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5209
§ 4.71a Schedule of ratings—musculoskeletal system.

Elbow instability (flail joint)

Elbow instability with excessive, uncontrolled movement at the joint.

What the rating means

Diagnostic code 5209 covers two distinct levels of elbow impairment, and which arm is affected changes the percentage. A flail joint of the elbow — meaning the joint has lost its normal structural stability — is rated at 60% for the major arm and 50% for the minor arm. A joint fracture with marked cubitus varus or cubitus valgus deformity, or with an ununited fracture of the head of the radius, is rated at 20% for either arm. The major arm is generally the dominant arm and the minor arm the nondominant arm. There is no intermediate rating between these two levels; the evidence either supports the higher flail-joint level or the lower deformity or ununited-fracture level. If you have a prosthetic replacement of the elbow joint evaluated under a separate diagnostic code, an additional rating under this code cannot also be assigned for the same joint unless the schedule specifically directs otherwise.

Evidence that helps

To support a rating for a flail joint, medical records and examination findings would need to show gross instability of the elbow, such as abnormal or uncontrolled movement at the joint that reflects loss of its structural integrity. An orthopedic or VA examination documenting this finding in the dominant or nondominant arm would be central evidence. For the lower level — marked cubitus varus or cubitus valgus deformity or an ununited fracture of the head of the radius — imaging such as X-rays can document the angular deformity or confirm that a fracture of the radial head has not healed. Examination findings describing the visible or measurable deformity also support this level. Statements from you or people who know you describing how elbow instability or deformity affects your ability to lift, carry, or perform tasks at work and in daily life can help show the functional impact of the condition at either level.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.