Claiming Thumb Condition / Thumb Pain?
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VA Rating Tiers
20%
fused or no opposition
20%
severe
10%
moderate
0%
mild
0%
Meets minimum criteria
Rating Notes
- ›20%: Marked limitation of thumb motion — significant loss of opposition or flexion. DC 5228.
- ›10%: Moderate limitation of thumb motion — some loss of opposition or pinch strength. DC 5228.
- ›0%: Mild limitation — service connected but non-compensable.
- ›DC 5228: Thumb, limitation of motion.
- ›10%: Limitation of opposition or abduction.
- ›20%: More severe limitation or ankylosis.
- ›Dominant thumb rates 10% higher under 38 CFR § 4.68.
- ›CMC arthroplasty (LRTI) is a common surgical treatment — post-surgical ROM drives the rating.
- ›If thumb limitation also causes grip weakness, also consider filing DC 5155 by analogy for hand function.
Eligibility Basics
✅
Current symptoms
✅
In-service event
✅
Diagnosis or lay evidence
- •DC 5228 — thumb, limitation of motion; rated based on opposition, abduction, and extension.
- •Dominant vs. non-dominant thumb affects combined rating under 38 CFR § 4.68.
- •CMC (basal joint) arthritis is a common service-related residual — document with X-ray.
- •UCL (ulnar collateral ligament) tears from injuries during service also fall under this code.
Evidence to Gather
Service Records
- •in-service records of thumb fracture, sprain, or ligament injury
- •sick call records documenting thumb pain during service
Medical Evidence
- •hand surgery or orthopedic records with thumb ROM measurements
- •thumb X-ray showing arthritis, fracture residuals, or instability
Lay Evidence (Buddy Statements)
- •personal statement describing thumb injury during service and current grip or pinch limitations
Diagnostic Tests
- •thumb X-ray
- •MRI thumb (ligament integrity)
- •goniometric ROM of CMC/MCP/IP joints
C&P Exam Preparation
Exam type: Orthopedic / Hand and Thumb DBQ
Be ready to describe
- •which thumb is affected and how it was injured
- •whether you can oppose thumb to each finger
- •impact on grip, pinch, and daily tasks
Prep notes
- •Demonstrate actual pinch and opposition — do not push through pain.
- •Note which hand is dominant.
- •Bring X-rays and any surgical records.
Quick Facts
- Diagnostic Code
- DC 5228
- Category
- Musculoskeletal
- Subcategory
- Upper Extremity
- Typical Claim Type
- direct
- Rating Range
- 0% – 20%
Also Known As
thumb conditionthumb painthumb injurythumb limitation of motionthumb stiffnessgamekeeper's thumbskier's thumbUCL thumbCMC arthritis thumbthumb fracture residualsthumb sprain chronic
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