Get ready for your exam
Elbow and forearm
What it is
Your elbow is the hinge in your arm and your forearm turns your palm up and down; VA rates how far it bends, how close it gets to straight, and how far your palm turns, and pays more for your dominant arm.
Normal movement (what VA counts as normal)
- Flexion (bend)0 to 145°
- Extension (straighten)0 (fully straight)
- Pronation (palm down)0 to 80°
- Supination (palm up)0 to 85°
VA's code numbers for this: 5205, 5206, 5207, 5208, 5209, 5210, 5211, 5212, 5213, 5052
What the examiner will do
- The examiner asks how and when the problem started, what treatment you have had, and how it affects work and daily life.
- They ask about flare-ups: how often, how long, what sets them off, and what you cannot do during one.
- They measure how far you can move the joint yourself (active motion) with a goniometer. They should note where pain begins.
- They move the joint for you (passive motion). They test it with weight on it and without weight on it. They compare it to your other side if that side is healthy. (Correia v. McDonald, 2016; 38 CFR 4.59.)
- They have you repeat each motion at least 3 times, then measure again (repetitive-use testing).
- They check strength, muscle loss (atrophy), tenderness, and whether the joint is stuck (ankylosis).
- They look at X-rays or other imaging, or order them.
- They ask about braces, canes, or other devices and how often you use them.
The examiner fills out a form called a DBQ. You can read it ahead of time: Elbow and Forearm Conditions DBQ (updated 2025-10-07) (opens VA's site).
The rating levels, in plain words
VA rates most joints by how far they move. The less you can move, the higher the level.
Flexion (bend)
Up to 110°
Your dominant arm
0%
Your other arm
0%
Bends to 110 degrees: 0%.
Rule: 38 CFR 4.71a, DC 5206
Up to 100°
Your dominant arm
10%
Your other arm
10%
Bends only to 100 degrees: 10% either arm.
Rule: 38 CFR 4.71a, DC 5206
Up to 90°
Your dominant arm
20%
Your other arm
20%
Only to 90 degrees (a right angle): 20% either arm.
Rule: 38 CFR 4.71a, DC 5206
Up to 70°
Your dominant arm
30%
Your other arm
20%
Only to 70 degrees: 30% dominant.
Rule: 38 CFR 4.71a, DC 5206
Up to 55°
Your dominant arm
40%
Your other arm
30%
Only to 55 degrees: 40% dominant.
Rule: 38 CFR 4.71a, DC 5206
Up to 45°
Your dominant arm
50%
Your other arm
40%
Only to 45 degrees: 50% dominant.
Rule: 38 CFR 4.71a, DC 5206
Extension (straighten)
Stays 60° or more short of straight
Your dominant arm
10%
Your other arm
10%
Stays 45 or 60 degrees short of straight: 10% either arm.
Rule: 38 CFR 4.71a, DC 5207
Stays 75° or more short of straight
Your dominant arm
20%
Your other arm
20%
Stays 75 degrees short of straight: 20% either arm.
Rule: 38 CFR 4.71a, DC 5207
Stays 90° or more short of straight
Your dominant arm
30%
Your other arm
20%
Stays 90 degrees bent: 30% dominant / 20% non-dominant.
Rule: 38 CFR 4.71a, DC 5207
Stays 100° or more short of straight
Your dominant arm
40%
Your other arm
30%
Stays 100 degrees bent: 40% dominant / 30% non-dominant.
Rule: 38 CFR 4.71a, DC 5207
Stays 110° or more short of straight
Your dominant arm
50%
Your other arm
40%
Stays 110 degrees bent: 50% dominant / 40% non-dominant.
Rule: 38 CFR 4.71a, DC 5207
Both limited
20%
Bends only to 100 AND stays 45 short of straight: 20% either arm.
Rule: 38 CFR 4.71a, DC 5208
Supination (palm up)
Up to 30°
10%
Can turn palm up only 30 degrees or less: 10% either arm.
Rule: 38 CFR 4.71a, DC 5213
Pronation (palm down)
Your dominant arm
20%
Your other arm
20%
Cannot turn palm all the way down (motion lost in the last quarter): 20% either arm.
Rule: 38 CFR 4.71a, DC 5213
Your dominant arm
30%
Your other arm
20%
Motion lost past the middle of the arc: 30% dominant / 20% non-dominant.
Rule: 38 CFR 4.71a, DC 5213
Flail elbow / ankylosis
Your dominant arm
60%
Your other arm
See text
Flail (floppy) elbow: 60% dominant / 50% other. Elbow fused: 40/30 (favorable, 90-70 degrees), 50/40 (intermediate), 60/50 (unfavorable).
Rule: 38 CFR 4.71a, DCs 5205, 5209
Your dominant arm is the one you write and eat with. Only one arm counts as dominant (38 CFR 4.69).
Measure it at home
With a helper and a cheap tool. Your home numbers help you describe your bad days honestly at the exam.
The tool to get
Best: a clear plastic goniometer (say GO-nee-OM-eh-ter). It looks like a protractor with two long arms joined by a pin. A 12-inch, 360-degree one costs about $5 to $10 online or at a medical supply store. This is the same kind of tool most examiners use.
Free: a phone goniometer or inclinometer (angle-measuring) app. Many are free. Tape or hold the phone flat along the body part, set it to zero at the start, then move.
No money and no phone: print a paper protractor (half circle, 0 to 180 degrees) on stiff paper. Tape two straws or paper strips to the center with a brad so they swing. Lay it against the joint.
A pen and the log sheet below. A second person (spouse, adult child, friend) to hold the tool, because you cannot measure yourself well.
A pencil to hold in your fist for the palm-turn test.
No tool yet? Print our paper protractor below.
Step by step, with a helper
1. Flexion and extension
- How to stand or lie
- Sit or stand, arm at your side, palm facing forward. Bend the elbow fully, then straighten it fully.
- Where the tool goes
- Pin on the outside bony bump of the elbow. Fixed arm runs up the outside of the upper arm toward the shoulder tip. Moving arm runs along the forearm to the thumb side of the wrist. Straight = 0.
- Who holds what
- Helper reads at 'pain' and at stop for bending, then reads how many degrees short of straight the arm stays.
2. Palm down / palm up
- How to stand or lie
- Sit. Elbow tucked at your side and bent to 90. Hold a pencil in your fist pointing up (thumb up = 0). Turn palm down, then palm up.
- Where the tool goes
- Pin at your knuckles. Fixed arm straight up and down. Moving arm lines up with the pencil.
- Who holds what
- Helper keeps your elbow against your side (moving the shoulder adds fake motion) and reads both directions.
Stop at the first real pain. Never force a joint to get a number. Stand close for balance during back and hip tests.
Check your number
Type the number where you had to stop.
Type your number above to see where it falls.
This is only to help you understand. The VA examiner measures and the VA decides.
The levels for flexion (bend) (pick an arm):
- 0° to 45°50%
- 46° to 55°40%
- 56° to 70°30%
- 71° to 90°20%
- 91° to 100°10%
- 101° to 110°0%
If your number is close to the next level, VA may give the higher one (38 CFR 4.7).
Your log: what to write each time
- DateExample: 10/12
- TimeExample: 7 pm
- Good day or flare-up day?Example: Flare-up day
- Body part and side (R/L)Example: Right elbow
- MotionExample: Bend elbow
- Degrees where pain STARTSExample: 90
- Degrees where you had to STOPExample: 110
- After 3 tries: degrees where you stopExample: 100
- Pain 0-10Example: 7
- Medicine taken today (what and when)Example: Ibuprofen 8 am
- Who measuredExample: Spouse
- Notes (clicking, giving way, swelling)Example: Hurt more after the 3rd try
Write it down (one line per try):
Measure on a normal day and again on a bad day. Do it 2 or 3 times over a few weeks. Bring the sheet to the exam.
Tap Print this page to get a blank log sheet and your exam-day checklist on paper.
Printable paper protractor
- Print at 100% scale; check the 90° line with a square corner (like the corner of a sheet of paper).
- Glue it to stiff paper or a cereal box. Push a brad through the center dot.
- Tape two paper strips or straws to the brad so they swing. One stays on the body part that doesn't move. The other follows the moving part.
- The top numbers count from the left. The small numbers count from the right. Use whichever side starts at 0.
This is only to help you understand. The VA examiner measures and the VA decides.
Exam-day checklist
Tick each one off. Nothing you tick is saved or sent anywhere.
Tell the examiner
Flare-ups
A flare-up is a time when your joint gets much worse for a while. The examiner must ask about your flare-ups and estimate, in degrees, how much motion you lose during them, even if your exam is on a good day (Sharp v. Shulkin, 2017). They can only skip this if they explain why after getting your information. Be ready to say: how often (for example, 2 times a week), how long each lasts (for example, 1 to 2 days), what triggers it, and exactly what you cannot do (for example, 'I can't lift my arm to comb my hair'). If you measured at home on a flare-up day, show that number.
Repeated use
The examiner will have you do each motion at least 3 times and then measure again. Tell them if pain, weakness, tiredness, or poor control gets worse with each try. The form also asks about repeated use over time, like at the end of a workday. Pain alone does not raise a rating; pain that actually limits how far, how strong, or how long you can move does (Mitchell v. Shinseki, 2011; DeLuca v. Brown, 1995; 38 CFR 4.40 and 4.45).
Honest exam rules
- Move each joint until pain starts. Say 'pain starts here' out loud. Stop when pain or stiffness stops you. Do not push through sharp pain to look tough. Do not stop before pain or stiffness really stops you, either. The examiner writes down both points.
- Give your real, full effort on strength tests. The goal is an exam that shows how you truly are.
- Describe a typical day AND your worst days. Bad days count, but say they are bad days and how often they happen.
- Take your medicine the way you normally do. Do not skip it, and do not take extra just for the exam. Tell the examiner what you took and when, and how you are when it wears off. (Court decisions Jones v. Shinseki (2012) and Ingram v. Collins (2025) say VA should not lower a joint rating because medicine helps, when the rating rules do not mention medicine. VA tried to change this by rule in February 2026 and took the change back on February 27, 2026.)
- Wear or bring any brace, cane, crutches, or walker you normally use. Bring the prescription or a record showing a provider ordered it.
- Bring a one-page list: your diagnoses, surgeries, treatments tried, medicines, how often you have flare-ups, your home measurement log, and what you can no longer do at work and at home.
- If you do not know or do not remember, say so. Do not guess.
- Fraud warning: knowingly giving VA false information is a federal crime (18 U.S.C. 1001) and can cost you all VA benefits (38 U.S.C. 6103). Honest, complete reporting is all you need.
Common mistakes
Pushing through pain so the examiner only writes down your end point. Painful motion is a key factor, and the exam should record where pain starts.
Where this comes from: 38 CFR 4.59; Burton v. Shinseki, 25 Vet. App. 1 (2011); Mitchell v. Shinseki, 25 Vet. App. 32 (2011)
Saying 'I'm fine' or only describing a good day. Flare-ups that are not described cannot be estimated.
Where this comes from: Sharp v. Shulkin, 29 Vet. App. 26 (2017); DBQ flare-up section
An exam that skipped passive motion, weight-bearing testing, or the opposite joint. That exam may be inadequate; you or your representative can point this out.
Where this comes from: Correia v. McDonald, 28 Vet. App. 158 (2016)
Not asking for at least the minimum rating when the joint is actually painful, unstable, or out of line from an old injury.
Where this comes from: 38 CFR 4.59; Petitti v. McDonald, 27 Vet. App. 415 (2015)
Not stating the dominant arm.
Where this comes from: 38 CFR 4.69
Not mentioning finger weakness or numbness after an elbow or forearm injury. Finger problems from tendon, muscle, or nerve damage are rated separately and combined (up to the loss-of-use-of-hand level).
Where this comes from: 38 CFR 4.71a, Note after DC 5213
Questions to ask together
A spouse, grown child or friend can read these out loud. Talk about each one before the exam, so nothing gets left out.
- Can you bring a fork or cup to your mouth with that hand?
- Can you straighten your arm all the way?
- Can you turn a key or doorknob without pain?
- Can you carry a full grocery bag with that arm?
- Can you turn your palm up to hold change?
Sources
- 38 CFR 4.71a, Schedule of ratings: musculoskeletal system (eCFR)
- 38 CFR 4.71, Measurement of ankylosis and joint motion (Plates I and II)
- 38 CFR 4.69, Dominant hand
- 38 CFR 4.59, Painful motion
- Elbow and Forearm Conditions DBQ
- VA public Disability Benefits Questionnaires (DBQs)
- DeLuca v. Brown, 8 Vet. App. 202 (1995)
- Mitchell v. Shinseki, 25 Vet. App. 32 (2011)
- Correia v. McDonald, 28 Vet. App. 158 (2016)
- Sharp v. Shulkin, 29 Vet. App. 26 (2017)
- Ingram v. Collins, No. 23-1798 (Vet. App. Mar. 12, 2025), cited by VA as 38 Vet. App. 130
- VA.gov: VA claim exam (C&P exam)
Checked against VA's rules on October 30, 2026.
Helping The Brave doesn't file or prepare claims. This guide is free education, not medical or legal advice. The VA examiner measures and VA decides your rating.