Wrist VA Rating Criteria and Diagnostic Codes (DC 5214–5215)

Complete wrist VA rating table (DC 5214, DC 5215, DC 5053, DC 5213, and 38 CFR 4.59)

The table below lists the rating percentages and criteria for wrist conditions under 38 CFR 4.71a and 38 CFR 4.59 for the Major (dominant) and Minor (non-dominant) hand.

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

Plate I normal ranges of motion and Diagnostic Code 5215

Under 38 CFR 4.71 and Plate I, wrist motion is measured from a 0-degree neutral baseline with the hand extended in line with the forearm:

• Dorsiflexion (extension): Bending the hand backward toward the top of the forearm (0° to 70°).
• Palmar flexion (flexion): Bending the hand forward toward the underside of the forearm (0° to 80°).
• Radial deviation: Tilting the wrist toward the thumb side (0° to 20°).
• Ulnar deviation: Tilting the wrist toward the pinky side (0° to 45°).

When the wrist retains active movement, Diagnostic Code 5215 (Wrist, limitation of motion of) assigns 10% (Major or Minor) under two thresholds:

1. Dorsiflexion less than 15° (10% Major / 10% Minor): Upward extension stops between 0° and 14°.
2. Palmar flexion limited in line with forearm (10% Major / 10% Minor): Forward flexion cannot pass the 0° forearm line.

Unlike the shoulder or ankle schedules, 10% is the maximum schedular rating under DC 5215 for limited motion of a single wrist.

The painful motion rule (38 CFR 4.59) and flare-ups (38 CFR 4.40 and 4.45)

Because few wrist injuries reduce dorsiflexion below 15° or prevent palmar flexion past 0°, most 10% wrist ratings rely on three companion regulations:

1. Painful motion (38 CFR 4.59): Actually painful, unstable, or malaligned joints warrant at least the minimum compensable rating. Because 38 CFR 4.45 classifies the wrist as a major joint, objective painful motion qualifies for 10% under DC 5215 (or DCs 5003, 5010, or 5024) even when dorsiflexion is 15° to 70° and palmar flexion exceeds 0°.
2. Functional loss (38 CFR 4.40): Disability includes inability to perform normal movements with normal excursion, strength, speed, coordination, and endurance due to pain or weakness during gripping or lifting.
3. Flare-ups and repetitive use (38 CFR 4.45 and DeLuca v. Brown): Examiners must test three repetitions of motion and estimate additional range-of-motion loss during flare-ups—which can also support higher separate ratings under DC 5213 when flare-ups restrict forearm rotation.

Wrist ankylosis (DC 5214) and total wrist replacement (DC 5053 vs. DC 5052)

Ankylosis is complete bony fusion or immobilization of the wrist joint. Diagnostic Code 5214 grades severity by fixed angle and hand dominance:

• Favorable in 20° to 30° dorsiflexion — 30% (Major) / 20% (Minor): Fusion in slight 20°–30° backward extension preserves flexor tendon tension for gripping.
• Any other position, except favorable — 40% (Major) / 30% (Minor): Fusion at neutral (0°), 1°–19° dorsiflexion, or above 30° dorsiflexion (without deviation).
• Unfavorable, in any degree of palmar flexion, or with ulnar or radial deviation — 50% (Major) / 40% (Minor): Fusion bent downward toward the palm or tilted toward the thumb or pinky side.
• Extremely unfavorable ankylosis (Note to DC 5214 / DC 5125) — 70% (Major) / 60% (Minor): Rated as loss of use of the hand under DC 5125 (and eligible for SMC-K). Partial fusions (four-corner fusion or proximal row carpectomy) retaining active motion are rated under DC 5215.

In 38 CFR 4.71a, Diagnostic Code 5052 applies to elbow replacement, whereas Diagnostic Code 5053 applies to wrist replacement (prosthesis). Under DC 5053 and Notes 1–4 to DCs 5051–5056 (85 FR 76453, effective February 7, 2021), total wrist replacement receives 100% (Major or Minor) for 1 year post-implantation (after the initial 1-month rating under 38 CFR 4.30 per Note 4), followed by 40% (Major) / 30% (Minor) for chronic severe painful motion or weakness, intermediate ratings by analogy to DC 5214, or a 20% minimum rating.

Dominant hand rules (38 CFR 4.69) and common wrist conditions

Under 38 CFR 4.69, only one hand is designated dominant (Major); for an ambidextrous veteran, the injured or most severely injured hand is rated as dominant. While DC 5215 (10%), 38 CFR 4.59 (10%), and the DC 5053 minimum (20%) pay the same rate on either side, DC 5214, DC 5053 severe residuals, DC 5125, and higher DC 5213 tiers pay 10% more for the Major hand.

• Distal radius/ulna fractures and forearm rotation (DC 5213): Under 38 CFR 4.71 Plate I (arm at side, elbow at 90°, forearm at 0° midposition), normal supination is 0° to 85° and pronation is 0° to 80°. Under DC 5213, supination limited to 30° or less warrants 10%; pronation lost beyond the last quarter of the arc (or fusion near mid-arc/moderate pronation) warrants 20%; pronation lost beyond the middle of the arc (or fusion in full pronation) warrants 30% Major / 20% Minor; and fusion in supination or hyperpronation warrants 40% Major / 30% Minor. Radius (DC 5212) or ulna (DC 5211) malunion warrants 10%, and lower-half radius nonunion with false movement warrants 30%/20% (or 40%/30% with ≥1 inch bone loss and marked deformity).
• TFCC tears, scaphoid fractures, and De Quervain’s tenosynovitis (DC 5024): TFCC tears and scaphoid fractures are rated at 10% under DC 5215 / 38 CFR 4.59 for painful or limited wrist motion, plus DC 5213 when DRUJ instability restricts forearm rotation. Under the Note to DCs 5013–5024, tenosynovitis (DC 5024) is rated as degenerative arthritis (DC 5003) at 10% for painful or limited motion, and under the Note to DCs 5205–5213, impaired finger movements from tendon tie-up are rated separately.

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

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

1. Sections I–II (Diagnosis and Flare-Ups): Records dominant hand status under 38 CFR 4.69, diagnoses, and flare-up frequency, duration, and functional impact.
2. Section III (Range of Motion): Measures active and passive dorsiflexion (normal endpoint 70°), palmar flexion (normal endpoint 80°), ulnar deviation (normal endpoint 45°), and radial deviation (normal endpoint 20°); records which range of motion exhibited pain and the degree endpoint at which limitation of motion is specifically attributable to pain, weakness, fatigability, incoordination, or other factors (Item 3A); tests at least three repetitions of observed repetitive-use motion (Item 3B); and in Items 3C (Repeated use over time) and 3D (Flare-ups), asks the examiner to estimate range of motion in degrees immediately after repeated use over time based on procurable evidence and lay statements.
3. Sections IV–X (Muscle Atrophy, Ankylosis, Surgery, and Imaging): Section IV records whether muscle atrophy is present and, if so, the circumference in centimeters of the normal versus atrophied side; Section V records ankylosis of the wrist and its severity (DC 5214); Section VI records prior surgery, including total wrist joint replacement (DC 5053); Sections VII–IX cover other findings and scars, assistive devices, and remaining effective function; and Section X records imaging and whether degenerative or post-traumatic arthritis is documented.

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

Secondary conditions, combined ratings, and accredited help

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

• Carpal tunnel syndrome (DC 8515) and ulnar neuropathy (DC 8516): Wrist fractures, arthritis, or flexor tenosynovitis may compress the median nerve (DC 8515: 10% mild, 30%/20% moderate, 50%/40% severe, 70%/60% complete) or ulnar nerve (DC 8516: 10% mild, 30%/20% moderate, 40%/30% severe, 60%/50% complete) under 38 CFR 4.124a, rated separately under 38 CFR 4.14.
• Separate forearm (DC 5213), scar (DC 7804), and contralateral overuse claims: A veteran may hold separate ratings on the same wrist for flexion/extension (DC 5215), supination/pronation (DC 5213), and painful/unstable surgical scars (DC 7804, 10%–30%), while favoring an injured wrist or using a cane may cause secondary overuse in the opposite wrist or shoulder.

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 before combining with other ratings, and our VA back pay calculator estimates retroactive pay.

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 guarantee an outcome; verify credentials in the VA Office of General Counsel Accreditation Search.