VA Disability Ratings for Amputation and Limb Loss (2026)

Bottom Line Up Front

Amputation is one of the few areas of the rating schedule where the criteria are mechanical rather than a judgment call. VA looks at where the limb was taken, finds that level in the schedule, and assigns the rating. There is no range of motion to measure and no flare-up to describe.

Four things decide what an amputation is worth:

1. The level. Higher up the limb pays more, and the jumps are large. A below-knee amputation that allows a prosthesis is 40 percent. The same leg taken at the middle third of the thigh is 60 percent.
2. Which side. For arms, hands and fingers, VA rates the dominant side higher. Every upper-extremity code has two columns.
3. The amputation rule. The combined rating for everything wrong with one limb cannot exceed what amputation at that level would pay. This caps claims that would otherwise stack.
4. Special Monthly Compensation. Most amputations at or above the wrist or ankle carry SMC, paid in addition to your percentage rating, not instead of it.

The ratings below come from 38 CFR 4.71a, the musculoskeletal rating schedule. The dollar figures and grant criteria are current as of October 2026.

How VA Rates Lower-Extremity Amputations

The single most consequential line in that table is the gap between 5164 at 60 percent and 5165 at 40 percent. Both are below-knee amputations. The difference is whether a prosthesis can be controlled by natural knee action. If your residual limb is too short, or complications mean the knee cannot drive the prosthesis, you belong at 60 percent and not 40, and that is a clinical question your orthopedist and prosthetist can answer in writing.

Note also that 5167 rates loss of use of a foot the same as an amputation, at 40 percent. You do not have to lose the foot to be rated as though you had. That standard is covered in what "loss of use" actually means to VA.

How VA Rates Upper-Extremity Amputations

Upper-extremity codes carry two ratings. Major means your dominant side. Minor means the other one. If you are right handed, a right-arm amputation is rated in the major column.

For multiple-finger amputations the rating depends on which fingers, not just how many, because the thumb and index finger carry most of the hand's function. Losing the thumb, index, long and ring fingers is 70 percent on the dominant hand. Losing the index, long, ring and little fingers, the same number of digits, is 60 percent.

Three technical notes in the schedule change outcomes often enough to be worth knowing:

• Multiple-finger amputation ratings apply at the proximal interphalangeal joints or through the proximal phalanges. Amputation through the middle phalanges is rated as unfavorable ankylosis instead, and amputations at the distal joints are rated as favorable ankylosis.
• If more than half the metacarpal bone is lost in a multiple-finger injury, 10 percent is added to, not combined with, the rating. Added means arithmetic. A 50 percent rating becomes 60, rather than the 55 that VA's combined-ratings math would produce.
• Combinations of amputations at different levels are rated on the grade of disability most representative of the combination. With an even number of fingers involved and two adjacent grades, VA selects the higher.

The Amputation Rule, and Why Your Rating Stopped Climbing

38 CFR 4.68 is short enough to quote in full:

The combined rating for disabilities of an extremity shall not exceed the rating for the amputation at the elective level, were amputation to be performed.

This is the rule that explains a result many veterans find baffling. You claim a knee condition, an ankle condition and a nerve condition in the same leg, each one is granted, and the leg still comes out at 40 percent. The regulation's own example is exactly that: the combined evaluations for disabilities below the knee cannot exceed 40 percent, which is diagnostic code 5165, the rating for a below-knee amputation that permits a prosthesis.

VA's logic is that it will not pay more for a limb you still have than it would pay if the limb were gone. Two practical consequences:

• Once you are at the cap for a segment, more claims in that segment add nothing. Your time is better spent on a different body system, or on the secondary conditions the limb has caused elsewhere.
• The cap moves up the limb. That 40 percent below-knee ceiling can still be combined with ratings for disabilities above the knee, up to the above-knee elective level. The rule limits each segment, not the whole leg.

One more line in 4.68 matters to amputees specifically: painful neuroma of a stump is assigned the evaluation for the elective site of reamputation. A painful neuroma is not a separate add-on rating; it moves you to the rating for the level where the limb would be taken again.

Special Monthly Compensation Comes With Most Amputations

In the rating schedule, nearly every amputation code at or above the wrist or ankle carries a footnote reading "Entitled to special monthly compensation." That is not a courtesy note. It means the schedule itself has identified you as qualifying for SMC.

SMC under 38 U.S.C. 1114(k), usually written SMC-K, is payable for the anatomical loss or loss of use of one hand or one foot, among other losses. It is paid in addition to your basic compensation rather than replacing it, and you can receive more than one SMC-K award at the same time. Higher SMC levels replace your basic rate entirely:

• SMC-L covers the loss or loss of use of both feet, or one hand and one foot.
• SMC-M covers the loss or loss of use of both hands, or both legs at a level preventing natural knee action with a prosthesis in place.
• SMC-N covers the loss of both arms at a level preventing use of prosthetics, or the loss of use of both legs at the hip.

The regulation that spells all of this out is 38 CFR 3.350, and the way it defines "natural knee action with prosthesis in place" is worth reading if you are near that line: if there is no movement in the joint at all, VA decides the question as though a prosthesis were already in place.

Our full SMC guide has the current monthly rates for every level.

The Housing Grants Nobody Tells You About

If you have lost a limb, or lost the use of one, you may be looking at a different benefit entirely. VA pays up to $126,526 in FY 2026 under the Specially Adapted Housing grant to buy, build or modify a home you own, and the first qualifying condition in the regulation is the loss or loss of use of both lower extremities such as to preclude locomotion without braces, crutches, canes or a wheelchair.

Several routes in 38 CFR 3.809 are relevant to amputees:

• Loss or loss of use of both lower extremities.
• Loss or loss of use of one lower extremity together with residuals of organic disease or injury that affect balance or propulsion.
• Loss or loss of use of one lower extremity together with loss or loss of use of one upper extremity.
• Loss or loss of use of both upper extremities such as to preclude use of the arms at or above the elbow.

There is also a route for the loss or loss of use of one lower extremity after 11 September 2001 where you cannot balance or walk without assistance. Be aware that Congress capped this one: only 120 veterans and service members per fiscal year can qualify on that basis. If you qualify but the cap is reached, you can receive it in a later year.

Smaller modifications that do not need a grant of that size usually run through HISA, the Home Improvements and Structural Alterations program, which is a lifetime benefit of $6,800 for work tied to a service-connected disability. HISA is a healthcare benefit rather than a housing benefit, so it goes through your VA medical center, not the regional office. See SAH, SHA, and HISA grants explained, and if you plan to buy or build rather than modify, how an SAH grant works alongside a VA home loan.

Evidence That Actually Matters for an Amputation Claim

Because the criteria are anatomical, the evidence burden is lighter than for most claims. What VA needs is unambiguous proof of the level and of service connection.

Level of amputation. The operative report is the best document you can submit, because it states what was removed and where. If the amputation was years ago and the operative report is gone, a current orthopedic or prosthetics note describing the residual limb in anatomical terms will do. The phrases that decide your rating:

• For a leg: whether the amputation is above or below the knee, and if above, which third of the thigh.
• For a below-knee amputation: whether a prosthesis can be controlled by natural knee action. This is the 40 versus 60 percent question.
• For an arm: the relationship to the insertion of the deltoid and the insertion of the pronator teres.
• For fingers: which joint, named specifically, and whether the metacarpal was resected.

Dominance. For upper-extremity claims, make sure the record states which hand is dominant. If you were right handed and lost your right arm, say so in your statement. Nothing in a surgical report establishes handedness, and the rating specialist is working from the file.

Service connection. For a traumatic amputation in service this is usually straightforward. The harder cases are amputations years later from a service-connected cause, such as diabetic peripheral vascular disease or an infection in a previously injured limb. Those are secondary service connection claims, and they need a medical opinion linking the amputation to the already-connected condition. Our nexus letter guide covers what that opinion has to say.

Do not forget the rest of the body. Amputees carry the load somewhere else, and VA recognizes those consequences as secondary conditions. Commonly granted secondaries after a lower-limb amputation include low back strain, degenerative changes in the remaining knee and hip, and skin conditions of the residual limb. Each is a separate claim with its own rating, and they are not capped by the amputation rule, because they are not disabilities of the amputated extremity.

What to Expect at the C&P Exam

Expect a short exam. The examiner will measure and describe the residual limb, check the skin and the fit of your prosthesis, and complete the amputations questionnaire. Bring the prosthesis and wear what you normally wear.

Things worth raising while you are in the room, because they are easy to leave out:

• Pain in the residual limb, and whether it is neuroma pain, which has its own rule under 4.68.
• Skin breakdown, ulceration or recurrent infection where the socket bears weight.
• How many hours a day you can tolerate the prosthesis, and what you do when you cannot.
• Phantom limb pain, and whether it is being treated.
• Falls, and what you use for balance indoors and outdoors.

The last two matter beyond the rating itself. Falls and the inability to walk without assistance are the language the housing grant regulations use.

Common Reasons These Claims Go Wrong

The rating was assigned at the wrong level. This is the most common error and the easiest to fix. Pull your rating decision, find the diagnostic code, and compare it against the tables above. If the code says 5165 but your operative report describes an amputation not improvable by a prosthesis controlled by natural knee action, you have a 60 percent case rated at 40.

SMC was never addressed. A rating decision that grants 40 percent under 5167 and says nothing about Special Monthly Compensation has missed something the rating schedule itself flags with a footnote. SMC entitlement does not require a separate application, but it does require someone to notice.

Dominance was assumed. If a dominant-hand amputation was rated in the minor column, that is a 10-point difference at most levels and worth correcting.

A toe amputation was rated at 0 percent. Check whether the metatarsal head was removed. Without metatarsal involvement, toes other than the great toe are rated 0 percent under 5172. With removal of the metatarsal head, one or two toes are 20 percent.

Secondary conditions were never claimed. Years of altered gait do measurable damage to the back and to the opposite knee and hip. Those are separate claims, and veterans frequently never file them.

Frequently Asked Questions

Can I get more than 100 percent for multiple amputations?

Not as a percentage. The schedule stops at 100. But Special Monthly Compensation levels run well above the 100 percent rate, and multiple amputations are exactly what those levels exist for. The loss of both hands, for example, is SMC-M.

Does a prosthesis reduce my rating?

No. Amputation ratings are based on the level of amputation, not on how well you function with a prosthesis. How well you do with a prosthesis can move you between 5164 and 5165 on a below-knee claim, but using one successfully is not a reason to reduce you.

Why is my left-arm amputation rated lower than someone else's right?

If they are right handed and you are not, the schedule treats their loss as the major extremity and yours as the minor one, at a lower rating for the identical level.

Is loss of use rated the same as amputation?

For the hand and the foot, yes. Diagnostic code 5125 rates loss of use of a hand at 70 percent major and 60 percent minor, the same as a forearm amputation below the pronator teres. Code 5167 rates loss of use of a foot at 40 percent, the same as a below-knee amputation permitting a prosthesis. The test VA applies is strict, and we cover it in this guide.

I had the amputation 30 years ago. Is it too late to claim?

No. There is no deadline to file an original claim for a service-connected condition. The effective date of any award will generally be the date you file, which is a reason not to wait longer.

Can an amputation rating be reduced?

An amputation is a permanent anatomical fact, so the rating is not subject to reduction on the basis of improvement, and you should not be scheduled for routine future examinations on it.

Resources

• 38 CFR 4.71a, Schedule of Ratings, Musculoskeletal System - amputation codes 5120 to 5173
• 38 CFR 4.68, Amputation rule
• 38 CFR 4.63, Loss of use of hand or foot
• 38 CFR 3.350, Special monthly compensation ratings
• 38 CFR 3.809, Specially adapted housing
• VA disability housing grants - current SAH and SHA amounts
• VA Form 21-526EZ - disability compensation application
• VA public-use Disability Benefits Questionnaires

Sources: 38 CFR Part 4, 38 CFR Part 3, VA Disability Compensation. Rating criteria verified against the current eCFR text in October 2026. Grant amounts are FY 2026 figures published by VA and change with the annual cost-of-construction index.