EDUCATIONAL TOOL ONLY. Not legal or medical advice. Not affiliated with the VA.
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Dupuytren's Contracture
✓ VERIFIED AGAINST 38 C.F.R.§ 4.71a (Musculoskeletal system) · reviewed 2026-05-27 · ClaimRecon Editorial Team
Dupuytren's Contracture is rated by the U.S. Department of Veterans Affairs under DC 5228 of 38 CFR § 4.71a, DC 5228 across 3 severity tiers (20% / 10% / 0%). 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
Progressive fibrous thickening of the palmar fascia causing one or more fingers to permanently curl inward toward the palm
RATING CRITERIA (3 LEVELS)
20%
With a gap of more than two inches (5.1 cm) between the thumb pad and the fingers, with the thumb attempting to oppose the fingers — Major or Minor (same rating). Applies when Dupuytren's contracture of the thumb flexion crease prevents full opposition.
10%
With a gap of one to two inches (2.5 to 5.1 cm) between the thumb pad and the fingers, with the thumb attempting to oppose the fingers — Major or Minor (same rating).
0%
Gap less than one inch — schedularly noncompensable under DC 5228. For ring/little finger Dupuytren's (most common anatomic site), DC 5230 provides no compensable schedular rating — pursue DC 5003 single-joint fallback under § 4.59 if painful motion is objectively documented, OR DC 5224-5227 (single-finger ankylosis) when contracture has progressed to fixed ankylosis.
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 text quoted verbatim from 38 C.F.R. § 4.71a (Musculoskeletal system). Source verified 2026-05-27 by ClaimRecon Editorial Team during a regulation-text comparison against the Cornell Law CFR mirror; eCFR.gov is the authoritative government source.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026