Ankylosis of the Ring or Little Finger — VA Disability Rating Criteria (DC 5227)

Diagnostic Code 5227 · 38 CFR §4.71a

What Is It?

DC 5227 assigns 0 percent. Ankylosis of the ring or little finger evaluates at zero on the major hand and zero on the minor hand, favorable or unfavorable, and there is no higher step inside this code. That is the honest starting point for this claim, and it is worth knowing before you file rather than after the decision arrives. A 0 percent evaluation is not nothing. It establishes service connection, which opens VA health care for the condition, preserves the effective date, and means a later increase does not require proving the service link again. It also matters if the hand gets worse or if other digits become involved, because the multiple-digit codes pay substantially more. The more useful part of this code is its Note, which directs the rater to "also consider whether evaluation as amputation is warranted and whether an additional evaluation is warranted for resulting limitation of motion of other digits or interference with overall function of the hand." Those are two separate routes off a 0 percent code, and both are real. Amputation of the ring finger (DC 5155) or the little finger (DC 5156) pays 20 percent with metacarpal resection where more than one-half the bone is lost, and 10 percent without metacarpal resection at the proximal interphalangeal joint or proximal to it — the same figures for either hand. A finger fused in a position that gets in the way of the others can also produce an additional evaluation for what it does to the rest of the hand. Ankylosis means the joint has no motion at all. Where the finger still moves but not fully, the relevant code is DC 5230, limitation of motion of the ring or little finger — which is also 0 percent for any limitation of motion, on either hand.

Rating Criteria

Evidence Needed

• Range of motion findings for the affected finger showing zero degrees, distinguishing true ankylosis from limited motion. Both evaluate at 0 percent under this code and DC 5230, so this matters less for the percentage than for what else can be claimed.
• A description of the position the finger is fixed in, and specifically whether it obstructs the adjacent fingers when they move or when the hand closes. That is the finding the Note's "interference with overall function of the hand" language is built on.
• Range of motion for the other digits of the same hand, measured with the ankylosed finger in its fixed position. If the fused finger costs the neighbors motion, that loss is separately ratable.
• Imaging showing the level of any bone loss. Where more than one-half of the metacarpal has been lost, the amputation evaluation under DC 5155 or DC 5156 rises from 10 to 20 percent, so the amount of bone gone is the operative fact.
• Grip and pinch strength testing, and a functional description of tasks the hand can no longer perform.
• Service treatment records for the original injury, plus any surgical history, since fusion is frequently the treatment rather than the injury.
• Documentation of pain in the joint. Under 38 CFR 4.59 an actually painful joint is entitled to at least the minimum compensable rating for that joint — but note that the minimum under this code is 0 percent, which is why the amputation and hand-function routes matter more here than the painful-motion rule.

C&P Exam Tips

• Ask the examiner directly whether evaluation as amputation would be more favorable. The Note to this code tells the rater to consider it, and the examination is where the findings that support it get recorded.
• Have the examiner measure the other fingers with the ankylosed finger in place. A little finger fused in extension can block the ring and long fingers from closing, and that loss belongs to those digits.
• Show the hand closing around an object rather than describing it. Where the fixed finger prevents a full fist or a flat grip, demonstrate it.
• Make sure the level of bone loss is documented if any metacarpal was resected. More than one-half of the bone lost is the line between the 10 and 20 percent amputation evaluations.
• Do not let the examination stop at the one finger. The Note is explicitly about the rest of the hand, and an examination that documents only the ankylosed digit forecloses the additional evaluation.
• Report pain, cold sensitivity, and any numbness — nerve involvement of the hand is separately evaluated and commonly accompanies crush and degloving injuries.
• Say what you have stopped doing at work and at home. Even where the schedular figure is zero, that record supports later increases and any extraschedular consideration.
• Confirm dominant hand for the record. It does not change this code, where both columns are zero, but it changes every other hand code that may come into play.

How to File

File it, and file it knowing the code itself pays nothing. Service connection at 0 percent secures the effective date, opens VA care for the condition, and removes the service-connection question from any future increase. Those are the reasons to file a claim the schedule values at zero. Then claim the two things the Note actually points at. Ask expressly that evaluation as amputation be considered — DC 5155 for the ring finger and DC 5156 for the little finger pay 20 percent where more than one-half of the metacarpal has been lost and 10 percent without metacarpal resection at or proximal to the proximal interphalangeal joint, identically for either hand. And ask for an additional evaluation for what the fixed finger does to the rest of the hand: the Note authorizes one for resulting limitation of motion of other digits or interference with overall function. Make sure the examination measures the neighboring fingers rather than only the ankylosed one. That single request is usually the difference between a 0 percent outcome and a compensable one, because the additional evaluation the Note allows has to be built from findings about the other digits.

Common Mistakes

Expecting a 10 percent evaluation for unfavorable ankylosis. DC 5227 lists 0 percent in both the major and minor columns and does not distinguish favorable from unfavorable — there is no 10 percent step in this code. Skipping the claim because the percentage is zero. The 0 percent grant is what preserves the effective date and the service-connection finding, and it is what a later increase is built on. Letting the examination cover only the affected finger. The additional evaluation the Note authorizes depends on findings about the other digits and about overall hand function, and those have to be measured. Not asking about amputation evaluation, which the Note directs the rater to consider and which is where the compensable figures for these two fingers actually live. Missing the metacarpal resection detail. Whether more than one-half of the bone was lost is the difference between 10 and 20 percent under DC 5155 and DC 5156. Assuming 38 CFR 4.59 rescues a painful ankylosed finger. That rule entitles a painful joint to the minimum compensable rating for the joint, and under this code the minimum is zero.

Frequently Asked Questions

Is unfavorable ankylosis of the little finger rated at 10 percent?

No. DC 5227 assigns 0 percent for ankylosis of the ring or little finger, and the schedule lists that figure in both the major and the minor column without distinguishing favorable from unfavorable. There is no compensable step inside this diagnostic code. The compensable routes are the ones named in the code's Note — evaluation as amputation, and an additional evaluation for the effect on the rest of the hand.

Then why file at all?

Because a 0 percent grant is still service connection. It fixes the effective date, it makes the condition eligible for VA health care, and it means that if the finger or the hand deteriorates later, the claim is an increase rather than a fresh service-connection case. Zero percent evaluations exist for exactly this purpose under 38 CFR 4.31.

What does the Note about amputation actually get me?

Amputation of the ring finger is DC 5155 and of the little finger is DC 5156. Each pays 20 percent with metacarpal resection where more than one-half the bone is lost, and 10 percent without metacarpal resection at the proximal interphalangeal joint or proximal to it — the same figures for the dominant and non-dominant hand. Where a finger is fused in a useless position and bone has been lost, that comparison is the one that can produce a compensable evaluation.

My fused little finger stops my other fingers from closing. Is that ratable?

Yes, and it is written into the code. The Note directs consideration of whether an additional evaluation is warranted for resulting limitation of motion of other digits or interference with overall function of the hand. The evidence for it is range of motion measured on the other fingers with the ankylosed finger in its fixed position — which only happens if the examination is asked to do it.

Does it matter which hand is affected?

Not for this code. DC 5227 lists 0 percent in both the major and the minor column, so handedness makes no difference to the evaluation. It matters a great deal for the other hand codes, so it is still worth having dominance recorded at the examination in case the claim moves to a multiple-digit code or to an amputation evaluation.

What if the finger still moves a little?

Then it is limitation of motion rather than ankylosis, and the applicable code is DC 5230 — limitation of motion of the ring or little finger — which the schedule also evaluates at 0 percent for any limitation of motion, on either hand. The practical consequences are the same: the value of the claim lies in service connection, in the effect on the rest of the hand, and in the amputation comparison.