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5139
§ 4.71a Schedule of ratings—musculoskeletal system.

Index, long and little finger loss

Amputation of the index, middle, and little fingers on one hand.

What the rating means

Diagnostic code 5139 covers the anatomical loss of three fingers together: the index, long, and little fingers. VA rates this condition at 50% if the loss is in your major hand (your dominant hand) and 40% if the loss is in your minor hand (your nondominant hand). These are the only two rating levels under this code.

When two or more digits of the same hand are affected by a combination of amputation, ankylosis, or limitation of motion not specifically listed elsewhere in the rating schedule, VA assigns the level that best represents your overall disability. When the disability falls equally between two levels, the higher level applies. The regulation also sets out specific rules for how ankylosis of finger joints is evaluated, including whether joints are fixed in favorable or unfavorable positions and how far you can flex your fingers toward your palm.

Evidence that helps

Medical records documenting the anatomical loss of the index, long, and little fingers are the core evidence for a rating under this code. Surgical or operative reports, discharge summaries, and pathology findings can confirm the nature and extent of the loss. A VA or private medical examination that identifies which hand is your dominant hand and which is your nondominant hand directly affects whether the 50% or 40% level applies, so records or statements establishing handedness matter.

If the condition involves ankylosis or limited motion rather than outright amputation, examination findings should measure the range of motion at each affected joint and record the gap between your fingertips and the proximal transverse crease of your palm when you try to flex your fingers. Findings showing whether joints are fixed in favorable or unfavorable positions are also relevant. Statements from you or people who know you describing how the loss of these three fingers affects tasks at work and in daily life can help show the full picture of your 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.