Musculoskeletal
Elbow & Forearm Conditions
Flexion, extension, and impairment of the ulna and radius under §4.71a
Elbow and forearm conditions are rated on limitation of flexion and extension and on impairment of the forearm bones under Codes 5205–5213 — and, like the shoulder, the dominant-hand distinction changes the payout.
What Elbow & Forearm Conditions Really Is
Elbow and forearm disability is lost flexion, extension, and rotation — plus the nerve entrapment and tendon damage that comes with decades of repetitive load.
What it actually means
Elbow and forearm disability is lost flexion, extension, and rotation — plus the nerve entrapment and tendon damage that comes with decades of repetitive load.
What the VA measures
Flexion and extension in degrees under DC 5206 and 5207, forearm supination and pronation under DC 5213, all in 38 CFR §4.71a and split by dominant and non-dominant arm.
Why claims get missed
Ulnar and radial nerve involvement goes unclaimed. Numbness and weakness in the hand from elbow-level entrapment is a separate rating under §4.124a.
What in Your Service Causes Elbow & Forearm Conditions
Service connection is not a feeling, it is a chain of evidence. These are the pathways the VA already recognises. Find yours, then make sure your file says it out loud.
Repetitive maintenance and tool work
Aviation, vehicle, and weapons maintenance produce documented tendinopathy and cumulative joint injury.
Load-bearing and crawling under load
Body armor, low crawls, and casualty drags load the elbow in ways civilian work does not.
Falls and direct trauma
Fractures and dislocations from jumps, obstacle courses, and vehicle events leave post-traumatic arthritis that appears years later.
How the Elbow Is Rated
Elbow disabilities are rated primarily on limitation of flexion (Code 5206) and extension (Code 5207), with higher ratings for ankylosis (Code 5205) and for flail joint or bone impairment (Codes 5209–5212). Limitation of pronation and supination — turning the forearm palm-up or palm-down — is rated separately under Code 5213.
Do Not Let It Be Folded Into the Shoulder
A common under-rating trap is having a genuine elbow or forearm condition swept into a single upper-extremity rating with the shoulder. The elbow has its own diagnostic codes and deserves its own evaluation. Painful motion and flare-ups under §4.40 and §4.45 must be considered, and an exam that ignores them may be inadequate.
What to Document
Measured flexion and extension with pain onset
Loss of forearm rotation (pronation/supination)
Grip weakness and dropped objects
Correct dominant-hand designation
Establishing Service Connection
To establish service connection for a musculoskeletal condition, veterans must meet three criteria. First, there must be a current diagnosis. Second, there must be evidence of an in-service injury, repetitive strain, or the physical demands of your duties that could have caused or aggravated it. Third, a nexus — a medical link — must connect the in-service event to the current condition.
Current diagnosis of the joint or spine condition
In-service injury, repetitive strain, or documented physical demands
Medical nexus linking the condition to service ("at least as likely as not")
Imaging (X-ray or MRI) showing arthritis, disc disease, or joint damage
Lay statements describing onset and continuity of pain since service
Why Work With an Accredited Advocate
Veterans should seek the assistance of an Accredited VA Disability Advocate because we guide you through the complex claims process and ensure all necessary evidence is gathered and presented effectively. Our advocates are trained to identify and link service-related conditions, increasing the likelihood of a successful claim. We also provide personalized representation, helping veterans navigate appeals and secure the benefits they deserve. As a VA-Accredited Claims Agent, our fees are regulated under 38 CFR §14.636 — and there are no fees unless we win your appeal.
The Rating Schedule, Spelled Out
Elbow and forearm conditions are rated under 38 CFR §4.71a, Diagnostic Codes 5205–5213, based on limitation of flexion and extension, ankylosis, and impairment of the forearm bones. Under §4.69 the dominant (major) side is rated higher than the non-dominant (minor) side.
Favorable ankylosis, at an angle between 90 and 70 degrees — 30% minor, 40% major.
Intermediate ankylosis, at an angle of more than 90 degrees, or between 70 and 50 degrees — 40% minor, 50% major.
Unfavorable ankylosis, at an angle of less than 50 degrees or with complete loss of supination or pronation — 50% minor, 60% major.
Flexion limited to 110 degrees.
Flexion limited to 100 degrees.
Flexion limited to 90 degrees — 20% on either side.
Flexion limited to 70 degrees — 20% minor, 30% major.
Flexion limited to 55 degrees — 30% minor, 40% major.
Flexion limited to 45 degrees — 40% minor, 50% major.
Extension limited to 45 degrees, or to 60 degrees.
Extension limited to 75 degrees — 20% on either side.
Extension limited to 90 degrees — 20% minor, 30% major.
Extension limited to 100 degrees — 30% minor, 40% major.
Extension limited to 110 degrees — 40% minor, 50% major.
Forearm flexion limited to 100 degrees and extension limited to 45 degrees — 20% on either side.
Joint fracture with marked cubitus varus or cubitus valgus deformity, or with ununited fracture of the head of the radius — 20% on either side.
Flail joint of the elbow — 50% minor, 60% major.
Nonunion of both the radius and ulna with flail false joint — 40% minor, 50% major.
Malunion of the ulna with bad alignment.
Nonunion in the lower half — 20% on either side.
Nonunion in the upper half with false movement, without loss of bone substance or deformity — 20% minor, 30% major.
Nonunion in the upper half with false movement, with loss of bone substance (1 inch / 2.5 cm or more) and marked deformity — 30% minor, 40% major.
Malunion of the radius with bad alignment.
Nonunion in the upper half — 20% on either side.
Nonunion in the lower half with false movement, without loss of bone substance or deformity — 20% minor, 30% major.
Nonunion in the lower half with false movement, with loss of bone substance (1 inch / 2.5 cm or more) and marked deformity — 30% minor, 40% major.
Limitation of supination to 30 degrees or less.
Limitation of pronation with motion lost beyond the last quarter of the arc, the hand does not approach full pronation; or loss (bone fusion) with the hand fixed near the middle of the arc or in moderate pronation — 20% on either side.
Limitation of pronation with motion lost beyond the middle of the arc; or loss (bone fusion) with the hand fixed in full pronation — 20% minor, 30% major.
Loss (bone fusion) with the hand fixed in supination or hyperpronation — 30% minor, 40% major.
Note: in all forearm and wrist injuries under Codes 5205 through 5213, multiple impaired finger movements caused by tendon tie-up, muscle or nerve injury are rated separately and combined, not to exceed the rating for loss of use of the hand.
Key Points to Remember
Rated under 38 CFR §4.71a (DC 5205–5213) on flexion, extension, ankylosis, and forearm bone impairment
Ratings differ for the dominant (major) versus non-dominant (minor) arm
Painful motion and flare-ups must be considered (§4.40 and §4.45)
Ankylosis and impairment of supination or pronation are separately ratable
What to Expect at Your Elbow and Forearm C&P Examination
The elbow is rated on four separate motions, and forearm rotation is graded on its own scale. Normal elbow motion is 0 to 145 degrees of flexion, with forearm supination 0 to 85 degrees and pronation 0 to 80 degrees. Flexion limited to 110 degrees is noncompensable, 100 degrees pays 10% and it steps up to 50% at 45 degrees. Extension limited to 45 degrees pays 10% and climbs to 50% at 110 degrees. As with the shoulder, dominance decides which column of the table you are rated in.
Handedness recorded, because Diagnostic Codes 5205 through 5213 all pay different amounts for the major and minor arm.
Goniometer measurement of elbow flexion and extension, both arms, active and passive.
Separate measurement of forearm supination and pronation — limitation of supination to 30 degrees or less is compensable on its own under Diagnostic Code 5213.
Repetitive-use testing, the point pain begins, and a flare-up estimate in degrees.
Stability testing for the ulnar and radial collateral ligaments, and examination for cubitus varus or valgus deformity.
Palpation and provocative testing for lateral and medial epicondylitis, and examination for ulnar nerve involvement at the cubital tunnel — an ulnar neuropathy is separately ratable under 38 CFR §4.124a.
Imaging review for ununited radial head fracture, nonunion or malunion of the radius or ulna, and any loss of bone substance measured in centimeters.
What Happens Once the C&P Exam Is Complete
The examiner compiles a detailed report — your medical history, physical findings, and diagnostic results — and assesses the severity, symptoms, and impact of your condition. That report is sent to the VA Regional Office handling your claim and becomes part of your official file, reviewed alongside your other evidence.
The VA may send the report back for corrections, clarification, or a second opinion if it finds it incomplete or unclear. This can delay your claim, because the VA requires thorough and accurate information to decide. Your claim only moves to the decision phase once the VA is satisfied with the evidence — which is exactly why the quality of the file we build for you matters so much. Once decided, your effective date controls how far back your back pay reaches, and any denial can be challenged through a Supplemental Claim, Higher-Level Review, or Board appeal.
The Advocate’s Take
An elbow condition is not a footnote to your shoulder claim. It has its own codes and its own rating — make sure it gets one.
Every Level the VA Can Assign You
These percentages come straight out of the rating schedule that governs elbow & forearm conditions — Diagnostic Code 5205. Read them slowly. If your current rating does not match what your records actually show, that gap is exactly what an appeal exists to correct.
30% / 40%
Favorable ankylosis, at an angle between 90 and 70 degrees — 30% minor, 40% major.
40% / 50%
Intermediate ankylosis, at an angle of more than 90 degrees, or between 70 and 50 degrees — 40% minor, 50% major.
50% / 60%
Unfavorable ankylosis, at an angle of less than 50 degrees or with complete loss of supination or pronation — 50% minor, 60% major.
Secondary Claims — Both Directions
Under 38 CFR §3.310, a condition caused or made worse by an already service-connected condition is itself service connected. That runs in both directions, and it is the single largest pool of unclaimed compensation in the system.
What can cause elbow & forearm conditions
If one of these is already service connected, this condition can be claimed as secondary to it.
Cervical spine radiculopathy
Nerve root involvement produces weakness and secondary joint pathology.
Shoulder condition
Altered upper-extremity mechanics load the elbow and are an accepted secondary pathway.
What elbow & forearm conditions can cause
If this condition is already service connected, each of these is a separate claim you may be owed.
Ulnar or radial neuropathy
Entrapment at the elbow is separately ratable under §4.124a and frequently missed.
Wrist and hand overuse conditions
Compensatory grip and rotation changes produce separately ratable disability below the elbow.
Depression from chronic pain
Persistent pain and loss of function support a secondary mental health claim.
A secondary claim still needs two things: a current diagnosis of the secondary condition, and a medical opinion saying it is at least as likely as not caused or aggravated by the service-connected condition. You do not have to prove it happened in service.
Building a Elbow & Forearm Conditions Claim That Wins
Every claim stands on three legs. Knock one out and the claim falls over, no matter how bad your symptoms are. Before you file, look at your file and find all three.
A current diagnosis
A doctor has to say you have it, now, in writing. Not "reports symptoms of" — a diagnosis. Without this leg, nothing else in the file matters.
A link to your service
An event, an injury, an exposure, or an already service-connected condition. Service records, unit records, buddy statements, and your own account all count as evidence.
A nexus that ties the two together
A medical opinion stating it is at least as likely as not that your service caused or aggravated the condition. That phrase is a legal standard: 50 percent or better. It is the leg most denials break.
Document the problem before you file
• Keep a dated symptom log for at least 30 days. Frequency, severity, and what it stopped you from doing.
• Get statements from people who see it — a spouse, a coworker, a battle buddy. Lay evidence is legal evidence.
• Pull your private treatment records. The VA only has to help; it does not have to go find everything.
• Write down what you have stopped doing. Lost work, lost sleep, lost activities. That is what impairment looks like on paper.
Your Rights in This Process
It costs nothing to file
Filing a VA claim is free. Accredited representatives may only charge for work on an appeal after an initial decision, and those fees are capped by 38 CFR §14.636.
The VA has a Duty to Assist you
Under 38 CFR §3.159 the VA must help you get the evidence it needs, and it must tell you what is missing before it denies you for missing it.
You can ask for a different examiner
You may request a trauma-informed clinician, or a clinician of a specific gender, for a C&P examination. Ask before the exam is scheduled.
You can claim every condition you have
There is no limit and no penalty. Primary conditions, secondary conditions, and conditions made worse by service all get filed.
You can appeal and be re-evaluated
A denial is not the end. You may submit new evidence, request a higher-level review, appeal to the Board, and ask for re-evaluation when your condition worsens.
You must be considered for TDIU
If your service-connected conditions keep you from holding substantially gainful employment, you may be paid at the 100 percent rate without a 100 percent rating.
Questions Veterans Ask About Elbow & Forearm Conditions Claims
Is tennis elbow ratable?
Lateral and medial epicondylitis are rated by analogy on the resulting limitation of motion and painful motion under 38 CFR §4.59, which entitles you to at least the minimum compensable evaluation for the joint when painful motion is documented.
What if my motion is nearly normal but it hurts constantly?
Section 4.59 requires that actually painful joints be entitled to at least the minimum compensable rating for the joint. A zero percent rating on a joint with documented painful motion is a correctable error.
Can numbness in my hand be part of this claim?
Yes, as a separate rating. Ulnar or radial nerve impairment is rated under 38 CFR §4.124a on the degree of paralysis — mild, moderate, or severe incomplete — in addition to the joint rating.
When You Are Ready to File
Talk to an accredited representative before you file. It costs nothing to ask, and the order you file in changes what the VA is allowed to award you. Albert L. Thombs Jr. is VA-Accredited Claims Agent #45147.
The application itself
This is the form that opens a disability compensation claim. List every condition you are claiming, and name the secondary conditions explicitly.
Release for private records
Authorises the VA to request records from your private doctors. Without it, treatment outside the VA may never reach your file.
Lay or buddy statement
The official form for your own statement and for statements from people who witnessed the event or the change in you.
Resources Worth Keeping
These are real, staffed VA lines. Tap to call from your phone.
Veterans Crisis Line
988
Then press 1. Text 838255. Available 24 hours a day, every day. You do not need to be enrolled in VA health care.
VA Benefits & Facility Line
1-800-827-1000
Claim status, general benefits questions, and help finding the right VA office.
Women Veterans Call Center
1-855-829-6636
Call or text. Staffed by women veterans who can connect you to services in your area.
Vet Centers
1-877-927-8387
Community-based counselling for combat veterans and their families. No VA enrollment required.
What This Rating Is Worth (2026)
| 10% | $180.42/mo |
| 20% | $356.66/mo |
| 30% | $552.47/mo |
| 40% | $795.84/mo |
| 50% | $1,132.90/mo |
| 60% | $1,435.02/mo |
| 70% | $1,808.45/mo |
| 80% | $2,102.15/mo |
| 90% | $2,362.30/mo |
| 100% | $3,938.58/mo |
Rates shown are the veteran-alone amounts effective December 1, 2025. A spouse, children, or dependent parents increase your payment at 30% and above. Every 10% you are under-rated can cost you thousands of dollars a year for the rest of your life.
Estimate Your Exact Pay
Veteran RepresentationYour VA Claim Exam: What to Expect
This official VBA video walks you through the entire C&P exam process. Understanding what happens in that room is the difference between a rating that reflects your true condition and one that undervalues you.
Veteran RepresentationWhat It Takes to Win These Benefits
The Three-Part Test
Service connection under 38 CFR §3.303 requires all three:
- 1A current, diagnosed disability
- 2An in-service event, injury, or exposure
- 3A medical nexus linking the two
Veteran RepresentationThe medical evidence the VA is actually looking for:
VA Claim Exams: Musculoskeletal / Rheumatological
This exam is specific to your body system. The examiner uses a specialized DBQ for this category of conditions, and the tests they perform determine your exact rating level. Watch this before your appointment.
What to Expect at Your C&P Exam
Your Compensation & Pension (C&P) exam is not treatment. It is a rating tool. The examiner will not fix anything — they complete a Disability Benefits Questionnaire (DBQ) and check the boxes that decide your rating. What happens in that room can move your rating an entire level, so walk in prepared.
Veteran RepresentationThe Forms You File — We Prepare Them For You
These are the forms that drive this claim. Start any of them on our site and an accredited agent prepares and files it for you — correctly, the first time.
Application for Disability Compensation
The core application that opens or reopens your claim.
Start this with usStatement in Support of Claim
Your own account and buddy/lay statements that fill the gaps in your record.
Start this with usAppoint Us as Your Representative
Authorizes our accredited agent to act on your behalf with the VA.
Start this with usUnemployability (TDIU) Application
Claims 100% pay when your conditions keep you from working — even below 100%.
Start this with usDisability Benefits Questionnaire
The exam form that captures the severity criteria for this specific condition.
Start this with usSMC & TDIU — When Your Rating Isn't the Whole Story
TDIU — Paid at 100% Without a 100% Rating
Total Disability based on Individual Unemployability (38 CFR §4.16) pays you at the 100% rate when your service-connected conditions prevent substantially gainful employment — even if your combined rating is lower. You may qualify if:
- One condition is rated 60% or higher, or
- Two+ conditions combine to 70% with at least one rated 40%, and
- Those conditions keep you from holding steady, gainful work.
- Cannot meet the numbers? Extraschedular TDIU under §4.16(b) may still apply.
Special Monthly Compensation (SMC)
SMC (38 CFR §3.350) pays above the normal schedule for especially serious losses — loss or loss of use of a body part, being housebound, or needing the aid and attendance of another person. Common levels:
- SMC-K — Loss / loss of use — Add-on for loss or loss of use of a specific body part (hand, foot, eye, reproductive organ, or certain other losses). Paid on top of your regular compensation. Can stack (up to the statutory cap).
- SMC-S — Housebound — Statutory housebound: a single 100% disability plus additional disabilities of 60%+, or substantially confined to your home. Veteran-alone rate shown.
- SMC-L — Aid & Attendance — You need the regular aid and attendance of another person, or have anatomical loss/loss of use of both feet, one hand and one foot, blindness, or are permanently bedridden. Veteran-alone rate shown.
- SMC-M — Higher Aid & Attendance — A higher level of aid and attendance (e.g., loss of use of both hands, or loss of use of both legs at a higher level). Veteran-alone rate shown.
These are the benefits veterans most often leave on the table because no one told them they qualified. If any of this sounds like your situation, call an accredited agent at 702-992-4883 — we screen for SMC and TDIU on every case.
Talk to a VA-accredited claims agent about elbow & forearm conditions
Albert L. Thombs Jr. is a US Army veteran, VA-Accredited Claims Agent #45147, and 100% service-connected himself. He personally reviews every request. Fees are capped by 38 CFR §14.636 — and there are no fees unless you win.
Three Ways to Put an Accredited Agent on Elbow & Forearm Conditions
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