VA Disability for Arthritis in the Hands: Codes, Ratings, and TDIU

The VA disability rating for arthritis in the hands depends on which type of arthritis you have and how much it limits your hand function. Degenerative and traumatic arthritis usually produce ratings of 10% or 20% on their own, but higher ratings become available through the finger limitation-of-motion codes, the ankylosis codes when joints freeze, and, for rheumatoid or psoriatic arthritis, a separate systemic-disease scale that reaches 100%.

Which Diagnostic Code Applies to Your Arthritis

The VA rates hand arthritis under 38 CFR § 4.71a, and the specific code depends on the underlying disease:

Degenerative arthritis (osteoarthritis) is rated under Diagnostic Code (DC) 5003 and requires X-ray confirmation.¹
Traumatic arthritis, common after an in-service hand injury, is rated under DC 5010, which sends the examiner back to the DC 5003 criteria.²
Rheumatoid arthritis is rated under DC 5002, using a systemic-disease framework rather than joint-by-joint motion.³
Psoriatic arthritis falls under DC 5009 and is evaluated by analogy to rheumatoid arthritis under DC 5002.⁴

The type matters because degenerative and traumatic arthritis are capped at relatively low schedular ratings, while rheumatoid and psoriatic arthritis can reach 100% based on the severity of the systemic disease.

How the VA Counts Hand and Finger Joints

Hands contain many small joints, and the VA groups them into “minor joint groups” for rating purposes. Under 38 CFR § 4.45(f), multiple involvements of the interphalangeal, metacarpal, and carpal joints of the upper extremities count as groups of minor joints, ratable on parity with a major joint like the shoulder or knee.⁵ A 2003 proposed rule clarified that a group of minor joints in the hand means any combination of three or more interphalangeal or metacarpophalangeal joints of a single hand.⁶ The wrist itself is a major joint.

So when arthritis hits several finger joints on one hand, the VA usually treats those joints together as one minor joint group equivalent to a single major joint, rather than assigning a separate rating for every affected knuckle.

Ratings for Degenerative and Traumatic Arthritis

DC 5003 (and DC 5010, which points to it) works in tiers. The VA looks first at whether motion is limited enough to be compensable under the finger-specific codes, and only falls back to DC 5003 itself when it is not.

If limitation of motion in the affected fingers is compensable, the condition is rated under the specific finger codes (DC 5228 through 5230), not under DC 5003. You cannot get both a DC 5003 rating and a limitation-of-motion rating for the same joints.⁷
If limitation of motion exists but is noncompensable, 10% is assigned for each major joint or group of minor joints affected, as long as the limitation is objectively confirmed by findings like swelling, muscle spasm, or painful motion.²
If there is no limitation of motion at all, 10% is available when X-rays show arthritis in two or more major joints or two or more minor joint groups. That rises to 20% when those joints also produce occasional incapacitating exacerbations.¹

The practical ceiling under DC 5003 alone is 10% or 20%. Higher numbers come from the finger codes or from ankylosis when the disease becomes severe enough to freeze joints.

Finger Limitation of Motion Codes

When arthritis restricts finger movement enough to be compensable, the VA uses these codes:⁸

DC 5228 (thumb): 0% for a gap of less than one inch between thumb pad and fingers during opposition; 10% for a gap of one to two inches; 20% for a gap greater than two inches.
DC 5229 (index and long fingers): 0% for a gap of less than one inch between fingertip and the proximal transverse crease of the palm (with extension limited by no more than 30 degrees); 10% for a gap of one inch or more, or extension limited by more than 30 degrees.
DC 5230 (ring and little fingers): any limitation of motion is noncompensable (0%).

Two or more affected fingers are evaluated separately and then combined. A note in the regulations (38 CFR § 4.71a, Note 5) provides for this. In one Board decision, a veteran received separate 10% ratings for the left thumb, index finger, and long finger.⁸

Ankylosis Ratings for Fixed Finger Joints

When arthritis progresses to the point that one or more finger joints become fixed in place, DC 5216 through 5227 apply, and the ratings climb quickly. The number depends on whether the ankylosis is favorable or unfavorable, how many fingers are involved, and whether the hand is dominant (major) or non-dominant (minor).⁹

Individually, unfavorable ankylosis of the thumb warrants 20%; unfavorable ankylosis of the index or long finger warrants 10%; the ring and little fingers receive 0% when rated alone. Multiple ankylosed fingers together yield much more. Unfavorable ankylosis of all five digits of the major hand warrants 60%.⁹ In one case, the Board found that limitation of motion in four fingers combined with functional impairment from pain was analogous to favorable ankylosis and warranted 40% under DC 5221.¹⁰

Ratings for Rheumatoid and Psoriatic Arthritis

Rheumatoid and psoriatic arthritis follow a very different scale because they are systemic diseases. The VA rates them under DC 5002 based on either the active disease process or the chronic residuals, whichever gives the higher rating. The two cannot be combined.³

Active process ratings under DC 5002:

20% for one or two exacerbations per year in a well-established diagnosis.
40% for symptom combinations producing definite health impairment confirmed by examination, or incapacitating exacerbations three or more times per year.
60% for weight loss and anemia producing severe health impairment, or severely incapacitating exacerbations four or more times per year.
100% for constitutional manifestations associated with active joint involvement that are totally incapacitating.¹¹

Rated instead on chronic residuals, the condition is evaluated using the limitation-of-motion or ankylosis codes for the joints involved. Where the limitation of motion is otherwise noncompensable, a 10% rating goes to each major joint or group of minor joints affected, with those ratings combined rather than added.³

Painful Motion Can Lift a 0% to 10%

Under 38 CFR §§ 4.40, 4.45, and 4.59, the VA must consider functional loss from pain, weakness, fatigability, and incoordination when evaluating musculoskeletal disabilities. This is the DeLuca standard, named for the Federal Circuit case that established it.²

The painful motion rule under § 4.59 is especially important for hand arthritis. If motion causes pain, that painful motion is treated as limited motion, and you are entitled to at least the minimum compensable rating for the joint even when the measured range would otherwise be noncompensable.² For a veteran who can still curl the fingers but hurts doing it, that is the difference between 0% and 10%.

The Bilateral Factor When Both Hands Are Affected

Arthritis in both hands triggers the bilateral factor under 38 CFR § 4.26. The VA combines the ratings for the left and right sides, then adds 10% of that combined value before folding the result into the overall disability calculation. The two sides do not have to carry identical diagnoses, but both must be service-connected and both must sit in the same paired body group (upper or lower extremities). If either side is rated at 0%, the bilateral factor does not apply.¹²

Combined ratings themselves are calculated with a table, not simple addition. Two 10% ratings combine to 19%, which rounds to 20%.¹³ The bilateral factor can sometimes push a combined value into the next 10% bracket.

When Severe Hand Arthritis Supports TDIU or SMC

If hand arthritis prevents you from holding down substantially gainful employment, you may qualify for Total Disability based on Individual Unemployability (TDIU), which pays at the 100% rate even when your combined schedular rating is lower. Hand use is central to many jobs, so hand arthritis can support a TDIU claim.¹⁴

Standard schedular TDIU requires at least one service-connected disability rated at 60% or more, or two or more service-connected disabilities combining to 70% or more with at least one rated at 40%.¹⁴ Degenerative arthritis in the hands rarely hits those numbers on its own, so most veterans reach TDIU either with additional service-connected conditions or through extraschedular TDIU under 38 CFR § 4.16(b), which requires showing that the condition uniquely prevents substantially gainful employment despite falling short of the standard thresholds.

At the outer edge, where hand arthritis leaves no effective function, Special Monthly Compensation may be available. The VA defines “loss of use” as no effective function remaining beyond what an amputation stump with a prosthesis could provide.¹⁵ Loss of use of one or both hands, combined with other qualifying conditions, can support SMC at levels L through O.

The 2026 Medication Rule and How It Affects Your Exam

An interim final rule took effect on February 17, 2026, amending 38 CFR § 4.10 to address how medication factors into disability ratings. It responded to the U.S. Court of Appeals for Veterans Claims decision in Ingram v. Collins (2025), which had held that examiners must estimate the “baseline severity” of a musculoskeletal condition by discounting the beneficial effects of medication when the relevant diagnostic code does not mention medication.¹⁶

The VA called that approach “unquantifiable, hypothetical” and said it would affect over 500 diagnostic codes and require re-adjudication of more than 350,000 pending claims. The new rule provides that examiners “will not estimate or discount improvements to the disability due to the effects of medication or treatment,” and that if medication lowers the level of disability, the rating will be based on that lowered level.¹⁶ If you take anti-inflammatories or other drugs that ease your hand arthritis, the VA will rate the condition as it actually presents at your Compensation and Pension exam, not as it would look untreated. Public comments on the rule were accepted through April 20, 2026.

1
U.S. Department of Veterans Affairs. Board of Veterans’ Appeals Decision, Citation 1303051
2
U.S. Department of Veterans Affairs. Board of Veterans’ Appeals Decision, Citation 1432833
3
U.S. Department of Veterans Affairs. Board of Veterans’ Appeals Decision, Citation 0809020
4
U.S. Department of Veterans Affairs. Board of Veterans’ Appeals Decision, Citation A21002804
5
eCFR. 38 CFR 4.45 – The Joints
6
Federal Register. Schedule for Rating Disabilities – The Musculoskeletal System
7
Hill & Ponton. VA Ratings for Arthritis Explained
8
U.S. Department of Veterans Affairs. Board of Veterans’ Appeals Decision, Citation 19144654
9
Cornell Law Institute. 38 CFR 4.71a – Schedule of Ratings, Musculoskeletal System
10
U.S. Department of Veterans Appeals. Board of Veterans’ Appeals Decision, Citation 0822218
11
U.S. Department of Veterans Affairs. Board of Veterans’ Appeals Decision, Citation A22001980
12
CCK Law. FAQ Friday – Bilateral Factor
13
U.S. Department of Veterans Affairs. About VA Disability Ratings
14
U.S. Department of Veterans Affairs. VA Individual Unemployability
15
U.S. Department of Veterans Affairs. Special Monthly Compensation Rates
16
Federal Register. Evaluative Rating Impact of Medication