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5144
§ 4.71a Schedule of ratings—musculoskeletal system.

Thumb and ring finger loss

Amputation of the thumb and ring finger on one hand.

What the rating means

Diagnostic code 5144 covers the combined anatomical loss of the thumb and ring finger on the same hand. VA rates this condition at 50% if the loss involves your major (dominant) hand and 40% if it involves your minor (nondominant) hand. These are the only two rating levels listed 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 otherwise specified in the rating schedule, VA assigns the evaluation level that best represents the overall disability. If the level of disability falls equally between two levels, the higher level applies. The major hand is generally your dominant hand and the minor hand your nondominant hand, so the hand you primarily use for daily tasks matters when VA assigns a rating under this code.

Evidence that helps

To support a rating under this code, your records should document the anatomical loss of both the thumb and the ring finger on the affected hand. Operative reports, pathology records, or clinical notes confirming the amputation or absence of these digits are the most direct evidence. Examination findings that clearly identify which hand is involved — dominant or nondominant — matter because the rating differs by hand.

If the condition involves ankylosis or limitation of motion rather than outright amputation, VA examines how far each digit can flex, whether joints are fixed in favorable or unfavorable positions, and the gap between the fingertip and the palm crease. Statements from you or people who know you describing how the loss of these two digits affects tasks such as gripping, writing, or other daily activities can help show the functional impact, which may be relevant when VA weighs the overall disability 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.