EDUCATIONAL TOOL ONLY. Not legal or medical advice. Not affiliated with the VA.
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Carpal Instability
DC 5215 | 38 CFR § 4.71a, DC 5215 |
Carpal Instability is rated by the U.S. Department of Veterans Affairs under DC 5215 of 38 CFR § 4.71a, DC 5215 across 6 severity tiers (50% / 40% / 30% / 20% / 10%…). Service connection requires (1) a current diagnosis, (2) an in-service event, injury, or exposure, and (3) a medical nexus opinion linking the two under 38 C.F.R. § 3.303.
OVERVIEW
Instability of the carpal bones in the wrist from ligament damage causing pain, clicking, weakness, and reduced grip strength
RATING CRITERIA (6 LEVELS)
50%
DC 5214 Major "Wrist, ankylosis of: Unfavorable" = 50%. (Verbatim § 4.71a DC 5214.) End-stage SLAC IV with spontaneous wrist ankylosis or surgical pancarpal fusion.
40%
DC 5214 Major "Any other position, except favorable" = 40%; DC 5214 Minor "Unfavorable" = 40%. (Verbatim § 4.71a DC 5214.)
30%
DC 5214 Major "Favorable in 20° to 30° dorsiflexion" = 30%; DC 5214 Minor "Any other position" = 30%. (Verbatim § 4.71a DC 5214.)
20%
DC 5214 Minor "Favorable in 20° to 30°" = 20%; OR — DC 5003 X-ray-only "2+ major joints with occasional incapacitating exacerbations" = 20% (SLAC progression involves radioscaphoid → midcarpal = 2+ joint groups). (Verbatim § 4.71a.)
10%
DC 5215 "Dorsiflexion <15°" = 10% (Major or Minor); DC 5215 "Palmar flexion limited in line with forearm" = 10%; OR — DC 5003 single-major-joint fallback with painful motion + positive instability tests (scaphoid shift / lunotriquetral ballottement / midcarpal shift) = 10%. (Verbatim § 4.71a.)
0%
Carpal instability diagnosed (positive instability tests, imaging-confirmed SL gap, DISI/VISI alignment) without compensable ROM AND without objectively-confirmed painful-motion findings.
KEY EVIDENCE TO GATHER
-Service treatment records showing injury or complaints
-Imaging (X-ray, MRI, CT)
-Range of motion measurements
-Flare-up documentation per Sharp v. Shulkin
-Buddy statements describing limitations
-Prescription history
-Physical therapy records
-Employment impact documentation
C&P EXAM TIPS (6)
1.Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation.
2.Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.
3.Tell the examiner about flare-ups: frequency, duration, estimated ROM loss. Sharp v. Shulkin (2017) requires estimates.
4.Request active, passive, weight-bearing, and non-weight-bearing ROM testing per Correia v. McDonald (2016).
5.If you use assistive devices (brace, cane), bring them.
6.Describe daily activity impact: work, sleep, household tasks.
SOURCES & EDITORIAL
Rating criteria reference 38 C.F.R. Part 4 (Schedule for Rating Disabilities). This entry has not yet undergone editorial review against the live regulation text — consult the authoritative source directly before relying on the criteria shown.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026