VA Disability Rating for Nonunion of Radius and Ulna
Diagnostic Code 5210 · 38 CFR §4.71a
What Is It?
Nonunion of the radius and ulna means that fractures of both forearm bones have failed to heal, leaving a false joint or unstable forearm. This is a serious condition because both bones must work together to support the forearm and allow rotation. When both bones have nonunion, the forearm becomes essentially non-functional, unable to bear weight or rotate properly. This condition typically results from severe high-energy fractures, often from combat injuries, vehicle accidents, or falls from height during military service. DC 5210 has a single criterion — "Radius and ulna, nonunion of, with flail false joint" — rated 50 percent for the major (dominant) arm and 40 percent for the minor arm under 38 CFR 4.69. Nonunion of only one forearm bone is rated under that bone's own code: DC 5211 for the ulna, DC 5212 for the radius.
Rating Criteria
| Rating | Criteria |
|---|---|
| 50% | Nonunion of the radius and ulna, with flail false joint — major (dominant) arm. |
| 40% | Nonunion of the radius and ulna, with flail false joint — minor (non-dominant) arm. |
Evidence Needed
- Imaging showing nonunion of both the radius and ulna
- Medical records from the original fractures during service
- Documentation of forearm instability and functional loss
- Records of surgical attempts to achieve union if any
- Documentation of which arm is dominant
C&P Exam Tips
- Show the examiner the instability of the forearm
- Demonstrate the inability to rotate the forearm or bear weight through the arm
- Describe tasks that are impossible due to the forearm instability
- Bring imaging showing the persistent nonunion
- Document your dominant arm
How to File
File under DC 5210 for nonunion of both forearm bones. Include imaging clearly showing persistent nonunion and document the severe functional limitations. If the arm keeps you from working, individual unemployability can be raised. DC 5210 alone (50 or 40 percent) is below the 60 percent single-disability threshold in 38 CFR 4.16(a), though § 4.16(a) counts disabilities of one or both upper extremities as one disability, and § 4.16(b) allows referral when the percentages are not met.
Common Mistakes
- Not distinguishing between nonunion of one bone versus both bones.
- Not getting follow-up imaging to confirm persistent nonunion.
- Failing to document the complete loss of forearm function.
- Not raising other disabilities of the same arm, which 38 CFR 4.16(a) counts together with this one for individual unemployability.
Frequently Asked Questions
What is the difference between nonunion and malunion?
Nonunion means the fracture never healed and the bone ends remain separate. Malunion means the fracture healed but in a misaligned position. Nonunion is generally rated higher because it creates an unstable false joint.
Can nonunion be fixed with surgery?
Sometimes, with bone grafting and internal fixation. However, nonunion of both forearm bones is difficult to treat and even after surgery, residual limitations often remain. Your rating should reflect your current level of function.