Elbow VA Rating: Diagnostic Codes 5205–5213 and Forearm Criteria

By Truth Veteran Benefits Desk · Reviewed by Truth Veteran Benefits Desk on October 25, 2026

The VA assigns an elbow VA rating under 38 CFR 4.71a using Diagnostic Codes 5205 through 5213 and 5052. Ratings range from 10% for painful motion (38 CFR 4.59) or mild limitation of flexion, extension, or supination up to 50% or 60% for severe motion loss, ankylosis, or a flail joint, and 100% for one year after total elbow replacement, with higher tiers paying 10% more on the dominant arm.

Older veteran sitting at a wooden kitchen table gently supporting his bent elbow and forearm in morning light

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How the VA rates elbow and forearm conditions under 38 CFR 4.71a

Understanding how an elbow VA rating is determined starts with 38 CFR 4.71a (“The Elbow and Forearm”). Repetitive push-ups, pull-ups, heavy munitions handling, vehicle and aviation maintenance, high-vibration tool use, and airborne falls place heavy stress on the humeroulnar, humeroradial, and proximal radioulnar joints. All upper-extremity evaluations follow the statutory VA disability ratings system.

When a veteran establishes service connection under 38 CFR 3.303 for lateral epicondylitis (“tennis elbow”), medial epicondylitis (“golfer’s elbow”), olecranon bursitis, biceps or triceps tendon tears, radial head fractures, or post-traumatic osteoarthritis, the VA evaluates functional impairment across nine diagnostic codes in 38 CFR 4.71a:

DC 5205: Elbow, ankylosis of (complete fixation or bony fusion of the elbow joint).
DC 5206: Forearm, limitation of flexion of (inability to bend the elbow fully).
DC 5207: Forearm, limitation of extension of (inability to straighten the arm fully).
DC 5208: Forearm, flexion limited to 100° and extension to 45°.
DC 5209: Elbow, other impairment of (flail joint, or joint fracture with marked cubitus varus/valgus deformity or ununited fracture of head of radius).
DC 5210: Radius and ulna, nonunion of, with flail false joint.
DC 5211: Ulna, impairment of (nonunion in upper or lower half, or malunion with bad alignment).
DC 5212: Radius, impairment of (nonunion in lower or upper half, or malunion with bad alignment).
DC 5213: Supination and pronation, impairment of (bone fusion, or limited pronation or supination).

Total elbow replacement is rated under Diagnostic Code 5052, while painful motion that does not reach the degree cutoffs of DCs 5206–5208 or 5213 is rated at 10% under 38 CFR 4.59 and Diagnostic Codes 5003, 5010, 5019, or 5024.

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Complete VA elbow and forearm rating table (DC 5205–5213, DC 5052, and 38 CFR 4.59)

The table below lists every rating percentage and criterion under current 38 CFR 4.71a and 38 CFR 4.59 for the dominant (Major) and non-dominant (Minor) arm.

Code	Condition and Regulatory Criteria (38 CFR 4.71a / 4.59)	Major/Minor
DC 5003/4.59	Painful motion of the elbow (or arthritis, bursitis, or tendinopathy under DCs 5003, 5010, 5019, 5024) with noncompensable range of motion	10%/10%
DC 5205	Elbow, ankylosis of: Unfavorable, angle <50° or complete loss of supination or pronation (60%/50%); Intermediate, angle >90°, or between 70° and 50° (50%/40%); Favorable, angle between 90° and 70° (40%/30%)	40%–60%/30%–50%
DC 5206	Forearm, limitation of flexion of: Flexion limited to 45° (50%/40%); 55° (40%/30%); 70° (30%/20%); 90° (20%/20%); 100° (10%/10%); 110° (0%/0%, or 10% with painful motion under 38 CFR 4.59)	0%–50%/0%–40%
DC 5207	Forearm, limitation of extension of: Extension limited to 110° (50%/40%); 100° (40%/30%); 90° (30%/20%); 75° (20%/20%); 60° (10%/10%); 45° (10%/10%)	10%–50%/10%–40%
DC 5208	Forearm, flexion limited to 100° and extension to 45°	20%/20%
DC 5209	Elbow, other impairment of: Flail joint (60%/50%); Joint fracture with marked cubitus varus or cubitus valgus deformity or ununited fracture of head of radius (20%/20%)	20% or 60%/20% or 50%
DC 5210	Radius and ulna, nonunion of, with flail false joint	50%/40%
DC 5211	Ulna, impairment of: Nonunion in upper half with false movement: with bone loss (1 inch/2.5 cm or more) and marked deformity (40%/30%), or without bone loss or deformity (30%/20%); Nonunion in lower half (20%/20%); Malunion with bad alignment (10%/10%)	10%–40%/10%–30%
DC 5212	Radius, impairment of: Nonunion in lower half with false movement: with bone loss (1 inch/2.5 cm or more) and marked deformity (40%/30%), or without bone loss or deformity (30%/20%); Nonunion in upper half (20%/20%); Malunion with bad alignment (10%/10%)	10%–40%/10%–30%
DC 5213	Supination and pronation, impairment of: Loss of (bone fusion): hand fixed in supination or hyperpronation (40%/30%), fixed in full pronation (30%/20%), or fixed near middle of arc or moderate pronation (20%/20%); Limitation of pronation: motion lost beyond middle of arc (30%/20%), or beyond last quarter of arc where hand does not approach full pronation (20%/20%); Limitation of supination: to 30° or less (10%/10%)	10%–40%/10%–30%
DC 5052	Elbow replacement (prosthesis): For 1 year following implantation (100%/100%); With chronic residuals of severe painful motion or weakness (50%/40%); With intermediate residuals, rate by analogy to DCs 5205–5208; Minimum evaluation (30%/20%)	30%–100%/20%–100%

Under the veteran-alone compensation schedule effective 2025-12-01, 10% pays $180.42 per month, 20% pays $356.66, 30% pays $552.47, 40% pays $795.84, 50% pays $1,132.90, 60% pays $1,435.02, and 100% pays $3,938.58.

Dominant (major) vs. non-dominant (minor) arm rules under 38 CFR 4.69

Diagnostic Codes 5052 and 5205 through 5213 split evaluations into Major (dominant) and Minor (non-dominant) columns. Under 38 CFR 4.69 (Dominant hand):

Evidence or testing: Handedness is determined by the evidence of record or by testing on VA examination.
One dominant hand: Only one hand is considered dominant. If you claim both elbows, one is rated under the Major column and the other under the Minor column.
Ambidextrous veterans: The injured hand—or the most severely injured hand if both arms are affected—is treated as the dominant (Major) hand.

At the 10% and 20% tiers across DCs 5206–5209 and 5211–5213, Major and Minor ratings are equal. At the 30% Major tier and above—such as flexion limited to 70° or less (DC 5206), extension limited to 90° or more (DC 5207), pronation lost beyond the middle of the arc (DC 5213), ankylosis (DC 5205), or total elbow replacement residuals (DC 5052)—the Major arm receives a 10% higher rating.

Normal range of motion (Plate I) and how flexion, extension, and rotation are rated

Under 38 CFR 4.71 and Plate I, goniometric measurements use two zero-degree baselines:

Elbow flexion (0° to 145°) and extension (145° to 0°): From a straight arm at the side (0°), bending the forearm upward traces 0° to 145°. Straightening the elbow back to a straight line returns from 145° to 0°.
Forearm supination (0° to 85°) and pronation (0° to 80°): Under 38 CFR 4.71(b), the arm is held at the side with the elbow flexed to 90° and the forearm in midposition (0°, thumb pointing up). Turning the palm upward is supination (0° to 85°); turning the palm downward is pronation (0° to 80°).

Flexion (DC 5206), extension (DC 5207), combined motion (DC 5208), and rotation (DC 5213)

DC 5206 (Flexion): Rated at 0% at 110°, 10% at 100°, 20% at 90°, 30%/20% at 70°, 40%/30% at 55°, and 50%/40% at 45° or less.
DC 5207 (Extension): Because full extension is 0°, an elbow that cannot straighten completely has a flexion contracture stopping on the 145°-to-0° arc before 0°. Extension limited to 45° or 60° (stopping 45° or 60° short of straight) warrants 10%; 75° warrants 20%; 90° warrants 30%/20%; 100° warrants 40%/30%; and 110° warrants 50%/40%.
DC 5208 vs. separate ratings: When flexion is limited to 100° and extension to 45°, DC 5208 assigns a single 20% rating. Under the M21-1 manual (Part V, Subpart iii, Chapter 1, Section B), if flexion or extension restriction is more severe than the DC 5208 cutoffs (for example, flexion limited to 90° for 20% under DC 5206 and extension limited to 45° for 10% under DC 5207), the VA assigns separate ratings under DC 5206 and DC 5207.
DC 5213 (Supination and pronation): Because forearm rotation occurs in a separate plane from hinge motion, DC 5213 can be rated separately alongside DC 5206, 5207, or 5208 when distinct functional loss is shown (unless complete loss of rotation is used for 60%/50% unfavorable ankylosis under DC 5205). Supination limited to 30° or less is 10%; pronation lost beyond the last quarter of the arc is 20% and beyond the middle of the arc is 30%/20%; and radioulnar bone fusion is 20% (middle of arc or moderate pronation), 30%/20% (full pronation), or 40%/30% (supination or hyperpronation).

Tennis elbow (epicondylitis), bursitis, tendinitis, and the 10% painful motion rule

Soft-tissue and arthritic diagnoses—including lateral epicondylitis (“tennis elbow”), medial epicondylitis (“golfer’s elbow”), and biceps/triceps tendinopathy (DC 5024), olecranon bursitis (DC 5019), and degenerative or post-traumatic arthritis (DCs 5003, 5010)—are rated on limitation of motion under DCs 5206–5208 and 5213. When range of motion exceeds the compensable cutoffs, two regulatory rules protect your claim:

Painful motion (38 CFR 4.59): Because 38 CFR 4.45 classifies the elbow as a major joint, objective painful motion on active or passive testing—or arthritis/tendinopathy under DC 5003/5024 with painful motion, swelling, or spasm—warrants 10%.
Functional loss (38 CFR 4.40) and flare-ups (38 CFR 4.45): If repetitive gripping, lifting, or flare-ups reduce functional flexion to 100°, 90°, or 70°, or limit supination to 30° or less, the VA rates your elbow on the estimated degrees of motion lost during flare-ups.

Ankylosis (DC 5205), bone nonunion/malunion (DCs 5209–5212), and elbow replacement (DC 5052)

Ankylosis (DC 5205): Complete joint fusion is rated at 40%/30% for favorable ankylosis (between 90° and 70°), 50%/40% for intermediate (more than 90°, or between 70° and 50°), and 60%/50% for unfavorable (less than 50° or with complete loss of supination or pronation).
Flail joint, fractures, and nonunion (DCs 5209–5212): Under DC 5209, a flail joint warrants 60%/50%, and a joint fracture with marked cubitus varus or valgus deformity or an ununited radial head fracture warrants 20%. Nonunion of both the radius and ulna with a flail false joint (DC 5210) is 50%/40%. Isolated ulna impairment (DC 5211) is rated higher in the upper half (40%/30% with false movement, 1 inch / 2.5 cm bone loss, and marked deformity; 30%/20% without bone loss/deformity; 20% in the lower half; 10% for malunion with bad alignment), whereas radius impairment (DC 5212) is rated higher in the lower half (40%/30% with 1 inch / 2.5 cm bone loss and marked deformity; 30%/20% without bone loss/deformity; 20% in the upper half; 10% for malunion with bad alignment). Under the Note to DCs 5205–5213, multiple impaired finger movements from tendon tie-up, muscle, or nerve injury are separately rated and combined, not to exceed the rating for loss of use of the hand.
Elbow replacement (DC 5052): Total elbow arthroplasty warrants 100% for 1 year following implantation (after the 1-month post-hospitalization rating under 38 CFR 4.30 per Note 4), followed by 50%/40% for chronic severe painful motion or weakness, intermediate ratings under DCs 5205–5208, and a permanent 30%/20% minimum evaluation.

How the C&P exam and Elbow and Forearm Conditions DBQ measure your claim

At a C&P exam, the clinician completes the Elbow and Forearm Conditions Disability Benefits Questionnaire (DBQ):

Sections 1–3 (Diagnosis, Flare-Ups, and Range of Motion): Records hand dominance, diagnoses, flare-up history, and goniometer active and passive flexion (145°), extension (0°), supination (85°), and pronation (80°); notes pain onset, tenderness, and crepitus; performs three repetitions of repetitive-use testing; and estimates flare-up range of motion.
Sections 4–12 (Atrophy, Ankylosis, Fractures, Rotation, and Surgery): Measures limb circumference (such as 10 cm above or below the elbow) for atrophy, records ankylosis angles (DC 5205), checks for flail joint, cubitus varus/valgus, radial head nonunion, radius/ulna nonunion or malunion, and DC 5213 rotation loss, and documents surgical scars, braces, imaging, and occupational impact.

Stop moving your arm as soon as pain begins during goniometer testing so the examiner records your accurate functional limit.

Secondary conditions, combined ratings, and free accredited help

Under 38 CFR 3.310(a), a disability proximately caused or aggravated by a service-connected elbow condition may qualify for secondary service connection with a medical nexus opinion:

Ulnar nerve neuropathy / cubital tunnel syndrome (38 CFR 4.124a, DC 8516): Elbow fractures, cubitus valgus deformity, osteophytes, or medial epicondylitis swelling may compress the ulnar nerve at the cubital tunnel, causing ring and little finger numbness and grip weakness rated at 10% (mild), 30%/20% (moderate), 40%/30% (severe), or 60%/50% (complete).
Median nerve (carpal tunnel syndrome, DC 8515), radial nerve neuropathy (DC 8514), shoulder overuse, and scars (DC 7804): Forearm trauma or compensatory overuse may affect peripheral nerves or the shoulder, while painful or unstable surgical scars warrant 10% to 30% under DC 7804.

Multiple ratings combine under 38 CFR 4.25, which you can calculate with our VA combined rating calculator. When compensable disabilities affect both upper extremities, 38 CFR 4.26 adds a 10% bilateral factor to their combined value before combining with other ratings.

If your claim was denied or underrated, Veterans Service Organizations (VSOs) such as the DAV, VFW, and American Legion provide representation free of charge, and VA-accredited claims agents or attorneys assist with appeals. No representative can promise an outcome; verify credentials through the VA Office of General Counsel Accreditation Search.

This guide explains the rules; it is not legal or medical advice. VA decisions depend on your records. Free help is available from accredited Veterans Service Organizations.

Frequently asked questions

How does the VA rate tennis elbow (lateral epicondylitis) or elbow tendinitis?

Under 38 CFR 4.71a, lateral or medial epicondylitis (DC 5024) and olecranon bursitis (DC 5019) are rated on limited motion under DCs 5206–5208 or 5213, or at 10% under 38 CFR 4.59 and DC 5003 for painful motion.

Can you get a 10% elbow VA rating if your range of motion is normal or limited only to 110 degrees?

Yes. Although DC 5206 lists flexion limited to 110° as 0%, 38 CFR 4.59 and DC 5003 award at least 10% for a major joint when painful motion, swelling, or spasm is objectively confirmed. Under 38 CFR 4.45 and 4.59, the elbow is a major joint that qualifies for a minimum 10% rating even when active flexion reaches the full 145° normal range.

Can you receive separate VA ratings for elbow flexion, extension, and forearm rotation on the same arm?

Yes. If flexion is limited to 100° and extension to 45°, DC 5208 assigns a single 20% rating. If either restriction is worse than DC 5208 cutoffs, separate ratings under DC 5206 and DC 5207 apply, and DC 5213 rotation can also be rated separately.

What does 'extension limited to 45 degrees' mean under Diagnostic Code 5207?

Under 38 CFR 4.71 Plate I, a straight arm is 0° and full flexion is 145°. 'Extension limited to 45 degrees' means a 45° flexion contracture where the elbow stops 45° short of straightening to 0°. Under DC 5207 in 38 CFR 4.71a, extension limited to 45° or 60° warrants 10%, 75° warrants 20%, and 90° to 110° warrants 30% to 50% (major) or 20% to 40% (minor).

What is the difference between a major and minor elbow VA rating?

Under 38 CFR 4.69 and 4.71a, your dominant arm is Major and your non-dominant arm is Minor. While 10% and 20% motion tiers are equal, severe tiers (such as 30%–60% Major) pay 10% more on the Major arm.

How does the VA rate total elbow replacement surgery?

Under DC 5052, total elbow replacement warrants 100% for 1 year after implantation (after 1-month convalescence under 38 CFR 4.30), followed by 50% major / 40% minor for severe painful motion or weakness, or a 30% major / 20% minor minimum.