Supination and pronation, impairment of (DC 5213)

Body system: Musculoskeletal SystemRegulation: 38 CFR § 4.71a

This condition affects your ability to rotate your forearm and hand - supination means turning your palm up (like holding soup), while pronation means turning your palm down. The VA rates this based on how much rotation you've lost, from 10% for limited movement to 30% if your hand is completely stuck in one position. Higher ratings go to veterans who can barely rotate their forearm at all, which significantly impacts daily activities like turning doorknobs, using tools, or eating.

Rating levels

  • 40% — Your forearm bones have fused together (ankylosis) so that your hand is permanently stuck in either a palm-up position (supination) or an extreme palm-down position (hyperpronation). You cannot rotate your hand or forearm at all because the bones are completely locked in place.
  • 30% — Your forearm bones have fused together so you've completely lost the ability to rotate your hand and wrist. Your hand is permanently stuck in either a palm-up position (supination) or an extreme palm-down position (hyperpronation), and you cannot turn it at all no matter how hard you try.
  • 30% — Your forearm bones have fused together (bone fusion) so that your hand is permanently stuck in a turned-down position (full pronation) and cannot rotate at all. You've completely lost the ability to turn your palm up or down, which means you can't do things like turn a doorknob, use a screwdriver, or turn your hand palm-up to receive change.
  • 20% — Your forearm bones have fused together (bone fusion) so that your hand is permanently stuck in a palm-down position and cannot be rotated at all. You've completely lost the ability to turn your hand palm-up or make any twisting motions with your wrist and forearm.
  • 20% — You qualify for this rating if the bones in your forearm have fused together (meaning they've grown together and can't move), which leaves your hand stuck in a position roughly halfway between palm-up and palm-down. You also qualify if you have moderate difficulty turning your hand palm-up (supination) or palm-down (pronation), even if the bones haven't fused.
  • 20% — You qualify for this rating if the bones in your forearm have fused together (meaning they've grown together and can't move), which leaves your hand stuck in a position roughly halfway between palm-up and palm-down. You also qualify if you have moderate difficulty turning your hand palm-up (supination) or palm-down (pronation), even if the bones haven't fused.
  • 30% — You have significant difficulty turning your forearm and hand from palm-down to palm-up (pronation is the motion that turns your palm downward). The rotation is so limited that you've lost more than half of your normal range of motion, meaning you can barely move past the midpoint where your palm faces sideways.
  • 20% — Your ability to rotate your forearm is limited, specifically when turning your palm downward (pronation). The movement is so restricted that you've lost more than half of your normal range of motion in that rotating movement.
  • 20% — Your hand cannot rotate fully palm-down (pronation is turning your palm to face down), and the movement stops before your hand can turn completely over. The limitation is significant enough that you've lost more than three-quarters of your normal rotating motion, so your hand gets stuck partway through the turning movement and cannot reach the full palm-down position.
  • 20% — Your hand cannot rotate fully palm-down (pronation is turning your palm to face down), and the movement stops before your hand can turn completely over. The limitation is significant enough that you've lost more than three-quarters of your normal rotating motion, so your hand gets stuck partway through the turning movement and cannot reach the full palm-down position.
  • 10% — You qualify for this rating if you can only turn your hand palm-up (supination) to 30 degrees or less from the neutral position. Normal supination allows you to rotate your hand about 90 degrees, so this represents a significant limitation in your ability to turn your palm upward, which affects everyday activities like turning doorknobs, using tools, or reaching for objects.
  • 10% — You qualify for this rating if you can only turn your hand palm-up (supination) to 30 degrees or less from the neutral position. Normal supination allows you to rotate your hand about 90 degrees, so this represents a significant limitation in your ability to turn your palm upward, which affects everyday activities like turning doorknobs, using tools, or reaching for objects.

Disclaimer: This tool is for informational purposes only and is not legal or medical advice. Always consult with your VSO representative or a qualified veterans benefits attorney for guidance on your specific claim.