C&P Exam for Wrist, ankylosis of (DC 5214)

Diagnostic code: 5214Condition: Wrist, ankylosis ofRegulation: 38 CFR § 4.71aDBQ: DBQ MUSC Wrist

Which form the examiner uses

For wrist, ankylosis of (DC 5214), the C&P examiner completes the following Disability Benefits Questionnaire (DBQ):

DBQ MUSC Wrist (public PDF on VA.gov)

DBQs are Department of Veterans Affairs Form 21-0960 series documents. Public DBQs are hosted on benefits.va.gov. A handful are examiner-only and are not posted publicly.

What the examiner records

The fields below are reproduced from the DBQ form the examiner completes for this diagnostic code. This is the structural map of the form, showing what the examiner is asked to measure, observe, and record. It is a factual reproduction of the public DBQ, not advice on how to answer.

This DBQ evaluates wrist conditions including range of motion, ankylosis, and surgical procedures.

How DC 5214 maps to this DBQ: for this diagnostic code specifically, the examiner typically completes sections I-V, VII, and X-XII of this form. Section V is the condition-specific section for this code. Sections VI and VIII-IX cover unrelated conditions on this DBQ and are skipped.

DIAGNOSIS (Section I)

1A. List the claimed condition(s) that pertain to this questionnaire:
1B. Select diagnoses associated with the claimed condition(s) (check all that apply): [diagnosis name], Side affected: Right / Left / Both, ICD code, Date of diagnosis (Right / Left)
The Veteran does not have a current diagnosis associated with any claimed condition(s) listed above.
1C. If there are additional diagnoses that pertain to wrist conditions, list using above format:

MEDICAL HISTORY (Section II)

2A. Describe the history (including onset and course) of the Veteran's wrist condition (brief summary):
2B. Does the Veteran report flare-ups of the wrist? Yes / No
If yes, document the Veteran's description of the flare-ups he or she experiences, including the frequency, duration, characteristics, precipitating and alleviating factors, severity and/or extent of functional impairment he or she experiences during a flare-up of symptoms.
2C. Does the Veteran report having any functional loss or functional impairment of the joint or extremity being evaluated on this questionnaire, including but not limited to after repeated use over time? Yes / No
If yes, document the Veteran's description of functional loss or functional impairment in his/her own words.

RANGE OF MOTION (Section III)

3A. Initial ROM measurements: All normal / Abnormal or outside of normal range / Unable to test / Not indicated
If "Unable to test" or "Not indicated", please explain:
If ROM is outside of "normal" range, but is normal for the Veteran (for reason other than a wrist condition, such as age, body habitus, neurologic disease), please describe:
If abnormal, does the range of motion itself contribute to a functional loss? Yes / No (if yes, please explain)
Can testing be performed? Yes / No
If this is the unclaimed joint, is it: Damaged / Undamaged
Active Range of Motion (ROM) - Dorsiflexion endpoint (70 degrees): degrees
Active Range of Motion (ROM) - Palmar flexion endpoint (80 degrees): degrees
Active Range of Motion (ROM) - Ulnar deviation endpoint (45 degrees): degrees
Active Range of Motion (ROM) - Radial deviation endpoint (20 degrees): degrees
If noted on examination, which ROM exhibited pain? (Select all that apply.) Dorsiflexion / Palmar flexion / Ulnar deviation / Radial deviation
If any limitation of motion is specifically attributable to pain, weakness, fatigability, incoordination, or other, please note the degree(s) in which limitation of motion is specifically attributable to the factors identified and describe. Dorsiflexion degree endpoint (if different than above)
Palmar flexion degree endpoint (if different than above)
Ulnar deviation degree endpoint (if different than above)
Radial deviation degree endpoint (if different than above)
Describe:
Passive Range of Motion - Dorsiflexion endpoint (70 degrees): degrees / Same as active ROM
Passive Range of Motion - Palmar flexion endpoint (80 degrees): degrees / Same as active ROM
Passive Range of Motion - Ulnar deviation endpoint (45 degrees): degrees / Same as active ROM
Passive Range of Motion - Radial deviation endpoint (20 degrees): degrees / Same as active ROM
If noted on examination, which passive ROM exhibited pain? (select all that apply): Dorsiflexion / Palmar flexion / Ulnar deviation / Radial deviation
Is there evidence of pain? Yes / No
If yes, check all that apply: weight-bearing / nonweight-bearing / active motion / passive motion / on rest/non-movement / does not result in/cause functional loss / causes functional loss
Is there objective evidence of crepitus? Yes / No
Is there objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue? Yes / No
If yes, please explain. Include location, severity, and relationship to condition(s).
3B. Observed repetitive use ROM - Is the Veteran able to perform repetitive-use testing with at least three repetitions? Yes / No
Is there additional loss of function or range of motion after three repetitions? Yes / No
After three repetitions - Dorsiflexion endpoint (70 degrees): degrees
After three repetitions - Palmar flexion endpoint (80 degrees): degrees
After three repetitions - Ulnar deviation endpoint (45 degrees): degrees
After three repetitions - Radial deviation endpoint (20 degrees): degrees
Select factors that cause this functional loss. (Check all that apply): N/A / Pain / Fatigability / Weakness / Lack of endurance / Incoordination / Other
3C. Repeated use over time - Is the Veteran being examined immediately after repeated use over time? Yes / No
Does procured evidence (statements from the Veteran) suggest pain, fatigability, weakness, lack of endurance, or incoordination which significantly limits functional ability with repeated use over time? Yes / No
Select factors that cause this functional loss. (Check all that apply): N/A / Pain / Fatigability / Weakness / Lack of endurance / Incoordination / Other
Estimate range of motion in degrees for this joint immediately after repeated use over time - Dorsiflexion endpoint (70 degrees): degrees
Estimate range of motion in degrees for this joint immediately after repeated use over time - Palmar flexion endpoint (80 degrees): degrees
Estimate range of motion in degrees for this joint immediately after repeated use over time - Ulnar deviation endpoint (45 degrees): degrees
Estimate range of motion in degrees for this joint immediately after repeated use over time - Radial deviation endpoint (20 degrees): degrees
Please cite and discuss evidence. (Must be specific to the case and based on all procurable evidence.)
3D. Flare-ups - Is the examination being conducted during a flare-up? Yes / No
Does procured evidence (statements from the Veteran) suggest pain, fatigability, weakness, lack of endurance, or incoordination which significantly limits functional ability with repeated use over time? Yes / No
Select factors that cause this functional loss. (Check all that apply): N/A / Pain / Fatigability / Weakness / Lack of endurance / Incoordination / Other
Estimate range of motion in degrees for this joint immediately after repeated use over time [during flare-up] - Dorsiflexion endpoint (70 degrees): degrees
Estimate range of motion in degrees for this joint immediately after repeated use over time [during flare-up] - Palmar flexion endpoint (80 degrees): degrees
Estimate range of motion in degrees for this joint immediately after repeated use over time [during flare-up] - Ulnar deviation endpoint (45 degrees): degrees
Estimate range of motion in degrees for this joint immediately after repeated use over time [during flare-up] - Radial deviation endpoint (20 degrees): degrees
Please cite and discuss evidence. (Must be specific to the case and based on all procurable evidence.) [flare-up]
3E. Additional factors contributing to disability: None / Interference with standing / Interference with sitting / Disturbance of locomotion / Swelling / Less movement than normal / Deformity / Weakened movement / More movement than normal / Instability of station / Atrophy of disuse / Other
Please describe additional contributing factors of disability:

MUSCLE ATROPHY (Section IV)

4A. Does the Veteran have muscle atrophy? Yes / No
4B. If yes, is the muscle atrophy due to the claimed condition in the diagnosis section? Yes / No
If no, provide rationale:
4C. Right upper extremity (specify location of measurement, such as "10 cm below anterior elbow crease"):
Circumference of more normal side: cm
Circumference of atrophied side: cm
4C. Left upper extremity (specify location of measurement, such as "10 cm below anterior elbow crease"):
Circumference of more normal side: cm
Circumference of atrophied side: cm

ANKYLOSIS (Section V)

5A. Is there ankylosis of the wrist? Yes / No
If yes, indicate severity of ankylosis: Extremely unfavorable
Unfavorable, in any degree of palmar flexion - If checked, provide degrees of palmar flexion:
Unfavorable, with ulnar deviation - If checked, provide degrees of ulnar deviation:
Unfavorable, with radial deviation - If checked, provide degrees of radial deviation:
Any other position except favorable - If checked, describe:
Favorable in 20 to 30 degrees dorsiflexion
5B: Comments if any:

SURGICAL PROCEDURES (Section VI)

6A. Indicate any surgical procedures that the Veteran has had performed (check all that apply): No surgery / Total wrist joint replacement / Arthroscopic or other wrist surgery
Total wrist joint replacement - Date of surgery:
Total wrist joint replacement - Residuals: None / Intermediate degrees of residual weakness, pain, or limitation of motion / Chronic residuals consisting of severe painful motion or weakness / Other residuals, describe:
Arthroscopic or other wrist surgery - Type of surgery:
Arthroscopic or other wrist surgery - Date of surgery:
Arthroscopic or other wrist surgery - Describe residuals:

OTHER PERTINENT PHYSICAL FINDINGS, COMPLICATIONS, CONDITIONS, SIGNS, SYMPTOMS, AND SCARS (Section VII)

7A. Does the Veteran have any other pertinent physical findings, complications, conditions, signs or symptoms related to any conditions listed in the diagnosis section above? Yes / No
If yes, describe (brief summary):
7B. Does the Veteran have any scars or other disfigurement (of the skin) related to any conditions or to the treatment of any conditions listed in the diagnosis section? Yes / No

ASSISTIVE DEVICES (Section VIII)

8A. Does the Veteran use any assistive devices? Yes / No
Brace - Frequency of use: Occasional / Regular / Constant
Other, describe: - Frequency of use: Occasional / Regular / Constant
8B. If the Veteran uses any assistive devices, specify the condition, indicate the side, and identify the assistive device used for each condition.

REMAINING EFFECTIVE FUNCTION OF THE EXTREMITIES (Section IX)

9A. Due to the Veteran's wrist condition(s), is there functional impairment of an extremity such that no effective function remains other than that which would be equally well served by an amputation with prosthesis (functions of the upper extremity include grasping, manipulation, etc.)? Yes, functioning is so diminished that amputation with prosthesis would equally serve the Veteran. / No
If yes, indicate extremities for which this applies: Right upper / Left upper
9B. For each checked extremity, identify the condition causing loss of function, describe loss of effective function and provide specific examples (brief summary):

DIAGNOSTIC TESTING (Section X)

10A. Have clinically relevant diagnostic imaging studies or other diagnostic procedures been performed or reviewed in conjunction with this examination? Yes / No
10B. If yes, is degenerative or post-traumatic arthritis documented? Yes / No - Indicate side: Right / Left / Both
10C. If yes provide type of test or procedure, date and results (brief summary):
10D. Are there any other clinically relevant diagnostic test findings or results related to the claimed condition(s) and/or diagnosis(es), that were reviewed in conjunction with this examination? Yes / No
If yes, provide type of test or procedure, date and results (brief summary):
10E. If any test results are other than normal, indicate relationship of abnormal findings to diagnosed conditions:

FUNCTIONAL IMPACT (Section XI)

11A. Regardless of the Veteran's current employment status, do the conditions listed in the diagnosis section impact his/her ability to perform any type of occupational task (such as standing, walking, lifting, sitting, etc.)? Yes / No
If yes, describe the functional impact of each condition, providing one or more examples:

REMARKS (Section XII)

12A. Remarks (if any - please identify the section to which the remark pertains when appropriate).

Rating Levels for DC 5214

The following tiers are reproduced from 38 CFR Part 4, the VA Schedule for Rating Disabilities. Toggle between the official VA criteria and a Plain English explanation.

Plain-English summaries are AI-generated to explain the official criteria. The official 38 CFR language is the binding legal standard. When in doubt, ask a VSO.

What the Board discussed in granted decisions for DC 5214

The themes below were extracted by clustering 500 grant-factor sentences from published Board of Veterans Appeals decisions for this diagnostic code. Frequencies indicate how often each theme appeared in the sample. This is a factual aggregate of the public record, not advice or strategy for any specific claim.

31% Benefit of the doubt doctrine cited as inapplicable
The Board noted that because the preponderance of evidence weighed against the claim, the benefit of the doubt doctrine did not apply and the claim was denied.
156 of 500 sample sentences
20% Benefit of the doubt resolved in veteran's favor
The Board found the evidence in approximate balance or equipoise and resolved reasonable doubt in favor of the veteran, granting or increasing the rating.
98 of 500 sample sentences
16% Legal standard for benefit of the doubt cited
The Board cited the statutory or regulatory standard requiring VA to give the benefit of the doubt to the claimant when positive and negative evidence is in approximate balance.
82 of 500 sample sentences
15% Medical nexus opinion of at least as likely as not noted
A VA or private examiner opined that the veteran's condition was at least as likely as not related to service, an in-service event, or a service-connected disability.
76 of 500 sample sentences
11% Evidence found in relative equipoise on the claim
The Board found the positive and negative evidence approximately balanced on a material issue, triggering application of the benefit of the doubt in the veteran's favor.
54 of 500 sample sentences
7% Board's responsibility to weigh evidence and determine equipoise noted
The Board cited its responsibility to determine whether the evidence supports the claim, is in relative equipoise with the veteran prevailing, or preponderates against the claim.
36 of 500 sample sentences
2% Wrist disability rating warranted under DC 5214 or related codes
The Board found the evidence supported assignment of a specific disability rating for the veteran's wrist condition under Diagnostic Code 5214 or an analogous code, often after applying the benefit of the doubt.
12 of 500 sample sentences
2% Negative medical nexus opinion noted in the record
A VA or private examiner opined that the veteran's condition was not at least as likely as not related to service or a service-connected disability.
10 of 500 sample sentences
2% TDIU entitlement found based on service-connected disabilities
The Board found, after weighing lay and medical evidence and resolving the benefit of the doubt in the veteran's favor, that entitlement to TDIU was warranted due to service-connected disabilities.
8 of 500 sample sentences
2% Examiner asked to opine on nexus or aggravation
A VA examiner was directed to provide an opinion on whether a current disability was at least as likely as not related to service, an in-service event, or a service-connected condition.
8 of 500 sample sentences

Disclaimer: This page reproduces public Department of Veterans Affairs forms (DBQs) and verbatim text from 38 CFR Part 4 (the VA Schedule for Rating Disabilities). It is informational only and is not legal or medical advice. For guidance on a specific claim, contact a VA-accredited representative.