VA Disability Rating for Other Elbow Impairment
Diagnostic Code 5209 · 38 CFR §4.71a
What Is It?
DC 5209, "Elbow, other impairment of," covers two elbow impairments that the range of motion and ankylosis codes do not capture. The first is flail joint of the elbow, where the joint is so unstable it has no useful function: 60 percent for the major (dominant) arm and 50 percent for the minor arm. The second is a joint fracture with marked cubitus varus or cubitus valgus deformity, or with an ununited fracture of the head of the radius: 20 percent for either arm. Those are the only criteria the code prints. A flail elbow is a severely disabling condition where the joint has excessive, uncontrollable motion. Veterans may develop these conditions from severe elbow fractures, blast injuries, or failed surgical procedures during service.
Rating Criteria
| Rating | Criteria |
|---|---|
| 60% | Flail joint — major (dominant) arm. |
| 50% | Flail joint — minor (non-dominant) arm. |
| 20% | Joint fracture, with marked cubitus varus or cubitus valgus deformity or with ununited fracture of head of radius — either arm. |
Evidence Needed
- Imaging showing the elbow structural abnormality
- Physical examination documenting joint instability or deformity
- Range of motion and stability testing results
- Medical records from the original injury during service
- Documentation of dominant arm
C&P Exam Tips
- Allow the examiner to test elbow stability in all directions
- Show any visible deformity in the elbow alignment
- Describe functional limitations from instability or deformity
- Demonstrate tasks that are impossible or dangerous due to the unstable elbow
- Document your dominant arm
How to File
File under DC 5209 for other elbow impairment. Clearly describe the type of impairment — a flail joint, or a joint fracture with marked cubitus varus or valgus deformity or an ununited fracture of the head of the radius. Include imaging and stability testing. If you have a flail elbow, document how the lack of elbow control affects all upper extremity function, and document which arm is dominant. If a fracture has healed without those findings but has cost motion, that loss is evaluated under the elbow motion codes (DCs 5206 and 5207).
Common Mistakes
- Not getting proper stability testing to document the degree of impairment.
- Having a flail joint rated as simple limitation of motion.
- Not documenting the angular deformity in fracture cases.
- Missing ulnar nerve damage associated with elbow deformity.
Frequently Asked Questions
What is a flail elbow joint?
A flail joint means the elbow has lost all structural stability and moves freely in directions it should not. The joint essentially has no useful function because you cannot control its movement. This is usually the result of severe bone and ligament destruction.
What is cubitus varus or valgus?
Cubitus varus is an inward angulation of the forearm relative to the upper arm, sometimes called gunstock deformity. Cubitus valgus is an outward angulation. Both are residuals of elbow fractures that healed in a misaligned position.