VA Disability Rating for Elbow Ankylosis
Diagnostic Code 5205 · 38 CFR §4.71a
What Is It?
Ankylosis of the elbow means the elbow joint is completely frozen or fused, with no bending or straightening movement possible. The angle at which the elbow is fixed determines the rating level, and DC 5205 sorts that angle into three bands. Favorable ankylosis is at an angle between 90° and 70°. Intermediate ankylosis is at an angle of more than 90°, or between 70° and 50°. Unfavorable ankylosis is at an angle of less than 50°, or with complete loss of supination or pronation — the forearm's ability to turn the palm up or down. Each band carries a major (dominant) and a minor (non-dominant) figure: 60 and 50 percent for unfavorable, 50 and 40 for intermediate, 40 and 30 for favorable. Under 38 CFR 4.69 only one arm is dominant. Veterans may develop elbow ankylosis from severe fractures, burns, blast injuries, or surgical fusion for instability or infection.
Rating Criteria
| Rating | Criteria |
|---|---|
| 60% | Unfavorable ankylosis, at an angle of less than 50° or with complete loss of supination or pronation — major (dominant) arm. |
| 50% | Unfavorable ankylosis, at an angle of less than 50° or with complete loss of supination or pronation — minor (non-dominant) arm. Also: intermediate ankylosis, at an angle of more than 90°, or between 70° and 50° — major (dominant) arm. |
| 40% | Intermediate ankylosis, at an angle of more than 90°, or between 70° and 50° — minor (non-dominant) arm. Also: favorable ankylosis, at an angle between 90° and 70° — major (dominant) arm. |
| 30% | Favorable ankylosis, at an angle between 90° and 70° — minor (non-dominant) arm. This is the minimum available under DC 5205. |
Evidence Needed
- Imaging confirming complete fusion or absence of elbow motion
- Range of motion testing showing zero active motion at the elbow
- Documentation of the angle at which the elbow is fixed
- Medical records linking the condition to service
- Records showing dominant versus non-dominant arm
C&P Exam Tips
- Allow the examiner to confirm zero motion at the elbow joint
- Make sure the exact angle of ankylosis is measured and documented
- Demonstrate what daily tasks you can and cannot perform with the fixed elbow
- Confirm which arm is dominant
- Describe how the fixed elbow affects work, dressing, and personal care
How to File
File under DC 5205 for elbow ankylosis. The exact angle of fusion is critical for determining your rating, so make sure it is precisely measured and documented in degrees, along with whether supination and pronation are completely lost — complete loss of either puts the elbow in the unfavorable band regardless of the angle. Document which arm is dominant, since every band has a major and a minor figure. Include imaging and service connection evidence.
Common Mistakes
- Not having the exact angle of ankylosis measured.
- Confusing severe limitation of motion with true ankylosis.
- Not documenting dominant versus non-dominant arm.
- Failing to claim secondary conditions from compensatory overuse of other joints.
Frequently Asked Questions
Why does the angle matter so much for elbow ankylosis?
Because the angle is most of the code. DC 5205 rates favorable ankylosis at an angle between 90° and 70°; intermediate ankylosis at an angle of more than 90°, or between 70° and 50°; and unfavorable ankylosis at an angle of less than 50°, or with complete loss of supination or pronation. A few degrees can move the elbow from one band to another, so the angle needs to be measured and written down in degrees rather than described.
Is a stiff elbow the same as ankylosis?
No. Ankylosis requires complete absence of motion. If you have any movement at the elbow, even a few degrees, the joint is not ankylosed. Severe limitation of elbow motion is rated under DC 5206 or 5207 instead.