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5147
§ 4.71a Schedule of ratings—musculoskeletal system.

Index and ring finger loss

Amputation of the index and ring fingers on one hand.

What the rating means

Diagnostic code 5147 covers the combined loss of the index finger and ring finger. VA rates this condition based on which hand is affected. If the loss involves your major hand — typically your dominant hand — the rating is 40 percent. If it involves your minor hand — typically your nondominant hand — the rating is 30 percent. These are the only two rating levels under this code.

The regulation also provides rules for situations where two or more digits of the same hand are affected by a combination of amputation, ankylosis, or limited motion not otherwise covered. In those cases, VA assigns the evaluation level that best represents the overall disability, choosing the higher level when the severity falls equally between two levels. If ankylosis is involved, VA looks at whether the affected joints are fixed in favorable or unfavorable positions, and at the gap between the fingertip and the palm when the finger is flexed as far as possible.

Evidence that helps

Medical records documenting the anatomical loss of both the index and ring fingers are central to a claim under this code. Surgical operative reports, pathology records, or amputation records that confirm what was removed and at what level help establish the nature of the loss. Examination findings showing the current state of each affected finger, including any remaining structures, support the rating.

If ankylosis rather than amputation is at issue, examination records should document whether one or both joints of a finger are fixed, the degree of flexion possible, and the measured gap between the fingertip and the proximal transverse crease of the palm when the finger is flexed as far as possible. A gap of more than two inches points toward unfavorable ankylosis, while two inches or less points toward favorable ankylosis. Statements from you or people who observe you regularly about how the loss of these fingers affects tasks at work and in daily life can also help show the functional impact of the disability.

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.