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Hand Osteoarthritis
DC 5003 | 38 CFR § 4.71a, DC 5003 |
Hand Osteoarthritis is rated by the U.S. Department of Veterans Affairs under DC 5003 of 38 CFR § 4.71a, DC 5003 across 7 severity tiers (60% / 50% / 40% / 30% / 20%…). 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
Degenerative joint disease of the hand and finger joints causing stiffness, swelling, bony nodules, and reduced grip strength
RATING CRITERIA (7 LEVELS)
60%
DC 5216 "Five digits of one hand, unfavorable ankylosis of" = 60% Major / 50% Minor; DC 5125 "Loss of use of hand" = 60% Major / 50% Minor. (Verbatim § 4.71a DC 5216 / DC 5125.) Most severe hand-arthritis cases reach this tier through multi-digit ankylosis.
50%
DC 5216 Minor "Five digits of one hand, unfavorable ankylosis" = 50%; DC 5217 Major "Four digits of one hand, unfavorable ankylosis of: Thumb and any three fingers" = 60% Major / 50% Minor (verbatim § 4.71a DC 5217); DC 5125 Minor "Loss of use of hand" = 50%.
40%
DC 5217 "Four digits, unfavorable ankylosis: Index, long, ring, and little fingers" = 50% Major / 40% Minor; DC 5217 Minor "Thumb and any three fingers" = 40%; DC 5218 "Three digits, unfavorable ankylosis: Thumb and any two fingers" = 50% Major / 40% Minor; DC 5224 "Thumb, ankylosis of: unfavorable" = 20% Major / 20% Minor (with additional rating for amputation per Note). (Verbatim § 4.71a DC 5217-5218 / DC 5224.)
30%
DC 5219 "Two digits, unfavorable ankylosis of: Thumb and any finger" = 40% Major / 30% Minor; DC 5218 Major "Three digits, unfavorable: Index, long, and ring; or other combinations" = 40% Major / 30% Minor. (Verbatim § 4.71a DC 5218-5219.)
20%
DC 5224 "Thumb, ankylosis of: unfavorable" = 20% (Major or Minor); DC 5219 "Two digits, unfavorable ankylosis: Index and long; or other combinations" = 30% Major / 20% Minor; DC 5218 Minor "Three digits, unfavorable: Long, ring, and little fingers" = 20%; DC 5220 "Five digits, FAVORABLE ankylosis" = 50% Major / 40% Minor → use this when ankylosis is favorable not unfavorable; OR — DC 5003 X-ray-only "2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations" = 20%. (Verbatim § 4.71a.) Per NOTE 1, X-ray-only does NOT combine with ROM-based.
10%
DC 5228 "Thumb, limitation of motion: With a gap of one to two inches between thumb pad and fingers" = 10%; DC 5224 "Thumb, ankylosis: favorable" = 10%; DC 5225 / 5226 / 5229 / 5230 single-finger ankylosis or limitation-of-motion = 0-10% per specific finger; OR — DC 5003 single-group ROM fallback: "10 pct is for application for each such… group of minor joints affected by limitation of motion" = 10% for the hand minor-joint group when joint-specific ROM is noncompensable but limitation is "objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion"; OR — DC 5003 X-ray-only "2 or more minor joint groups" = 10%. (Verbatim § 4.71a DC 5003.)
0%
X-ray-confirmed hand arthritis without compensable ROM under DC 5224-5230 AND without objectively-confirmed painful-motion / swelling / muscle-spasm findings AND without 2+ minor joint groups involved (would qualify for DC 5003 X-ray-only 10%). (Verbatim § 4.71a DC 5003.)
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