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5223
§ 4.71a Schedule of ratings—musculoskeletal system.

Two fingers favorable stiffness

Two fingers on one hand are locked in a position that allows some hand function.

What the rating means

VA rates favorable ankylosis of two digits of one hand under diagnostic code 5223. Ankylosis means a joint is fixed and cannot move. Favorable ankylosis means the joint is locked in a position that still allows some useful hand function, as defined by the rating schedule. The rating depends on which two fingers are affected and whether the hand is your major (dominant) or minor (nondominant) hand.

If the thumb and any one finger are ankylosed, the rating is 30% for the major hand and 20% for the minor hand. If the index finger and the long, ring, or little finger are ankylosed together, the rating is 20% for either hand. If the affected two fingers are the long and ring, long and little, or ring and little fingers, the rating is 10% for either hand.

When two or more digits of the same hand are affected by a combination of conditions not directly listed in the schedule, VA assigns the level that best represents the overall disability, choosing the higher level when the disability falls equally between two levels.

Evidence that helps

Medical records documenting which specific fingers are ankylosed and confirming that the ankylosis is favorable — meaning only one joint per digit is fixed, and the fingertip can come within two inches of the proximal transverse crease of the palm when flexed — support a rating under this code. For the thumb, records showing only one joint is ankylosed and the thumb pad can come within two inches of the fingers when attempting opposition also support a favorable finding.

Examination findings that identify the affected hand as your major or dominant hand or your minor or nondominant hand are relevant because some rating levels differ between the two. Imaging such as X-rays can document the fixed joint positions and rule out rotation or angulation of bone, which would change the evaluation. Statements from you or people who know you describing how the stiffened fingers affect grip, fine motor tasks, or work duties can help show the practical impact of the condition, which may be relevant when VA weighs the overall level of 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.