The ulna is the inner and larger bone of the forearm, between the wrist and the elbow on the side opposite to the thumb. Impairment refers to any loss or abnormal change related to structure or function. In this case, the ulna is involved.

Impairment of the ulna may be caused by diseases of the bone or loss of bone. Causes contributing to the impairment may include: tumors; loss of the limb; fractures; dislocation; other traumas such as strains, sprains or crushing injuries; and a flail joint.

Manifestations that may be present include: pain; swelling; crepitus; restricted motion; deformity; inflammation; instability; decreased circulation; and shortened limb.

Diagnostic measures may include: general physical examinations and examinations of nerve and muscle function; laboratory studies; and radiology studies such as x-ray, magnetic resonance imaging (MRI), bone scan, or computed tomography (CT) scan. A goniometer to measure range of motion may be used.

Surgical correction of fractures, traction, bone grafting for certain severe fractures, immobilization with casting or splinting may be part of the treatment plan. Physical therapy may also be indicated as well as medications to treat infection or pain.

Potential for deformity, osteomyelitis, and weakness may be residuals.

• The rating schedule for musculoskeletal was updated on February 7, 2021. Protection still does apply and should be considered with existing evaluations (38 CFR 3.951(a)).

• To properly rate disability, accurate measurement of shoulder and arm ranges of motion is required and must be reported in degrees. The use of a goniometer in the measurement of ranges of motion in shoulder and arm in flexion, elevation, abduction, external rotation, and internal rotation is indispensable. 38 CFR 4.46 [Accurate measurement]

• 38 CFR 4.59 may be applied separately to the elbow, the forearm, and the wrist to result in potentially three separate evaluations for painful motion when the evidence otherwise supports such a finding.  However, 38 CFR 4.59 may only be applied once to the elbow and may not be separately applied to both elbow flexion and elbow extension.

• When examination or other evidence denotes pain present in the joint or periarticular region but does not delineate the specific motions in which pain is present and there is a potential for a separate evaluation under 38 CFR 4.59, obtain a medical opinion to determine which motions are painful. When the examiner cannot delineate which motions are associated with pain, resolve doubt in favor of the Veteran, per 38 CFR 4.3, and consider painful motion to be present in the separate plane such as to allow assignment of the separate minimum compensable evaluation under 38 CFR 4.59.

• In all the forearm and wrist injuries, codes 5205 through 5213, multiple impaired finger movements due to tendon tie-up, muscle or nerve injury, are to be separately rated and combined not to exceed rating for loss of use of hand. 38 CFR 4.71 (a) [Schedule of ratings-musculoskeletal system]