How VA Rates Wrist Pain: DC 5214-5215 Dorsiflexion, Palmar Flexion, and Ankylosis Guide

Diagnostic Code 5215 evaluates common wrist injuries, sprains, and arthritis through goniometer measurements. A 10% rating is awarded for either hand if dorsiflexion (bending wrist upward) is limited to less than 15 degrees, or if palmar flexion (bending wrist downward) is limited so that the hand is fixed in line with the forearm.

When a wrist joint is completely stiffened or surgically fused (arthrodesis), it is rated under DC 5214 as ankylosis: favorable ankylosis (fixed in 20 to 30 degrees of dorsiflexion) receives 20% for the major hand and 10% for the minor; any other position receives 30% major and 20% minor; and unfavorable ankylosis (fixed in extreme flexion or with complete loss of rotation) receives 50% major and 40% minor.

Under 38 CFR 4.59, veterans whose wrist movements cause documented pain are entitled to a 10% rating, even if their degrees of dorsiflexion and palmar flexion exceed the restricted limits in DC 5215. The examiner must record the exact arc of movement where pain begins during active and passive range of motion tests.

Veterans frequently experience both wrist arthritis and carpal tunnel syndrome simultaneously. Under 38 CFR 4.14, wrist arthritis (rated on limited joint motion under DC 5215) and carpal tunnel syndrome (rated on median nerve paralysis under DC 8515) represent distinct physical impairments and can be rated separately without violating the pyramiding rule.

Claims require a Wrist DBQ documenting precise degrees of dorsiflexion, palmar flexion, radial deviation, and ulnar deviation. X-rays confirming scaphoid fractures, degenerative changes, or post-surgical hardware, combined with physical therapy notes detailing functional grip limitations, provide vital corroborating evidence.