Loss of Index, Middle, and Ring Fingers — VA Disability Rating (DC 5138)
Diagnostic Code 5138 · 38 CFR §4.71a
What Is It?
Amputation of the index, middle and ring fingers of one hand. 38 CFR 4.71a rates this under DC 5138, "Index, long and ring" — 50 percent on the dominant (major) hand, 40 percent on the non-dominant (minor) hand; the schedule calls the middle finger the long finger. Three fingers of one hand with the thumb intact fall into four entries, each with its own page: DC 5138 (index, long and ring), DC 5139 (index, long and little) and DC 5140 (index, ring and little) are 50 percent dominant and 40 percent non-dominant, and DC 5141 (long, ring and little) is 40 percent dominant and 30 percent non-dominant. The multiple-finger ratings apply to amputations at the proximal interphalangeal joints or through the proximal phalanges; where a metacarpal is also resected, more than half the bone lost, the schedule adds 10 percent — added to, not combined with, the multiple-finger rating — subject to the amputation rule. The number 5128, kept in this page's URL, is the schedule's entry for amputation of the thumb, index, long and little fingers.
Rating Criteria
| Rating | Criteria |
|---|---|
| 50% | Dominant (major) hand — amputation of the index, long and ring fingers. |
| 40% | Non-dominant (minor) hand — amputation of the index, long and ring fingers. |
Evidence Needed
Service treatment records or VA medical records documenting the amputation. Operative reports if surgical. Documentation of the specific amputation level. Prosthetic evaluation records. For traumatic amputations, line of duty determination and incident documentation.
C&P Exam Tips
- Ensure the examiner documents the exact level of amputation
- Report any residual limb complications such as phantom pain, neuromas, or skin breakdown
- Describe prosthetic use limitations and fit problems if applicable
- Mention if dominant or non-dominant extremity is affected
How to File
File under DC 5138 with documentation of the amputation level. Include operative reports, prosthetic fitting records, and evidence of any residual limb complications. Ensure your claim specifies dominant vs non-dominant extremity when applicable. File secondary claims for phantom pain, mental health conditions, and compensatory musculoskeletal issues separately.
Common Mistakes
Not claiming Special Monthly Compensation (SMC) which is a separate entitlement on top of the disability rating. Failing to file for secondary conditions like phantom pain or depression. Not documenting prosthetic complications that may warrant additional ratings. Not specifying dominant vs non-dominant extremity when applicable.
Frequently Asked Questions
What is Special Monthly Compensation (SMC) for amputations?
SMC is additional monthly compensation paid on top of your regular disability rating. SMC(k) applies to anatomical loss or loss of use of a hand, foot, or creative organ. Higher SMC levels apply for combinations of losses or when aid and attendance is needed. SMC is not automatic — ensure it is specifically claimed.
Does the VA provide prosthetic devices?
Yes. Veterans with service-connected amputations are entitled to VA prosthetic services at no cost, including initial fitting, replacements, repairs, and upgrades to newer technology. This includes microprocessor knees, myoelectric upper extremity prosthetics, and specialized devices.
Can I get TDIU with an amputation rating?
Yes. If your amputation rating (alone or combined with other disabilities) prevents you from maintaining substantially gainful employment, you may qualify for Total Disability based on Individual Unemployability (TDIU), which pays at the 100% rate even if your combined rating is lower.