codes 5214–5215
Key Terms Defined
Palmar Flexion vs. Dorsiflexion (Extension)
Palmar Flexion is bending the wrist down toward the palm side. Normal palmar flexion is 80 degrees. Dorsiflexion (Extension) is bending the wrist up toward the back of the hand. Normal dorsiflexion is 70 degrees.
Ankylosis (DC 5214)
Total loss of movement in the wrist (fusion). Favorable ankylosis in 20° to 30° dorsiflexion is 30% major / 20% minor. Any other position, except favorable, is 40% major / 30% minor. Unfavorable ankylosis (any degree of palmar flexion, or ulnar or radial deviation) is 50% major / 40% minor. Extremely unfavorable ankylosis will be rated as loss of use of hands under diagnostic code 5125.
DeLuca Criteria
A principle requiring the VA to measure ROM after repetitive use to account for "functional loss" due to pain, fatigue, and weakness.
Range of Motion (degrees)
- Normal Extension (Dorsiflexion): 0 to 70 degrees
- Key Compensable Motion Rule: Under DC 5215, dorsiflexion less than 15° or palmar flexion in line with the forearm supports the schedular 10% rating.
- Normal Flexion (Palmar): 0 to 80 degrees
- Higher Ratings Usually Require: Ankylosis/fusion under DC 5214 rather than simple painful limitation of motion.
- Painful Motion: Under 38 CFR § 4.59, painful motion can support the minimum compensable rating for that joint when the evidence warrants it.
Service Connection Paths
🎯 Direct Service Connection
Wrist injury (sprain, fracture, tendonitis) occurred during military service. Records should show the incident and a current diagnosis.
🔗 Secondary Service Connection
Wrist issues caused by an elbow injury (kinetic chain), or secondary to a nerve condition like Carpal Tunnel Syndrome or Radiculopathy.
Secondary Conditions to Pursue if You Have Service-Connected Wrist Issues
Wrist impairment can impact the hand and forearm significantly.
Carpal Tunnel Syndrome
DC 8515Commonly discussedWrist trauma or chronic inflammation is commonly discussed with median nerve entrapment.
Hand/Finger Limitations
DC 5216-5230Commonly discussedDigit codes run from DC 5216 through DC 5230. Separate finger findings are not the same as the wrist rating.
Elbow Strain / Tendonitis
DC 5206Commonly discussedLoss of wrist flexibility forces the elbow and forearm muscles to overwork.
De Quervain's Tenosynovitis
DC 5024Sometimes discussedTenosynovitis (DC 5024) is rated as degenerative arthritis, based on limitation of motion of the affected part.
Already Service-Connected for These? Wrist May Qualify as a Secondary
If you have service connection for any of the following, your wrist condition may be claimable as a secondary.
Elbow Condition
DC 5206Shoulder Condition
DC 5201Median Nerve Damage
DC 8515Ulnar Nerve Damage
DC 8516Special Considerations
Bilateral Factor
If both wrists — or, more generally, both upper extremities — each have a compensable rating, VA may apply the bilateral factor under 38 CFR § 4.26.
VA first combines the paired-side ratings the usual way, then adds 10 percent of that combined value (added, not combined again). That figure is treated as one disability when it is combined with other ratings. It is not an automatic +10 points on your overall combined rating. The factor applies only when each paired side has a partial disability of compensable degree.
Hand/Finger Pyramiding
Under 38 CFR § 4.14, the VA will not rate the same symptoms twice under different diagnostic codes. Separate wrist and finger ratings need separate findings that do not overlap.
Evidence Map — What the Schedule Actually Lists
- • Dorsiflexion less than 15°, or palmar flexion limited in line with the forearm
- • Painful motion can also support the minimum compensable rating under 38 CFR § 4.59
- • DC 5215 has no 20% row. Limitation of motion stops at 10%.
- • Favorable ankylosis in 20° to 30° dorsiflexion: 30% major, 20% minor
- • Any other position, except favorable: 40% major, 30% minor
- • Unfavorable ankylosis (any degree of palmar flexion, or ulnar or radial deviation): 50% major, 40% minor
- • Extremely unfavorable ankylosis will be rated as loss of use of hands under diagnostic code 5125.
What Leads to Lower Ratings or Denials
- C&P examiner scored limited motion without goniometer measurements (examiners are expected to measure range of motion with a goniometer when rating limited motion; missing measurements can weaken the record)
- Documented painful motion was not addressed under 38 CFR § 4.59 (it can support the minimum compensable rating when the evidence warrants it)
- Rater missed that the wrist is fused in an unfavorable position (higher rating)
- Repetitive use testing was skipped (failing to account for fatigue)
Next Steps
If your wrist rating is 0% or 10% but you have severe stiffness:
- Check dorsiflexion against the less-than-15° rule in DC 5215. The 20° to 30° range is the favorable ankylosis position in DC 5214, not a limitation-of-motion cutoff.
- Ensure your dominant hand is correctly identified
- If you have numbness or grip strength loss, look into a secondary "nerve impairment" claim
This is general educational information only — not legal or medical advice.
Source: 38 CFR § 4.71a, Diagnostic Codes 5214–5215 • 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.