VA BENEFITS REFERENCE
38 CFR 4.71a: Shared Regulatory Context
Read the source context and regulatory notes referenced by diagnostic-code pages using 38 CFR 4.71a, with official citations and the current text date.
These source provisions supply context for the linked rating criteria. They are not separate evaluations automatically assigned to every condition. Read the diagnostic code and its own cross-references together.
A semantic text table is provided below this original graphic. Its cells, axes and footnotes were checked against the official image; blanks remain source blanks.
A semantic text table is provided below this original graphic. Its cells, axes and footnotes were checked against the official image; blanks remain source blanks.
A semantic text table is provided below this original graphic. Its cells, axes and footnotes were checked against the official image; blanks remain source blanks.
| Rating | ||
|---|---|---|
| Major | Minor | |
| Note (1): When an evaluation is assigned for joint resurfacing or the prosthetic replacement of a joint under diagnostic codes 5051-5056, an additional rating under § 4.71a may not also be assigned for that joint, unless otherwise directed. | ||
| Note (2): Only evaluate a revision procedure in the same manner as the original procedure under diagnostic codes 5051-5056 if all the original components are replaced. | ||
| Note (3): The term “prosthetic replacement” in diagnostic codes 5051-5053 and 5055-5056 means a total replacement of the named joint. However, in DC 5054, “prosthetic replacement” means a total replacement of the head of the femur or of the acetabulum. | ||
| Note (4): The 100 percent rating for 1 year following implantation of prosthesis will commence after initial grant of the 1-month total rating assigned under § 4.30 following hospital discharge. | ||
| Note (5): The 100 percent rating for 4 months following implantation of prosthesis or resurfacing under DCs 5054 and 5055 will commence after initial grant of the 1-month total rating assigned under § 4.30 following hospital discharge. | ||
| Note (6): Special monthly compensation is assignable during the 100 percent rating period the earliest date permanent use of crutches is established. | ||
| 1 Also entitled to special monthly compensation. | ||
| Rating | ||
|---|---|---|
| Major | Minor | |
| combinations of disabilities | ||
| 1 Also entitled to special monthly compensation. | ||
| Impairment of one extremity | Impairment of other extremity | |||||
|---|---|---|---|---|---|---|
| Anatomical loss or loss of use below elbow | Anatomical loss or loss of use below knee | Anatomical loss or loss of use above elbow (preventing use of prosthesis) | Anatomical loss or loss of use above knee (preventing use of prosthesis) | Anatomical loss near shoulder (preventing use of prosthesis) | Anatomical loss near hip (preventing use of prosthesis) | |
| Anatomical loss or loss of use below elbow | M Codes M-1 a, b, or c, 38 CFR 3.350 (c)(1)(i) | L Codes L-1 d, e, f, or g, 38 CFR 3.350(b) | M1⁄2 Code M-5, 38 CFR 3.350 (f)(1)(x) | L1⁄2 Code L-2 c, 38 CFR 3.350 (f)(1)(vi) | N Code N-3, 38 CFR 3.350 (f)(1)(xi) | M Code M-3 c, 38 CFR 3.350 (f)(1)(viii) |
| Anatomical loss or loss of use below knee | L Codes L-1 a, b, or c, 38 CFR 3.350(b) | L1⁄2 Code L-2 b, 38 CFR 3.350 (f)(1)(iii) | L1⁄2 Code L-2 a, 38 CFR 3.350 (f)(1)(i) | M Code M-3 b, 38 CFR 3.350 (f)(1)(iv) | M Code M-3 a, 38 CFR 3.350 (f)(1)(ii) | |
| Anatomical loss or loss of use above elbow (preventing use of prosthesis) | N Code N-1, 38 CFR 3.350 (d)(1) | M Code M-2 a, 38 CFR 3.350 (c)(1)(iii) | N1⁄2 Code N-4, 38 CFR 3.350 (f)(1)(ix) | M1⁄2 Code M-4 c, 38 CFR 3.350 (f)(1)(xi) | ||
| Anatomical loss or loss of use above knee (preventing use of prosthesis) | M Code M-2 a, 38 CFR 3.350 (c)(1)(ii) | M1⁄2 Code M-4 b, 38 CFR 3.350 (f)(1)(vii) | M1⁄2 Code M-4 a, 38 CFR 3.350 (f)(1)(v) | |||
| Anatomical loss near shoulder (preventing use of prosthesis) | O Code O-1, 38 CFR 3.350 (e)(1)(i) | N Code N-2 b, 38 CFR 3.350 (d)(3) | ||||
| Anatomical loss near hip (preventing use of prosthesis) | N Code N-2 a, 38 CFR 3.350 (d)(2) | |||||
| Note.-Need for aid attendance or permanently bedridden qualifies for subpar. L. Code L-1 h, i (38 CFR 3.350(b)). Paraplegia with loss of use of both lower extremities and loss of anal and bladder sphincter control qualifies for subpar. O. Code O-2 (38 CFR 3.350(e)(2)). Where there are additional disabilities rated 50% or 100%, or anatomical or loss of use of a third extremity see 38 CFR 3.350(f) (3), (4) or (5). | ||||||
| Rating | ||
|---|---|---|
| Major | Minor | |
| Arm, amputation of: | ||
| 1 Entitled to special monthly compensation. | ||
| Rating | ||
|---|---|---|
| Major | Minor | |
| Forearm, amputation of: | ||
| 1 Entitled to special monthly compensation. | ||
| Rating | ||
|---|---|---|
| Major | Minor | |
| multiple finger amputations | ||
| 1 Entitled to special monthly compensation. | ||
| Rating | ||
|---|---|---|
| Major | Minor | |
| (a) The ratings for multiple finger amputations apply to amputations at the proximal interphalangeal joints or through proximal phalanges. | ||
| (b) Amputation through middle phalanges will be rated as prescribed for unfavorable ankylosis of the fingers. | ||
| (c) Amputations at distal joints, or through distal phalanges, other than negligible losses, will be rated as prescribed for favorable ankylosis of the fingers. | ||
| (d) Amputation or resection of metacarpal bones (more than one-half the bone lost) in multiple fingers injuries will require a rating of 10 percent added to (not combined with) the ratings, multiple finger amputations, subject to the amputation rule applied to the forearm. | ||
| (e) Combinations of finger amputations at various levels, or finger amputations with ankylosis or limitation of motion of the fingers will be rated on the basis of the grade of disability; i.e., amputation, unfavorable ankylosis, most representative of the levels or combinations. With an even number of fingers involved, and adjacent grades of disability, select the higher of the two grades. | ||
| (f) Loss of use of the hand will be held to exist when no effective function remains other than that which would be equally well served by an amputation stump with a suitable prosthetic appliance. | ||
| 1 Entitled to special monthly compensation. | ||
| Rating | ||
|---|---|---|
| Major | Minor | |
| Four digits of one hand, amputation of: | ||
| 1 Entitled to special monthly compensation. | ||
| Rating | ||
|---|---|---|
| Major | Minor | |
| Three digits of one hand, amputation of: | ||
| 1 Entitled to special monthly compensation. | ||
| Rating | ||
|---|---|---|
| Major | Minor | |
| Two digits of one hand, amputation of: | ||
| 1 Entitled to special monthly compensation. | ||
| Rating | ||
|---|---|---|
| Major | Minor | |
| single finger amputations | ||
| 1 Entitled to special monthly compensation. | ||
| Rating | ||
|---|---|---|
| Major | Minor | |
| Note: The single finger amputation ratings are the only applicable ratings for amputations of whole or part of single fingers. | ||
| 1 Entitled to special monthly compensation. | ||
| Rating | |
|---|---|
| Thigh, amputation of: | |
| 2 Also entitled to special monthly compensation. | |
| Rating | |
|---|---|
| Leg, amputation of: | |
| 2 Also entitled to special monthly compensation. | |
| Rating | ||
|---|---|---|
| Major | Minor | |
| Note: In all the forearm and wrist injuries, codes 5205 through 5213, multiple impaired finger movements due to tendon tie-up, muscle or nerve injury, are to be separately rated and combined not to exceed rating for loss of use of hand. | ||
| Rating | ||
|---|---|---|
| Major | Minor | |
| (1) For the index, long, ring, and little fingers (digits II, III, IV, and V), zero degrees of flexion represents the fingers fully extended, making a straight line with the rest of the hand. The position of function of the hand is with the wrist dorsiflexed 20 to 30 degrees, the metacarpophalangeal and proximal interphalangeal joints flexed to 30 degrees, and the thumb (digit I) abducted and rotated so that the thumb pad faces the finger pads. Only joints in these positions are considered to be in favorable position. For digits II through V, the metacarpophalangeal joint has a range of zero to 90 degrees of flexion, the proximal interphalangeal joint has a range of zero to 100 degrees of flexion, and the distal (terminal) interphalangeal joint has a range of zero to 70 or 80 degrees of flexion | ||
| (2) When two or more digits of the same hand are affected by any combination of amputation, ankylosis, or limitation of motion that is not otherwise specified in the rating schedule, the evaluation level assigned will be that which best represents the overall disability (i.e., amputation, unfavorable or favorable ankylosis, or limitation of motion), assigning the higher level of evaluation when the level of disability is equally balanced between one level and the next higher level | ||
| (3) Evaluation of ankylosis of the index, long, ring, and little fingers: | ||
| (i) If both the metacarpophalangeal and proximal interphalangeal joints of a digit are ankylosed, and either is in extension or full flexion, or there is rotation or angulation of a bone, evaluate as amputation without metacarpal resection, at proximal interphalangeal joint or proximal thereto | ||
| (ii) If both the metacarpophalangeal and proximal interphalangeal joints of a digit are ankylosed, evaluate as unfavorable ankylosis, even if each joint is individually fixed in a favorable position | ||
| (iii) If only the metacarpophalangeal or proximal interphalangeal joint is ankylosed, and there is a gap of more than two inches (5.1 cm.) between the fingertip(s) and the proximal transverse crease of the palm, with the finger(s) flexed to the extent possible, evaluate as unfavorable ankylosis | ||
| (iv) If only the metacarpophalangeal or proximal interphalangeal joint is ankylosed, and there is a gap of two inches (5.1 cm.) or less between the fingertip(s) and the proximal transverse crease of the palm, with the finger(s) flexed to the extent possible, evaluate as favorable ankylosis | ||
| (4) Evaluation of ankylosis of the thumb: | ||
| (i) If both the carpometacarpal and interphalangeal joints are ankylosed, and either is in extension or full flexion, or there is rotation or angulation of a bone, evaluate as amputation at metacarpophalangeal joint or through proximal phalanx | ||
| (ii) If both the carpometacarpal and interphalangeal joints are ankylosed, evaluate as unfavorable ankylosis, even if each joint is individually fixed in a favorable position | ||
| (iii) If only the carpometacarpal or interphalangeal joint is ankylosed, and there is a gap of more than two inches (5.1 cm.) between the thumb pad and the fingers, with the thumb attempting to oppose the fingers, evaluate as unfavorable ankylosis | ||
| (iv) If only the carpometacarpal or interphalangeal joint is ankylosed, and there is a gap of two inches (5.1 cm.) or less between the thumb pad and the fingers, with the thumb attempting to oppose the fingers, evaluate as favorable ankylosis | ||
| (5) If there is limitation of motion of two or more digits, evaluate each digit separately and combine the evaluations | ||
| Rating | ||
|---|---|---|
| Major | Minor | |
| I. Multiple Digits: Unfavorable Ankylosis | ||
| Rating | ||
|---|---|---|
| Major | Minor | |
| II. Multiple Digits: Favorable Ankylosis | ||
| Rating | ||
|---|---|---|
| Major | Minor | |
| III. Ankylosis of Individual Digits | ||
| Rating | ||
|---|---|---|
| Major | Minor | |
| IV. Limitation of Motion of Individual Digits | ||
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Official Sources
Last verified 2026-10-25. Source publication or legal effective dates are shown separately where available.
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