ANKYLOSIS OF THE RING OR LITTLE FINGER

Summary

The Veteran, who served in the Marine Corps from June 1967 to June 1970, appeals the denial of a compensable disability rating for right little finger ankylosis and an increased disability rating for right hand ulnar nerve neuropathy. Regarding the right little finger ankylosis, the Board reviewed the applicable diagnostic codes (DC 5227 and 5230) and found that the Veteran was already receiving the maximum available noncompensable rating. The Board concluded that the ankylosis did not approximate amputation or cause functional impairment warranting a higher rating, and thus denied a compensable rating. For the right hand ulnar nerve neuropathy, the Veteran sought a rating higher than the current 40 percent. The Board reviewed the VA examination from May 2023, which noted moderate intermittent pain, moderate paresthesias, and mild incomplete paralysis of the ulnar nerve. The Board found that the evidence persuasively weighed against a rating higher than 40 percent, as the findings did not meet the criteria for severe incomplete paralysis or complete paralysis, and no other applicable diagnostic codes were warranted. The benefit of the doubt doctrine was not applied as the evidence weighed against the claims. Therefore, the Board denied entitlement to a compensable rating for right little finger ankylosis and denied an increased rating for right hand ulnar nerve neuropathy.

Rationale

DC 5227 and 5230 provide noncompensable ratings for ankylosis of the little finger.; Ankylosis does not equate to amputation or warrant a higher rating.; Weight of evidence against claim for compensable rating.

Full Decision Text

Citation Nr: A26039605
Decision Date: 04/28/26	Archive Date: 04/28/26

DOCKET NO. 251216-624163
DATE: April 28, 2026

ORDER

Entitlement to a compensable disability rating for right little finger ankylosis is denied.

Entitlement to a disability rating in excess of 40 percent for right hand ulnar nerve neuropathy is denied.

FINDINGS OF FACT

1. The Veteran's right little finger ankylosis is not manifested by symptoms approximating an amputation of that finger, or by involvement of other fingers or the whole hand so as to warrant a compensable or separate rating.

2. Throughout the period on appeal, the Veteran's right hand ulnar nerve neuropathy has been manifest by no more than severe incomplete paralysis of the major right ulnar nerve.

CONCLUSIONS OF LAW

1. The criteria for entitlement to a compensable disability rating for right little finger ankylosis have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.71a, Diagnostic Code (DC) 5227-5010.

2. The criteria for entitlement to a disability rating in excess of 40 percent for right hand ulnar nerve neuropathy have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.321, 4.1, 4.3, 4.7, 4.123, 4.124, 4.124a, DC 8516.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served in the Marine Corps from June 1967 to June 1970. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2025 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).

In the December 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the April 2025 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. 

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. §20.900(c) (2018); 38 U.S.C. § 7107(a)(2) (2012).

Increased Rating

1. Entitlement to a compensable disability rating for right little finger ankylosis

The Veteran is generally seeking a compensable disability rating for his right little finger ankylosis. See December 2025 NOD. 

The Veteran's service-connected disability is rated under DC 5227-5010. Under DC 5227, a noncompensable rating is assigned for unfavorable or favorable ankylosis of the ring or little finger regardless whether the finger is on the major (dominant) or minor (non-dominant) hand. 38 C.F.R. § 4.71a DC 5227. The Board notes the right hand is the major hand for the Veteran per the April 2012 VA examination which shows he is right-handed.

The Veteran is currently and has throughout the appeal period been in receipt of a noncompensable rating. The noncompensable rating is the only rating available under DC 5227. As a result, the Board will consider other potentially applicable DCs in the Rating Schedule. Under DC 5230, a maximum zero percent rating is assigned for any limitation of motion of the little finger (whether on the major or minor hand). 38 C.F.R. § 4.71a, DC 5230. Thus, the Veteran is also in receipt of the maximum disability rating under DC 5230. In this regard, while it is the intention of the rating schedule to recognize actually painful, unstable,
 shows he is right-handed.

The Veteran is currently and has throughout the appeal period been in receipt of a noncompensable rating. The noncompensable rating is the only rating available under DC 5227. As a result, the Board will consider other potentially applicable DCs in the Rating Schedule. Under DC 5230, a maximum zero percent rating is assigned for any limitation of motion of the little finger (whether on the major or minor hand). 38 C.F.R. § 4.71a, DC 5230. Thus, the Veteran is also in receipt of the maximum disability rating under DC 5230. In this regard, while it is the intention of the rating schedule to recognize actually painful, unstable, or misaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint, there is no compensable rating available under either DC 5227 or 5230. 38 C.F.R. § 4.71a.

Although the Board recognizes that the Veteran currently is in receipt of the maximum zero percent disability rating, the Note to DC 5227 states that an amputation evaluation should also be considered, particularly where ankylosis is present. 38 C.F.R. § 4.71a. Ankylosis is defined as immobility and consolidation of a joint due to disease, injury, or surgical procedure. Lewis v. Derwinski, 3 Vet. App. 259 (1992).

Here, the Veteran is noted as having ankylosis of the proximal interphalangeal joint of the little finger on his right hand at his April 2012 VA examination. The examiner stated that the finger was in full flexion. Ankylosis whether favorable or unfavorable, still does not equate to a compensable rating. Additionally, the weight of the evidence is against a finding that the right little finger is so disabled by ankylosis or by other symptoms, to include pain, such that its functional impairment more nearly approximates amputation. Thus, the Board concludes that an increased, compensable rating is not warranted via the amputation codes because the nature of the Veteran's service-connected right little finger disability is not analogous to amputation.

The Board recognizes that the treatment records show complaints of pain and the inability to extend the little finger. See April 2024 VA Treatment Record. However, limitation of motion does not entitle the Veteran to a higher disability rating. Even if rated under DC 5230, which addresses limitation of motion of the little finger, the Veteran is already in receipt of the maximum schedular disability rating available for limitation of motion of the right little finger. 

Accordingly, the Board finds that the current noncompensable evaluation adequately compensates the Veteran for the pain and functional impairment caused by the service-connected right little finger disability (including ankylosis). DeLuca v. Brown, 8 Vet. App. 202, 206; 38 C.F.R. §§ 4.40, 4.45, 4.59. Furthermore, in Johnston v. Brown, 10 Vet. App. 80, 85 (1997), the Court determined that if a claimant is already receiving the maximum disability rating, it is not necessary to consider whether 38 C.F.R. §§ 4.40 and 4.45 are applicable. 

The Board finds that the weight of the evidence is against the Veteran's claim for a compensable rating for the service-connected right little finger disability. As the weight of the evidence is against the claim, the benefit of the doubt doctrine is not for application and the claim for a compensable rating is denied. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (2021).

2. Entitlement to a disability rating in excess of 40 percent for right hand ulnar nerve neuropathy

The Veteran's right hand neuropathy has been service-connected since June 30, 1970. A 40 percent disability rating was granted in a September 2012 rating decision, effective March 30, 2012. The Veteran is seeking a higher rating. See December 2025 NOD. 

The Veteran's right hand neuropathy is evaluated under Diagnostic Code 8516, which provides a 10 percent rating when incomplete paralysis is mild, 30 percent when it is moderate and 40 percent when it is severe. These ratings are for the major extremity. A 60 percent rating is available for complete paralysis, resulting in the "griffin claw" deformity, due to flexor contraction of ring and little fingers, atrophy very marked in dorsal interspace and thenar and hypothenar emin
1970. A 40 percent disability rating was granted in a September 2012 rating decision, effective March 30, 2012. The Veteran is seeking a higher rating. See December 2025 NOD. 

The Veteran's right hand neuropathy is evaluated under Diagnostic Code 8516, which provides a 10 percent rating when incomplete paralysis is mild, 30 percent when it is moderate and 40 percent when it is severe. These ratings are for the major extremity. A 60 percent rating is available for complete paralysis, resulting in the "griffin claw" deformity, due to flexor contraction of ring and little fingers, atrophy very marked in dorsal interspace and thenar and hypothenar eminences; loss of extension of ring and little fingers cannot spread the fingers (or reverse), cannot adduct the thumb; flexion of wrist weakened. 38 C.F.R. § 4.124a, DC 8516.

The words "mild," "moderate," and "severe" as used in the various Diagnostic Codes are not defined in the Rating Schedule. Regulations provide that ratings for peripheral neurological disorders are to be assigned based on the relative impairment of motor function, trophic changes, or sensory disturbance. 38 C.F.R. § 4.120. Consideration is also given for loss of reflexes, pain, and muscle atrophy. See 38 C.F.R. §§ 4.123, 4.124.

The term "incomplete paralysis" indicates a degree of lost or impaired function substantially less than the type of picture for complete paralysis given with each nerve, whether due to varied level of the nerve lesion or to partial regeneration. When the involvement is wholly sensory, the rating is for the mild, or at most, the moderate degree. The disability ratings for the peripheral nerves are for unilateral involvement; when bilateral, the ratings combine with application of the bilateral factor. 38 C.F.R. § 4.124a, Note at "Diseases of the Peripheral Nerves." The Note to 38 C.F.R. § 4.124a establishes a maximum disability rating for conditions that are wholly sensory, as opposed to a minimum disability rating for conditions that are more than wholly sensory. See Miller v. Shulkin, 28 Vet. App. 376 (2017). 

The medical evidence of record includes several VA examinations, the most recent of which was conducted in May 2023. The VA examiner noted that the Veteran's dominant hand is his right hand. The examination report indicates that the Veteran's right upper extremity had moderate intermittent pain, moderate paresthesias and/or dysesthesia, and moderate numbness. The VA examiner noted that the Veteran's right upper extremity had no constant pain. Muscle strength testing revealed normal strength elbow flexion and extension, and active movement against some resistance with wrist flexion and extension, grip, and pinch (thumb to index finger). There was no muscle atrophy. Reflex and sensory testing were normal. There were no trophic changes. Special tests were conducted for the median nerve, and the Phalen's sign and Tinel's sign were both positive for his right extremity. Lastly, the VA examiner noted mild incomplete paralysis of the ulnar nerve. Thus, the evidence reveals that, at worst, the Veteran's right hand neuropathy is manifested by severe incomplete paralysis of the major extremity. 

The Board has considered all other potentially applicable Diagnostic Codes, but there is no evidence showing the Veteran has neurological impairment associated with any other peripheral nerves that have not already been service-connected. Therefore, a separate or higher rating under a different Diagnostic Code is not warranted.  

For the foregoing reasons, the evidence of record persuasively weighs against the Veteran's claim for a rating in excess of 40 percent for right hand neuropathy. As the evidence of record persuasively weighs against a rating in excess of 40 percent, the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch, 21 F.4th at 776.

 

 

Cory M. Picton

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	G. N. Wilson, Associate Counsel

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.