Wrist Conditions
38 CFR § 4.71a — Musculoskeletal System
Diagnostic Codes
5214–5215
Why your DC matters: The VA uses DC 5214 for ankylosis (fusion) and 5215 for limitation of motion. These codes determine how your wrist's restricted movement or fusion translates into a disability percentage.
⚠️ Are You Potentially Under-Rated? Self-Check
If you are currently rated at 0% or 10% and any of these apply, you may have grounds for an increase claim:
- ☐ Your wrist cannot bend forward (flexion) past 15 degrees (normal is ~70-80°)
- ☐ Your wrist cannot bend backward (extension) past 20 degrees (normal is ~70°)
- ☐ You have painful motion during the C&P exam (minimum 10% rating required for painful motion)
If your wrist is frozen/fused (ankylosis):
- ☐ Is it fused at an angle outside the "favorable" range (20° to 30° of extension)? Non-functional positions often qualify for 30% or 40% (dominant).
This is general educational information only — not legal or medical advice.
Official VA Rating Criteria — Wrist (DC 5214–5215)
| Rating | VA Criteria (Limitation of Motion) | Key Evidence at This Level |
|---|---|---|
| 30%+* | Ankylosis under DC 5214. Ratings increase depending on whether the wrist is dominant or non-dominant and whether the fusion position is favorable or unfavorable. | Surgical history, orthopedic findings, and exam notes showing the wrist is fixed/fused rather than merely painful or stiff. |
| 10% | Under DC 5215, dorsiflexion less than 15 degrees; or palmar flexion limited in line with the forearm. In practice, painful motion can also support the minimum compensable rating under 38 CFR § 4.59. | Goniometer measurements, painful-motion findings, splint/brace use, and records showing loss of function in writing, lifting, or grip tasks. |
| 0% | Service connection with noncompensable limitation and without sufficiently documented painful motion or ankylosis. | Diagnosis present, but the record does not yet show compensable mechanical loss or functional impairment. |
*The wrist is unusual: limitation of motion under DC 5215 tops out at 10%, while materially higher ratings usually require ankylosis under DC 5214. Dominant vs. non-dominant hand matters most once ankylosis is in play.
Source: 38 CFR § 4.71a, Diagnostic Codes 5214–5215
Key Terms Defined
Palmar Flexion vs. Dorsiflexion (Extension)
Palmar Flexion is bending the wrist down toward the palm side. Dorsiflexion (Extension) is bending the wrist up toward the back of the hand. Normal for both is roughly 70° to 80°.
Ankylosis (DC 5214)
Total loss of movement in the wrist (fusion). Rated at 20% to 50% depending on dominant/non-dominant and whether it's fused in a "favorable" (20° to 30° extension) or "unfavorable" position.
DeLuca Criteria
A principle requiring the VA to measure ROM after repetitive use to account for "functional loss" due to pain, fatigue, and weakness.
Range of Motion (degrees)
- Normal Extension (Dorsiflexion): ~70° (higher is better)
- Key Compensable Motion Rule: Under DC 5215, dorsiflexion less than 15° or palmar flexion in line with the forearm supports the schedular 10% rating.
- Normal Flexion (Palmar): ~80° (higher is better)
- Higher Ratings Usually Require: Ankylosis/fusion under DC 5214 rather than simple painful limitation of motion.
- Painful Motion: If any movement causes pain, the VA must award at least a 10% rating for that joint.
Service Connection Paths
🎯 Direct Service Connection
Wrist injury (sprain, fracture, tendonitis) occurred during military service. Records should show the incident and a current diagnosis.
🔗 Secondary Service Connection
Wrist issues caused by an elbow injury (kinetic chain), or secondary to a nerve condition like Carpal Tunnel Syndrome or Radiculopathy.
Secondary Conditions to Pursue if You Have Service-Connected Wrist Issues
Wrist impairment can impact the hand and forearm significantly.
Carpal Tunnel Syndrome
DC 8515StrongWrist trauma or chronic inflammation is a leading cause of median nerve entrapment.
Hand/Finger Limitations
DC 5216StrongReduced wrist motion often leads to compensatory finger strain or weakened grip.
Elbow Strain / Tendonitis
DC 5206StrongLoss of wrist flexibility forces the elbow and forearm muscles to overwork.
De Quervain's Tenosynovitis
DC 5215 analogousModerateInflammation of the thumb-side tendons is often linked to chronic wrist strain.
Already Service-Connected for These? Wrist May Qualify as a Secondary
If you have service connection for any of the following, your wrist condition may be claimable as a secondary.
Elbow Condition
DC 5206Shoulder Condition
DC 5201Median Nerve Damage
DC 8515Ulnar Nerve Damage
DC 8516Special Considerations
Bilateral Factor
If both wrists are affected, you get the "bilateral factor" — a 10% bump to your combined rating for those specific conditions.
Hand/Finger Pyramiding
Be careful when claiming wrist and finger issues. The VA may combine them into a single "hand" rating if they use the same functional limitations.
Evidence Map — What Unlocks Each Rating
- • ROM showing extension ≤ 30° or flexion ≤ 30°
- • Medical notes documenting pain during movement
- • Personal statement describing how the wrist pain limits writing or carrying
- • ROM showing extension ≤ 15° or flexion ≤ 15°
- • X-ray/MRI confirming advanced osteoarthritis or structural damage
- • Documentation of the need for a wrist brace or splint
What Leads to Lower Ratings or Denials
- C&P examiner did not use a goniometer (they MUST use one)
- Painful motion was ignored (pain = 10% minimum for the joint)
- Rater missed that the wrist is fused in an unfavorable position (higher rating)
- Repetitive use testing was skipped (failing to account for fatigue)
Next Steps
If your wrist rating is 0% or 10% but you have severe stiffness:
- Check your ROM against the 15°/30° thresholds above
- Ensure your dominant hand is correctly identified
- If you have numbness or grip strength loss, look into a secondary "nerve impairment" claim
This is general educational information only — not legal or medical advice.
Source: 38 CFR § 4.71a, Diagnostic Codes 5214–5215 • va.gov
⚠️ Important Disclaimer
This page provides general educational information only based on public VA regulations (38 CFR) and va.gov resources. It is not legal, medical, or claims assistance. Ratings and service connections are decided case-by-case by the VA based on the individual veteran’s evidence. We do not prepare claims, generate documents, or provide personalized advice. Always consult a VA-accredited Veterans Service Organization (VSO), attorney, or your physician for help with your specific situation. Verify the latest rules on va.gov.