§ 4.71a Schedule of ratings—musculoskeletal system.

Elbow stiffness or immobility (ankylosis)

Complete stiffness or immobility of the elbow joint in a fixed position.

What the rating means

Elbow ankylosis means your elbow joint has fused and can no longer move through its normal range. VA rates this condition based on two things: the angle at which your elbow is fixed, and whether the arm is your major (dominant) or minor (nondominant) arm.

The highest rating applies when the elbow is fixed at an angle of less than 50 degrees, or when you have a complete loss of the ability to rotate your forearm (supination or pronation). This is called unfavorable ankylosis and is rated at 60% for the major arm and 50% for the minor arm.

A middle rating applies when the elbow is fixed at an angle of more than 90 degrees, or between 70 and 50 degrees. This is called intermediate ankylosis and is rated at 50% for the major arm and 40% for the minor arm.

The lowest rating applies when the elbow is fixed at an angle between 90 and 70 degrees. This is called favorable ankylosis and is rated at 40% for the major arm and 30% for the minor arm. The angle of fixation and which arm is affected are the two factors that separate each rating level.

Evidence that helps

Medical records and examination findings that document the fixed angle of your elbow are central to this rating. A VA or private orthopedic examination with goniometric measurements showing the exact degree at which your elbow is locked will directly support placement at a specific rating level. If your elbow is fixed at less than 50 degrees or you have lost all forearm rotation, records confirming complete absence of supination or pronation help support the highest rating.

Imaging such as X-rays can confirm fusion of the joint and may show the angle of fixation. Surgical or treatment records showing the history of how the ankylosis developed can also be useful.

Statements from you or people who know you describing how the fixed elbow affects your ability to use your arm for work tasks or daily activities — such as lifting, carrying, or reaching — can help show the functional impact. Because the rating differs by arm, records or statements that clearly identify which arm is affected, and whether that arm is your dominant or nondominant arm, are relevant to which percentage applies.

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.

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What the rating means

Evidence that helps

Secondary conditions

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