Wrist & hand

"Wrist and hand" covers a group of problems with the wrist joint, the hand, and the nerves that pass through the wrist. The VA does not pay for an injury just because it happened; it pays for the lasting disability it leaves behind. To connect a wrist or hand condition to service on a direct basis, the VA generally looks for a current diagnosis, an in-service event or injury, and medical evidence linking the two. Carpal tunnel syndrome is a little different: it is caused by pressure on the median nerve at the wrist, so the VA rates it as a nerve condition rather than as a bone-and-joint condition.

For the wrist joint itself, the VA uses two main diagnostic codes in its musculoskeletal rating schedule (38 CFR 4.71a). Diagnostic Code 5215 covers limitation of motion of the wrist, and 10 percent is the highest rating it allows (for example, dorsiflexion less than 15 degrees, or palmar flexion limited in line with the forearm). If the wrist becomes stiff and "frozen" (ankylosis), Diagnostic Code 5214 applies and pays more as the position gets worse: for the dominant ("major") hand it runs 30 percent for favorable ankylosis, 40 percent for other positions, and 50 percent for unfavorable ankylosis, with slightly lower numbers for the non-dominant hand; extremely unfavorable ankylosis is instead rated as loss of use of the hand. Carpal tunnel is rated under Diagnostic Code 8515 for the median nerve, where the percentage is driven by how severe the nerve damage is and by which hand is affected — mild incomplete paralysis is 10 percent, moderate is 30 percent (major) or 20 percent (minor), severe is 50 or 40 percent, and complete paralysis is 70 or 60 percent.

Most wrist, hand, and carpal tunnel claims are decided on a direct basis, because these conditions are not on the special exposure lists (such as Agent Orange, burn pits, Camp Lejeune, or the PACT Act). There is, however, one helpful shortcut for arthritis: arthritis is one of the "chronic diseases" the VA can presume is service-connected if it shows up to at least a 10 percent degree within one year of leaving active duty, under the rules in 38 CFR 3.307 and 3.309. When a presumption applies, you do not have to prove the medical link yourself. If a claim is denied, that is a starting point, not the end — the VA has review and appeal options.

This is general educational information about how the VA's rules work, not legal advice or a VA decision about your own claim.