EDUCATIONAL TOOL ONLY. Not legal or medical advice. Not affiliated with the VA.
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Upper Extremity Amputation
DC 5120-5156 | 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand |
Upper Extremity Amputation is rated by the U.S. Department of Veterans Affairs under DC 5120-5156 of 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand across 3 severity tiers (40%+ -- Severe limitation or ankylosis / 20% -- Moderate limitation / 10% -- Mild limitation or painful motion). 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. This condition is frequently rated as secondary to Shoulder Condition - Contralateral or Cervical Spine Condition under 38 C.F.R. § 3.310.
OVERVIEW
Surgical or traumatic loss of part or all of an upper extremity (finger, hand, arm, shoulder). Anatomic-level specific canonicals — arm-amputation-above-elbow (DC 5121), arm-amputation-below-elbow (DC 5123), hand-amputation (DC 5125), finger-amputation-thumb/index/multiple/ring/little — carry the full rating tiers with major/minor extremity tiers based on dominant-hand status. This record covers cross-cutting concerns (phantom limb pain, prosthesis-fitting issues, contralateral overuse, occupational impact, depression from functional loss).
RATING CRITERIA (3 LEVELS)
40%+ -- Severe limitation or ankylosis
Severe limitation of motion or ankylosis of the affected joint. Specific percentages depend on the joint and whether dominant/non-dominant.
20% -- Moderate limitation
Moderate limitation of motion with significant functional impairment. DeLuca factors may increase the effective rating.
10% -- Mild limitation or painful motion
Mild limitation of motion, or X-ray evidence of arthritis with painful motion under 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
SECONDARY CONDITIONS (4 MAPPED)
DC
Overuse of remaining arm
DC
Asymmetric loading affects neck
DC
Neurological pain in missing limb
DC
Adjustment to disability
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