Loss of use of both hands

To support a 100% rating under diagnostic code 5109, evidence needs to show that you have lost effective use of both hands. Medical records documenting the cause of the loss — such as traumatic injury, nerve damage, amputation, or severe disease affecting both hands — are central. VA examination findings that describe the actual function remaining in each hand carry significant weight. Physicians' notes recording that you cannot perform grasping, pinching, or other purposeful hand movements help establish the threshold. Imaging, nerve conduction studies, or surgical reports can corroborate the severity. Statements from you or people who know you that describe how the condition affects daily tasks — such as dressing, preparing food, or holding objects — show the practical impact on function. Records from occupational therapists or rehabilitation specialists that document functional limitations can also reflect the degree of loss that VA's standard requires.