How VA Rates Elbow Pain: DC 5205-5209 Flexion, Extension, and Forearm Rotation Guide

Elbow motion is divided into flexion (bending) and extension (straightening). Under DC 5206, flexion limited to 100 degrees receives 10% for either arm; flexion limited to 90 degrees receives 20% for the major arm and 10% for the minor; flexion limited to 70 degrees receives 30% major and 20% minor; and flexion limited to 50 degrees receives 40% major and 30% minor. Under DC 5207, extension limited to 45 degrees receives 10%, limited to 60 degrees receives 20%, and limited to 75 degrees receives 30% for either arm.

The elbow and radioulnar joints control forearm rotation. Under DC 5209, forearm pronation (turning palm down) or supination (turning palm up) is evaluated: limitation of pronation with motion lost beyond the midpoint receives 20% major and 10% minor; limitation of supination with hand fixed in hyperpronation receives 30% major and 20% minor.

When an elbow is surgically fused or completely stiffened, it is evaluated under DC 5205 as ankylosis: ankylosis in a favorable position (bent between 90 and 110 degrees) receives 30% major and 20% minor; ankylosis in intermediate positions receives 40% major and 30% minor; and unfavorable ankylosis (fixed in full extension or acute flexion) receives 50% major and 40% minor.

Because manual tasks depend heavily on the dominant extremity, several elbow diagnostic codes provide higher percentages for the major arm. Additionally, under 38 CFR 4.59, documented pain during active motion entitles the veteran to the minimum compensable rating of 10% even if motion remains outside the restricted ranges.

Claims require an Elbow and Forearm DBQ with goniometric measurements of active and passive flexion, extension, pronation, and supination. Examiners must also evaluate repetitive use and flare-ups under 38 CFR 4.40 and DeLuca v. Brown, documenting any additional degrees of motion loss after repeated movement.