DC 5152 · 38 CFR 4.71a
Above-Elbow Amputation of Arm C&P Exam Prep
To document the precise anatomical level of the above-elbow amputation, assess residual limb (stump) condition, evaluate prosthetic use and fit, identify any complications such as phantom pain or neuroma, and determine functional limitations to support accurate disability rating under DC 5152.
- Format:
- Interview + Physical
- Typical duration:
- 30-60 minutes
- DBQ form:
- amputations (amputations)
- Examiner:
- Orthopedic Surgeon, Physiatrist, or Prosthetist
What the examiner evaluates
- Exact amputation level relative to anatomical landmarks (e.g., deltoid insertion, shoulder joint)
- Whether amputation is above or below the deltoid insertion
- Residual limb (stump) condition: length, shape, skin integrity, scarring, and soft tissue coverage
- Presence of painful neuroma, bone spurs, or other stump complications
- Phantom limb pain or sensation
- Prosthetic device use: type, frequency, fit, and functional benefit
- Shoulder joint mobility of the residual limb side
- Muscle strength in residual limb and contralateral extremity
- Any secondary conditions caused or aggravated by the amputation
- Functional limitations in activities of daily living, occupational tasks, and self-care
- Use of assistive devices beyond the prosthesis
- Overall impact on daily functioning and quality of life
Exam will be conducted in person at a VA facility or contracted examiner office. You have the right to request that the exam be recorded in most states. Bring your prosthetic device(s) to the exam. The examiner will visually inspect the residual limb, so wear clothing that allows easy exposure of the affected arm.
Measurements and tests
Amputation Level Assessment
What it measures: Precise anatomical level of amputation relative to key landmarks including the deltoid insertion, shoulder joint, and humeral length remaining
What to expect: The examiner will visually inspect and measure the residual limb, documenting the distance from anatomical landmarks. They will determine whether the amputation is a forequarter, shoulder disarticulation, above deltoid insertion, or below deltoid insertion.
Critical thresholds
- Forequarter amputation (complete removal of arm, shoulder girdle, clavicle, and scapula) Highest rating tier under DC 5152 - dominant arm 80%, non-dominant arm 70%
- Shoulder disarticulation (complete removal of humerus) High rating tier under DC 5152 - dominant arm 80%, non-dominant arm 70%
- Amputation above deltoid insertion High rating tier - dominant arm 80%, non-dominant arm 70%
- Amputation below deltoid insertion Lower rating tier - dominant arm 70%, non-dominant arm 60%
Tips
- Know the exact level of your amputation before the exam - review your surgical records
- Understand whether your remaining stump allows any shoulder joint movement
- Be prepared to describe whether shoulder musculature is preserved or compromised
- If you have had revisions or re-amputations, ensure all dates and levels are documented
Pain considerations: Phantom limb pain and residual limb pain are distinct - report both accurately. Phantom pain (perceived in the missing arm) and stump pain (at the amputation site) both affect functional capacity and should be communicated clearly.
Residual Limb (Stump) Evaluation
What it measures: Condition of the stump including skin integrity, scar tissue, presence of neuromas, bone spurs, tenderness, and adequacy for prosthetic fitting
What to expect: The examiner will physically inspect the stump, palpate for tender areas, assess scarring, check for adherent scar tissue, and evaluate whether the stump is suitable for prosthetic use. They will note any complications that prevent or limit prosthetic wear.
Critical thresholds
- Defective stump (painful, unstable, or poorly healed) A defective stump may qualify for special ratings or additional compensation beyond the base amputation rating
- Neuroma present and symptomatic May support higher rating or secondary service connection for nerve condition
- Skin breakdown or ulceration preventing prosthetic use Documents inability to use prosthesis, supporting higher functional limitation rating
Tips
- Do not apply lotions or coverings to the stump on the day of the exam that might obscure findings
- Wear or bring your prosthetic socket to demonstrate fit issues
- Report any areas of skin irritation, breakdown, or pain caused by prosthetic socket
- Describe how long you can wear the prosthesis before discomfort forces removal
- Note any changes in stump volume that affect prosthetic fit
Pain considerations: Accurately describe stump pain intensity on a 0-10 scale, its character (burning, stabbing, aching), what aggravates it (prosthetic wear, pressure, temperature changes), and how it limits your ability to use the prosthesis consistently throughout the day.
Shoulder Range of Motion Assessment
What it measures: Remaining shoulder girdle and any residual humeral motion on the amputated side, as well as compensatory shoulder function
What to expect: For above-elbow amputees with preserved shoulder joint, the examiner may assess residual shoulder flexion, abduction, and rotation. For shoulder disarticulations or forequarter amputations, this assessment is not applicable but examiner will note absence of shoulder girdle structures.
Critical thresholds
- Preserved shoulder joint with full range of motion Supports myoelectric or body-powered prosthetic candidacy and higher functional potential
- Limited or absent shoulder motion Documents increased functional limitation and may support higher rating for amputation with defective stump
Tips
- Report any pain with shoulder movement on the amputated side
- Describe how shoulder movement (or lack thereof) affects prosthetic control
- Note if you experience fatigue or weakness in residual shoulder muscles during the day
- If you use a body-powered prosthesis, describe how shoulder harness use causes secondary pain or skin irritation
Pain considerations: Report shoulder pain during any attempted movement of the residual limb. Describe how pain affects your ability to control a body-powered prosthesis via shoulder harness movement, and note if pain increases with repeated use throughout the day.
Prosthetic Device Evaluation
What it measures: Type of prosthesis used, frequency of use, functional benefit, fit adequacy, and any complications from prosthetic use
What to expect: The examiner will ask detailed questions about your prosthetic use history and may physically examine the device. They will document whether you use a body-powered hook or hand, myoelectric prosthesis, activity-specific prosthesis, or no prosthesis, and assess how well it functions for daily tasks.
Critical thresholds
- No prosthesis used or prosthesis provides no functional benefit Critical documentation for maximum rating; absence of functional prosthesis supports highest disability level
- Prosthesis used with significant limitations Documents functional impairment even with prosthetic assistance
- Prosthesis improves function but cannot restore normal use Supports continued high disability rating despite prosthetic use
Tips
- Bring all prosthetic devices to the exam - body-powered, myoelectric, cosmetic, and activity-specific
- Demonstrate tasks you cannot perform even with the prosthesis
- Be specific about how many hours per day you can comfortably wear the prosthesis
- Describe specific activities the prosthesis cannot help you perform (e.g., fine motor tasks, overhead reach, heavy lifting)
- Report skin irritation, sweating, or socket fit problems that limit daily wear time
Pain considerations: Describe any pain caused by wearing the prosthetic harness or socket, including skin abrasion, pressure sores, shoulder strain from body-powered cables, and how this pain increases with extended wear or repetitive use of the device.
Rating criteria by percentage
80%
Above-elbow amputation of the dominant arm at or above the deltoid insertion, shoulder disarticulation, or forequarter amputation of the dominant arm. These represent the highest level of upper extremity loss with the greatest functional impact.
Key symptoms
- Complete loss of dominant arm at or above deltoid insertion
- Forequarter amputation with loss of shoulder girdle, clavicle, and/or scapula
- Shoulder disarticulation with complete removal of the humerus
- Inability to perform any grasping, reaching, or manipulation with dominant extremity
- Reliance on non-dominant hand for all tasks
- Significant phantom limb pain
- Limited or absent prosthetic functional benefit at this level
From 38 CFR: Under 38 CFR 4.71a DC 5152, amputation at the shoulder joint (disarticulation) or above the deltoid insertion on the dominant arm warrants 80%. Forequarter amputation also falls at this level.
70%
Above-elbow amputation of the dominant arm below the deltoid insertion, OR above-elbow amputation of the non-dominant arm at or above the deltoid insertion, shoulder disarticulation of the non-dominant arm, or forequarter amputation of the non-dominant arm.
Key symptoms
- Amputation of dominant arm below deltoid insertion with preserved shoulder musculature
- Any forequarter or shoulder disarticulation of the non-dominant arm
- Loss of non-dominant arm at or above deltoid insertion
- Preserved shoulder joint function on dominant side but complete loss of forearm and hand
- Significant functional limitation despite partial shoulder musculature preservation
- Difficulty with bilateral tasks
- Phantom limb pain or neuroma pain affecting function
From 38 CFR: Under DC 5152, dominant arm amputation below the deltoid insertion rates at 70%, as does non-dominant arm amputation at or above the deltoid insertion. The dominant/non-dominant distinction is critical to the rating level.
60%
Above-elbow amputation of the non-dominant arm below the deltoid insertion. This represents the lowest rating tier within above-elbow amputations, applicable when the non-dominant arm is amputated but the shoulder musculature and deltoid function are preserved.
Key symptoms
- Non-dominant arm amputation below deltoid insertion
- Preserved shoulder joint and deltoid on non-dominant side
- Complete loss of non-dominant forearm and hand function
- Ability to partially control body-powered prosthesis via preserved shoulder musculature
- Functional limitations predominantly affecting non-dominant side tasks
- Phantom limb pain on non-dominant side
From 38 CFR: Under DC 5152, non-dominant arm amputation below the deltoid insertion rates at 60%. The preserved deltoid function allows better prosthetic control, which is reflected in the lower rating tier compared to higher-level amputations.
Describing your symptoms accurately
Phantom Limb Pain
How to describe it: Describe the frequency, intensity, character, and triggers of pain perceived in the missing limb. Use specific descriptors such as burning, electric shock sensations, cramping, or aching. Explain how it disrupts sleep, concentration, and daily activities.
Example: On my worst days, I wake at 2 or 3 AM with a burning, cramping sensation in my missing hand and forearm that feels like my fingers are being crushed. The pain rates 8 out of 10 and lasts for hours. I cannot return to sleep, which leaves me exhausted and unable to concentrate the next day. This happens several times per week.
Examiner listens for: Frequency and duration of phantom pain episodes, pain intensity, character of pain, aggravating and relieving factors, impact on sleep and daily function, medication requirements, and whether pain prevents prosthetic use or activity engagement.
Avoid: Saying 'I just have some phantom pain sometimes' without quantifying frequency, duration, and functional impact. The examiner needs specific details to document this accurately.
Prosthetic Use Limitations
How to describe it: Be specific about what you cannot do with the prosthesis, how long you can wear it before pain or discomfort forces removal, and what daily tasks remain impossible even with the best available prosthetic technology. Describe socket fit problems, harness discomfort, and functional gaps.
Example: On a bad day my socket causes skin breakdown on the distal stump within two hours of wear. I have to remove it and spend the rest of the day without any prosthetic function. Even on good days, I cannot perform fine motor tasks like buttoning a shirt, typing, or cutting food - tasks I have to ask my family to help with every single day.
Examiner listens for: Hours per day the prosthesis is worn, reasons for limiting wear time, specific functional tasks the prosthesis cannot perform, skin or soft tissue complications from prosthetic use, and how prosthetic limitations affect employment and daily living.
Avoid: Saying 'my prosthesis works pretty well' without clarifying the many tasks it cannot replicate or the daily limitations you still experience. A prosthesis does not restore normal function and that gap must be documented.
Activities of Daily Living Impact
How to describe it: Describe specific tasks you cannot perform independently, those requiring modifications, those requiring assistance from another person, and the time burden these limitations impose. Include personal hygiene, meal preparation, dressing, driving, household tasks, and occupational activities.
Example: On my worst days I cannot independently button my shirt, cut my own food, tie my shoes, open jars, carry items while walking, or type on a keyboard. I rely on my spouse to help with personal care tasks every morning. Getting dressed takes me 30-45 minutes instead of 10. I cannot perform my former job duties at all.
Examiner listens for: Specific named tasks that are impossible or significantly modified, reliance on family or caregivers, time inefficiency in completing basic tasks, modifications to home or vehicle, and loss of employment capacity or need for vocational rehabilitation.
Avoid: Saying 'I manage okay' or 'I adapt to most things' without describing the specific compensatory strategies, the time required, the help needed, and what you simply cannot do. Adaptation does not mean the disability is not severe.
Residual Limb Pain and Stump Complications
How to describe it: Describe any pain, tenderness, skin breakdown, neuroma sensations, or other complications at the amputation site itself. Distinguish this from phantom pain. Include how stump complications limit prosthetic use and daily function.
Example: On my worst days the neuroma at my stump causes sharp electric-shock pain whenever the area is touched or bumped. Even the weight of clothing against the stump is unbearable. I cannot wear my prosthesis at all on these days, which leaves me completely without upper extremity function on the affected side.
Examiner listens for: Presence and location of neuromas, bone spurs, adherent scar tissue, skin breakdown, tenderness to palpation, how stump complications limit prosthetic wear time, and whether the stump is considered defective under rating criteria.
Avoid: Minimizing stump complications because they seem minor compared to the amputation itself. Stump complications are independently ratable and affect the overall functional picture significantly.
Psychological and Functional Adjustment Impact
How to describe it: Accurately describe how the amputation has affected your mental health, social functioning, self-image, and overall quality of life. If you have a diagnosed secondary psychiatric condition, describe its connection to the amputation. This supports secondary service connection claims.
Example: On my worst days I experience severe depression and anxiety about my appearance and inability to function as I did before. I avoid social situations because of embarrassment about my amputation and prosthesis. I have withdrawn from hobbies and relationships that defined my identity before my injury.
Examiner listens for: Depression, anxiety, PTSD related to the injury, social withdrawal, changes in relationships, impact on self-esteem and identity, avoidance behaviors, and whether psychiatric care has been sought or is needed.
Avoid: Not mentioning psychological impact because it seems outside the scope of a musculoskeletal exam. Mental health effects of amputation are directly relevant to secondary conditions and overall functional impairment ratings.
Common mistakes to avoid
Not bringing the prosthetic device to the exam
Why: The examiner needs to physically assess the prosthesis type, fit, and function. Without it, critical documentation about prosthetic limitations, socket fit problems, and functional gaps may be missed or underreported.
Do this instead: Bring all prosthetic devices you own or use - body-powered, myoelectric, cosmetic, and activity-specific. If you have multiple, bring the one you use most frequently and be prepared to explain why you do not use others.
Impact: All rating levels - prosthetic evaluation is central to the DBQ
Failing to distinguish dominant versus non-dominant arm
Why: The VA rating schedule for above-elbow amputations assigns higher ratings to the dominant arm. If you do not clearly establish and document which arm was amputated and which is your dominant arm, you may receive the lower non-dominant rating by default.
Do this instead: Clearly state at the beginning of the exam which arm was amputated and confirm that it was your dominant arm if applicable. If you were right-handed before the amputation and the right arm was amputated, state this explicitly and ensure it is documented.
Impact: Difference between 60-70% (non-dominant) and 70-80% (dominant) ratings
Describing function on a good day rather than accurately representing the full range including worst days
Why: M21-1 guidance instructs that ratings should reflect the average disability over time, including bad days. If you only describe how you function on your best days, the examiner may underestimate the severity of your condition.
Do this instead: When asked how you are doing, describe both your good days and your bad days. Say 'On my best days I can do X, but on my worst days, which happen Y times per week, I cannot do A, B, or C.' This gives the examiner the full picture required for accurate rating.
Impact: All rating levels
Not reporting phantom limb pain or minimizing its severity
Why: Phantom pain is a legitimate, documented complication of amputation that affects functional capacity, sleep, and quality of life. Minimizing it deprives the examiner of information needed to document the full impact of the condition.
Do this instead: Proactively report phantom pain even if not directly asked. Describe frequency, intensity (0-10 scale), character, triggers, duration of episodes, and how it affects sleep and daily function. Report current medications taken for phantom pain.
Impact: All rating levels; also relevant to secondary conditions
Failing to report stump complications as separate issues
Why: Neuromas, bone spurs, adherent scarring, skin breakdown, and other stump complications are separately ratable and affect the overall disability picture. Veterans sometimes focus only on the amputation level and overlook stump pathology.
Do this instead: Proactively describe any stump complications to the examiner. Report neuroma pain, any tender spots, skin breakdown from the prosthetic socket, and any conditions that prevent or limit prosthetic use. These may support additional ratings or a defective stump finding.
Impact: All levels; defective stump may warrant special ratings
Understating the time burden of compensatory strategies
Why: Veterans often become skilled at adapting to their amputation and may describe their adaptations without noting how much longer tasks take or how much effort is required. This can make the disability appear less severe than it is.
Do this instead: When describing tasks you can perform, always include how long they take compared to before the amputation, what modifications were required, and what level of physical or mental effort is involved. Efficiency loss is a real functional limitation.
Impact: All rating levels; particularly relevant for functional impact documentation
Not mentioning secondary conditions caused by the amputation
Why: Above-elbow amputees commonly develop secondary conditions including chronic shoulder pain from overuse, cervical spine problems, contralateral arm overuse injuries, psychological conditions, and skin conditions from prosthetic use. These may be separately ratable.
Do this instead: Report all conditions that developed after or because of your amputation, even if they seem unrelated. Mention shoulder pain, neck pain, contralateral arm pain, depression, anxiety, skin conditions, and any other health changes. Ask your VSO about secondary service connection claims.
Impact: Relevant to combined rating and overall compensation level
Prep checklist
- critical
Gather all medical records related to the amputation
Collect surgical operative reports, hospitalization records, physical therapy notes, prosthetic fitting records, and any records of stump complications or revisions. Organize these chronologically and bring copies to the exam.
before exam
- critical
Document your dominant hand status
If your dominant arm was amputated, ensure this is clearly noted in your records and prepare to state it clearly at the exam. If you have written confirmation from a treating provider, bring it. This directly affects your rating percentage.
before exam
- critical
Write down your worst-day functional limitations
Before the exam, sit down and write out everything you cannot do independently, everything that takes significantly longer, everything that requires help, and everything that causes pain. Review this before the appointment so you do not forget important limitations under exam pressure.
before exam
- critical
Compile a complete prosthetic history
Document every prosthetic device you have received, the dates, who prescribed them, and why you do or do not use each one. Include any documented problems with fit, function, or socket complications. Contact your prosthetics clinic for records if needed.
before exam
- recommended
Identify and document all secondary conditions
List every health condition that has developed or worsened since your amputation, including shoulder problems, neck pain, contralateral limb overuse, skin conditions, and psychological conditions. Discuss these with your VSO before the exam to determine secondary service connection filing strategy.
before exam
- recommended
Request a buddy statement if applicable
Ask a family member, caregiver, or close friend who observes your daily limitations to write a buddy statement (VA Form 21-10210) describing what they witness. Submit this to your VA claims file before the exam.
before exam
- recommended
Review your VA claims file for accuracy
Request access to your claims file through va.gov or your VSO and review it for accuracy. Ensure your dominant arm status, amputation level, and all relevant medical records are present. Note any missing documents before the exam.
before exam
- recommended
Write down current medications for phantom pain and stump pain
List all medications - prescription and over-the-counter - that you take for phantom pain, stump pain, or related conditions. Include dosage, frequency, and how well they control symptoms. Bring this list to the exam.
before exam
- critical
Bring all prosthetic devices to the exam
Bring every prosthetic device you own or have been issued - body-powered, myoelectric, cosmetic, activity-specific prostheses, and any harness or suspension systems. Bring the device you use most frequently and be prepared to demonstrate its limitations.
day of
- critical
Wear clothing that allows easy exposure of the residual limb
Wear a short-sleeved shirt or a shirt that can easily be removed or rolled up to expose the full residual limb. The examiner needs to visually inspect and palpate the entire stump without obstruction.
day of
- recommended
Do not apply heavy lotions, wraps, or coverings to the stump
Avoid applying heavy lotions, occlusive dressings, or prosthetic liners to the stump before the exam unless medically necessary, as these may obscure skin condition, scarring, and soft tissue findings that need to be documented.
day of
- recommended
Arrive early and bring your written notes
Arrive 15-20 minutes early to complete paperwork. Bring your written list of limitations, medications, prosthetic history, and secondary conditions so you can refer to it during the exam and ensure nothing is omitted.
day of
- optional
Check your state's recording rights and bring a recorder if applicable
In most states, veterans have the right to record their C&P examination. Check your state's laws and VA policy in advance. If permitted, bring a small audio recorder or use your smartphone to record the exam for your records.
day of
- critical
State your dominant arm status immediately and clearly
At the start of the exam, clearly state which arm was amputated and confirm it was your dominant arm (if applicable). Say 'The amputated arm was my dominant right arm' so this is unambiguously recorded in the examiner's notes.
during exam
- critical
Report both phantom pain and stump pain separately and in detail
Clearly distinguish between phantom limb pain (perceived in the missing hand or arm) and residual limb stump pain (at the amputation site). Describe each separately with frequency, intensity, character, triggers, and functional impact.
during exam
- critical
Describe worst-day functioning, not best-day functioning
When the examiner asks about your function, answer by describing the full range including your worst days. Say 'On my worst days, which occur X times per week, I cannot do...' rather than answering only in terms of your best-case capacity.
during exam
- recommended
Demonstrate prosthetic limitations during the exam
If the examiner asks you to demonstrate prosthetic use, show tasks you struggle with or cannot perform, not just what you can do. Demonstrate grasping limitations, fine motor failures, overhead reach limitations, and any discomfort caused by the device during use.
during exam
- recommended
Report all secondary conditions and how they connect to the amputation
Proactively mention shoulder pain, neck pain, overuse injuries in the remaining arm, skin breakdown from prosthetic use, psychological effects, and any other conditions that developed after the amputation. Ask the examiner to document these even if they say it is outside the scope of this exam.
during exam
- recommended
Ask the examiner to clarify and correct any inaccuracies
You have the right to ask what the examiner is writing and to request correction if something is inaccurate. If the examiner records something that does not reflect your actual condition, politely say 'I want to make sure that accurately reflects what I said - can you clarify that?'
during exam
- critical
Write down everything that happened immediately after the exam
As soon as you leave the exam, write down or dictate everything discussed, what the examiner observed, what was or was not documented, and any concerns you have about the accuracy of the examination. This contemporaneous record is valuable for appeals.
after exam
- critical
Request a copy of the completed DBQ
After the exam, submit a written request to the VA for a copy of the completed Amputations DBQ. Review it for accuracy, particularly regarding amputation level, dominant arm documentation, prosthetic findings, and stump condition. Report any inaccuracies to your VSO immediately.
after exam
- recommended
Notify your VSO if the exam was inadequate
If the examiner did not physically inspect the stump, did not ask about phantom pain, did not evaluate prosthetic function, or dismissed your reported symptoms, report this to your VSO immediately. An inadequate exam can be challenged and a new exam requested.
after exam
- recommended
Follow up on secondary condition claims
If you reported secondary conditions during the exam that were not in your original claim, discuss with your VSO whether to file formal secondary service connection claims for those conditions. Do not wait to see if the primary exam captures them adequately.
after exam
Your rights during a C&P exam
- You have the right to have your C&P examination recorded in most states - check your state's laws and VA policy before the exam and bring a recording device if permitted.
- You have the right to request a copy of the completed DBQ and all examination findings from your C&P exam.
- You have the right to submit a written statement before or after the exam documenting your symptoms and functional limitations (VA Form 21-4138 or 21-10210).
- You have the right to have a VSO, attorney, or claims agent accompany you to the exam in most circumstances - confirm current VA policy before your appointment.
- You have the right to challenge an inadequate C&P examination by requesting a new exam through your VSO if the examiner failed to conduct a thorough physical examination, ignored your reported symptoms, or produced a report inconsistent with the evidence.
- You have the right to submit a buddy statement (VA Form 21-10210) from anyone who observes your daily limitations, and this statement must be considered as part of the claims evidence.
- You have the right to request that your dominant arm status be explicitly documented in the examination, as this directly determines your rating percentage under DC 5152.
- You have the right to submit independent medical opinions (IMOs) from private physicians that may contradict or supplement the C&P examiner's findings.
- You have the right to appeal any rating decision through the Supplemental Claim, Higher-Level Review, or Board of Veterans Appeals pathways if you believe the rating does not accurately reflect your disability level.
- You have the right to be treated with dignity and respect during the examination. If the examiner is dismissive, cursory, or fails to complete required assessment components, document this and report it to your VSO.
Related conditions
- Phantom Limb Pain Direct complication of amputation - phantom pain is a neurological pain syndrome perceived in the missing limb, commonly requiring separate treatment and documentation as part of the overall amputation disability picture.
- Shoulder Joint Conditions (Rotator Cuff, Impingement) Secondary condition - above-elbow amputees frequently develop overuse injuries and degenerative conditions in the residual limb shoulder joint due to altered biomechanics and prosthetic harness use. May be separately ratable with secondary service connection.
- Cervical Spine Conditions Secondary condition - altered posture and biomechanical compensation for above-elbow amputation commonly leads to cervical spine degeneration, muscle strain, and nerve impingement. Document onset relative to amputation for secondary service connection.
- Contralateral Arm Overuse Syndrome Secondary condition - the remaining arm is required to perform all bilateral tasks alone, leading to chronic overuse injuries including lateral epicondylitis, carpal tunnel syndrome, rotator cuff pathology, and arthritis in the contralateral extremity.
- Depression and Anxiety (Secondary to Amputation) Secondary psychiatric condition - major depressive disorder, generalized anxiety disorder, adjustment disorder, and PTSD related to the traumatic amputation event are well-documented sequelae that may be separately ratable with secondary service connection.
- Skin Conditions (Dermatitis, Contact Dermatitis, Folliculitis) Secondary condition - chronic skin conditions at the prosthetic socket interface, including contact dermatitis, folliculitis, pressure ulcers, and hyperhidrosis, are common complications of prosthetic use and may be separately ratable.
- Sleep Apnea (Secondary to Phantom Pain) Potential secondary condition - chronic phantom limb pain that disrupts sleep may contribute to or exacerbate sleep disorders including sleep apnea. Document sleep disruption history for potential secondary service connection consideration.
- Neuroma of Residual Limb Direct complication - neuromas form at severed nerve endings in the residual limb and cause significant localized pain. A painful neuroma may be separately ratable or may support a defective stump finding, affecting the overall rating.
Get a personalized prep packet
This guide covers what to expect for any veteran with this condition. If you have already uploaded your medical records, sign in to generate a packet that maps your specific symptoms to the DBQ fields your examiner will fill out.
This C&P exam preparation guide is for educational purposes only and does not constitute legal, medical, or claims advice. Always consult with a qualified Veterans Service Organization (VSO) representative or VA-accredited attorney for guidance specific to your claim. Never exaggerate, minimize, or fabricate symptoms during a C&P examination.