Ankylosis of the Long (Middle) Finger — VA Disability Rating Criteria (DC 5226)
Diagnostic Code 5226 · 38 CFR §4.71a
What Is It?
Ankylosis of the long (middle) finger means complete loss of motion in the middle finger joints. The middle finger is the longest digit and contributes significantly to grip strength. Its loss of motion affects the ability to firmly grasp objects and perform tasks requiring a full power grip.
Rating Criteria
| Rating | Criteria |
|---|---|
| 10% | Either hand — ankylosis of the long (middle) finger, favorable or unfavorable. 38 CFR 4.71a lists one row for DC 5226: 10 percent major, 10 percent minor, whichever the position. |
Evidence Needed
Medical records documenting complete loss of motion (ankylosis) in the affected finger joints. X-rays or imaging showing joint fusion or fixation. Range of motion testing showing zero degrees of motion. Documentation of whether ankylosis is in favorable or unfavorable position. Service treatment records or nexus opinion linking the condition to military service.
C&P Exam Tips
- Ensure the examiner documents that the joint has ZERO motion — not just limited motion
- Have the examiner note whether the position is favorable or unfavorable for function
- Demonstrate what tasks you cannot perform due to the fixed finger position
- Report if the ankylosed finger interferes with motion of adjacent fingers
- Mention if the condition affects your dominant or non-dominant hand
How to File
File a claim for ankylosis of the affected finger(s) under DC 5226. Provide imaging showing joint fusion and range of motion testing confirming zero degrees of motion. Specify whether this affects your dominant or non-dominant hand, as ratings may differ. Include evidence of how the condition limits your occupational and daily functioning.
Common Mistakes
Confusing limited range of motion with ankylosis — ankylosis requires complete absence of motion. Not specifying dominant vs non-dominant hand. Failing to document whether the position is favorable or unfavorable. Not claiming secondary conditions in adjacent joints that compensate for the ankylosed finger.
Frequently Asked Questions
What is the difference between limited motion and ankylosis?
Limited motion means the joint still moves but not through its full range. Ankylosis means the joint has absolutely zero motion — it is completely fixed or fused in one position. The VA rates these very differently, so accurate documentation is critical.
Does it matter if ankylosis is in favorable or unfavorable position?
Yes. Favorable ankylosis means the finger is fixed in a position that still allows some useful hand function. Unfavorable ankylosis means the finger is fixed in a position that impairs hand function or gets in the way of using other fingers. Unfavorable position receives a higher rating.
Can I get a higher rating if the ankylosis affects my dominant hand?
For multi-finger ankylosis codes (DC 5216-5223), the dominant hand typically receives a higher rating than the non-dominant hand. For single finger ankylosis (DC 5224-5227), the rating is generally the same regardless of dominance, though functional impact should still be documented.