38 CFR § 4.71a · Musculoskeletal System

VA Disability Ratings for Knee Conditions

These are the eight knee diagnostic codes in 38 CFR § 4.71a that have a page here, and each has its own criteria: which one applies depends on the diagnosis and on what the examination measures and finds. Each code's criteria are quoted below.

The eight knee diagnostic codes

Does knee pain count?

38 CFR § 4.59: “It is the intention to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint.”

Knee Replacement (Prosthesis) (DC 5055)

DC 5055, quoted from 38 CFR § 4.71a
Rating	38 CFR criteria (quoted)
100%	Minor“For 4 months following implantation of prosthesis or resurfacing”
60%	Minor“Prosthetic replacement of knee joint: With chronic residuals consisting of severe painful motion or weakness in the affected extremity”
30%	Minor“Prosthetic replacement of knee joint: Minimum evaluation, total replacement only”

“Note: At the conclusion of the 100 percent evaluation period, evaluate resurfacing under diagnostic codes 5256 through 5262; there is no minimum evaluation for resurfacing.”

The full Knee Replacement (Prosthesis) guide

Knee, Ankylosis (DC 5256)

DC 5256, quoted from 38 CFR § 4.71a
Rating	38 CFR criteria (quoted)
60%	“Extremely unfavorable, in flexion at an angle of 45° or more”
50%	“In flexion between 20° and 45°”
40%	“In flexion between 10° and 20°”
30%	“Favorable angle in full extension, or in slight flexion between 0° and 10°”

The full Knee, Ankylosis guide

Knee, Other Impairment of (DC 5257)

DC 5257, quoted from 38 CFR § 4.71a
Rating	38 CFR criteria (quoted)
30%	“Recurrent subluxation or instability: Unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribes both an assistive device ( e.g., cane(s), crutch(es), walker) and bracing for ambulation” “Patellar instability: A diagnosed condition involving the patellofemoral complex with recurrent instability after surgical repair that requires a prescription by a medical provider for a brace and either a cane or a walker”
20%	“Recurrent subluxation or instability: One of the following: (b) Unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribes either an assistive device ( e.g., cane(s), crutch(es), walker) or bracing for ambulation” “Patellar instability: A diagnosed condition involving the patellofemoral complex with recurrent instability after surgical repair that requires a prescription by a medical provider for one of the following: A brace, cane, or walker”
10%	“Recurrent subluxation or instability: Sprain, incomplete ligament tear, or complete ligament tear (repaired, unrepaired, or failed repair) causing persistent instability, without a prescription from a medical provider for an assistive device ( e.g., cane(s), crutch(es), walker) or bracing for ambulation” “Patellar instability: A diagnosed condition involving the patellofemoral complex with recurrent instability (with or without history of surgical repair) that does not require a prescription from a medical provider for a brace, cane, or walker”

“Note (1): For patellar instability, the patellofemoral complex consists of the quadriceps tendon, the patella, and the patellar tendon.”
“Note (2): A surgical procedure that does not involve repair of one or more patellofemoral components that contribute to the underlying instability shall not qualify as surgical repair for patellar instability (including, but not limited to, arthroscopy to remove loose bodies and joint aspiration).”

The full Knee, Other Impairment of guide

Knee, dislocated semilunar cartilage (DC 5258)

DC 5258, quoted from 38 CFR § 4.71a
Rating	38 CFR criteria (quoted)
20%	“Cartilage, semilunar, dislocated, with frequent episodes of “locking,” pain, and effusion into the joint”

The full Knee, dislocated semilunar cartilage guide

Removal of semilunar cartilage (DC 5259)

DC 5259, quoted from 38 CFR § 4.71a
Rating	38 CFR criteria (quoted)
10%	“Cartilage, semilunar, removal of, symptomatic”

The full Removal of semilunar cartilage guide

Limitation of Flexion of the Leg (Knee) (DC 5260)

DC 5260, quoted from 38 CFR § 4.71a
Rating	38 CFR criteria (quoted)
30%	“Flexion limited to 15°”
20%	“Flexion limited to 30°”
10%	“Flexion limited to 45°”
0%	“Flexion limited to 60°”

The full Limitation of Flexion of the Leg (Knee) guide

Limitation of Extension of the Leg (Knee) (DC 5261)

DC 5261, quoted from 38 CFR § 4.71a
Rating	38 CFR criteria (quoted)
50%	“Extension limited to 45°”
40%	“Extension limited to 30°”
30%	“Extension limited to 20°”
20%	“Extension limited to 15°”
10%	“Extension limited to 10°”
0%	“Extension limited to 5°”

The full Limitation of Extension of the Leg (Knee) guide

Tibia and Fibula, Impairment of (Including Shin Splints) (DC 5262)

DC 5262, quoted from 38 CFR § 4.71a
Rating	38 CFR criteria (quoted)
40%	“Nonunion of, with loose motion, requiring brace”
30%	“Medial tibial stress syndrome (MTSS), or shin splints: Requiring treatment for no less than 12 consecutive months, and unresponsive to surgery and either shoe orthotics or other conservative treatment, both lower extremities”
20%	“Medial tibial stress syndrome (MTSS), or shin splints: Requiring treatment for no less than 12 consecutive months, and unresponsive to surgery and either shoe orthotics or other conservative treatment, one lower extremity”
10%	“Medial tibial stress syndrome (MTSS), or shin splints: Requiring treatment for no less than 12 consecutive months, and unresponsive to either shoe orthotics or other conservative treatment, one or both lower extremities”
0%	“Medial tibial stress syndrome (MTSS), or shin splints: Treatment less than 12 consecutive months, one or both lower extremities”

The full Tibia and Fibula, Impairment of (Including Shin Splints) guide

Common questions about knee ratings

Which diagnostic codes does the VA use for the knee?

Eight knee codes have pages here, all in 38 CFR § 4.71a: DC 5055, Knee Replacement (Prosthesis); DC 5256, Knee, Ankylosis; DC 5257, Knee, Other Impairment of; DC 5258, Knee, dislocated semilunar cartilage; DC 5259, Removal of semilunar cartilage; DC 5260, Limitation of Flexion of the Leg (Knee); DC 5261, Limitation of Extension of the Leg (Knee); DC 5262, Tibia and Fibula, Impairment of (Including Shin Splints). Each has its own criteria, so the diagnosis and the findings on examination decide which applies.

Does the VA rate knee pain?

Pain on motion counts. 38 CFR 4.59 says: "It is the intention to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint." The knee codes themselves rate what the examination measures and finds, such as how far the knee bends or straightens, or instability.

How does the VA rate knee instability?

Under DC 5257. At 30%: "Recurrent subluxation or instability: Unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribes both an assistive device ( e.g., cane(s), crutch(es), walker) and bracing for ambulation" or "Patellar instability: A diagnosed condition involving the patellofemoral complex with recurrent instability after surgical repair that requires a prescription by a medical provider for a brace and either a cane or a walker". At 20%: "Recurrent subluxation or instability: One of the following: (b) Unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribes either an assistive device ( e.g., cane(s), crutch(es), walker) or bracing for ambulation" or "Patellar instability: A diagnosed condition involving the patellofemoral complex with recurrent instability after surgical repair that requires a prescription by a medical provider for one of the following: A brace, cane, or walker". At 10%: "Recurrent subluxation or instability: Sprain, incomplete ligament tear, or complete ligament tear (repaired, unrepaired, or failed repair) causing persistent instability, without a prescription from a medical provider for an assistive device ( e.g., cane(s), crutch(es), walker) or bracing for ambulation" or "Patellar instability: A diagnosed condition involving the patellofemoral complex with recurrent instability (with or without history of surgical repair) that does not require a prescription from a medical provider for a brace, cane, or walker".