Claim Raven explanation
What this means
For special monthly compensation, loss of use focuses on the effective function that remains in a hand or foot. The rule compares that function with what an amputation stump and suitable prosthetic appliance could provide.
Actual amputation is not required for this particular loss-of-use test. The section discusses grasping and manipulation for a hand and balance and propulsion for a foot, along with specified qualifying findings.
How this helps your claim
This helps you understand why detailed functional evidence matters. A severe diagnosis or difficulty using the limb is important context, but the medical findings must address the rule's functional standard.
What to check in your records
Use your decision, examination reports, and relevant records to check the following points.
- Locate findings about remaining hand or foot function.
- Review evidence of grasping, manipulation, balance, or propulsion as applicable.
- Compare the medical explanation with the specific loss-of-use provisions below.
Describe the effective function that remains
Loss of use is a functional comparison, not just a description of weakness or pain. For a hand, records may address grasping and manipulation; for a foot, balance and propulsion. The examination should explain what useful function remains under the regulatory test.
Use actual activities and assistance needs to make the functional picture understandable. Being unable to perform one difficult task is not automatically equivalent to loss of use. Conversely, the presence of the limb does not by itself answer whether the specified functional standard is met.
Must a hand or foot actually be amputated?
No. This particular loss-of-use provision can apply without anatomical amputation when its requirements are met. It compares remaining effective function with the stated prosthetic alternative. That is a legal and medical evaluation, not a suggestion to pursue an amputation or a conclusion from self-testing.
Official regulatory text
38 CFR § 4.63
eCFR snapshot: September 3, 2026. Layout and spacing are adapted for reading. The full section and its tables are included below.
§ 4.63 Loss of use of hand or foot.
Loss of use of a hand or a foot, for the purpose of special monthly compensation, will be held to exist when no effective function remains other than that which would be equally well served by an amputation stump at the site of election below elbow or knee with use of a suitable prosthetic appliance. The determination will be made on the basis of the actual remaining function of the hand or foot, whether the acts of grasping, manipulation, etc., in the case of the hand, or of balance and propulsion, etc., in the case of the foot, could be accomplished equally well by an amputation stump with prosthesis.
(a) Extremely unfavorable complete ankylosis of the knee, or complete ankylosis of 2 major joints of an extremity, or shortening of the lower extremity of 3 1 ⁄ 2 inches (8.9 cms.) or more, will be taken as loss of use of the hand or foot involved.
(b) Complete paralysis of the external popliteal nerve (common peroneal) and consequent, footdrop, accompanied by characteristic organic changes including trophic and circulatory disturbances and other concomitants confirmatory of complete paralysis of this nerve, will be taken as loss of use of the foot.
[29 FR 6718, May 22, 1964, as amended at 43 FR 45349, Oct. 2, 1978]
Related references
- 38 CFR § 4.1: What a VA disability rating measures
- 38 CFR § 3.159: VA duty to assist: records and examinations
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