Forearm Impairment of Pronation/Supination

DC 5213Musculoskeletal38 CFR 4.71a, DC 5213

Limited ability to rotate the forearm — either turning the palm down (pronation) or turning the palm up (supination). Normal supination is 0 to 85 degrees and normal pronation is 0 to 80 degrees. These motions are essential for activities like turning a doorknob, using tools, or typing. The VA rates impaired pronation and supination based on the degree of motion lost.

How the VA rates this condition

The VA rates this condition based on objective clinical measurements and test results. The examiner will use standardized tests or lab values to determine the severity of your condition rather than relying primarily on subjective symptom reports.

Diagnostic code

DC 5213

Rating range

10% – 40%

Rating levels

Rating criteria are defined in 38 CFR 4.71a, DC 5213. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

You have loss of supination and pronation due to bone fusion on your dominant side with the hand fixed near full pronation, or on your non-dominant side with the hand fixed in supination or hyperpronation.

What the VA looks for

Bone fusion fixing forearm rotation documented
Hand fixed in full pronation on dominant side
Complete loss of forearm rotation
Severe impairment of hand function
Major occupational limitations

Common Pitfalls

⚠Not getting precise goniometer measurements — pronation and supination must be measured accurately with a goniometer. The specific degree of motion loss determines the rating level.
⚠Not specifying dominant arm — the ratings differ for the major (dominant) vs. minor (non-dominant) arm. Always document handedness.
⚠Overlooking the cause of the limitation — forearm rotation can be limited by radial head fractures, forearm fractures with malunion, radioulnar synostosis, or elbow pathology. Identifying the cause helps establish service connection.
⚠Not documenting functional impact — explain how limited pronation/supination affects specific daily activities like driving, eating, typing, and using tools.

Related DBQ Forms

DBQ Elbow and Forearm Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

Forearm Impairment of Pronation/Supination

How the VA rates this condition

Diagnostic code

DC 5213

Rating range

10% – 40%

Rating levels

Rating Levels

What the VA looks for

Bone fusion fixing forearm rotation documented
Hand fixed in full pronation on dominant side
Complete loss of forearm rotation
Severe impairment of hand function
Major occupational limitations

Common Pitfalls

⚠Not getting precise goniometer measurements — pronation and supination must be measured accurately with a goniometer. The specific degree of motion loss determines the rating level.

⚠Not specifying dominant arm — the ratings differ for the major (dominant) vs. minor (non-dominant) arm. Always document handedness.

⚠Overlooking the cause of the limitation — forearm rotation can be limited by radial head fractures, forearm fractures with malunion, radioulnar synostosis, or elbow pathology. Identifying the cause helps establish service connection.

⚠Not documenting functional impact — explain how limited pronation/supination affects specific daily activities like driving, eating, typing, and using tools.