VASRD 5055 · Musculoskeletal System
Knee Replacement (Prosthesis) VA Disability Rating
This code covers a total knee replacement and knee resurfacing. It carries a 100 percent evaluation for 4 months following implantation of the prosthesis or resurfacing; after that the evaluation turns on how the knee actually functions.
VA Rating Tiers
How the VA Evaluates Knee Replacement (Prosthesis)
Diagnostic code 5055 covers knee resurfacing and prosthetic knee replacement. A 100 percent evaluation is assigned for 4 months following implantation of prosthesis or resurfacing. After that period, prosthetic replacement of the knee joint with chronic residuals consisting of severe painful motion or weakness in the affected extremity is evaluated at 60 percent, and the minimum evaluation, total replacement only, is 30 percent. The schedule directs that intermediate degrees of residual weakness, pain or limitation of motion be rated by analogy to diagnostic codes 5256, 5261, or 5262 rather than at an intermediate percentage under this code, and its note adds that at the conclusion of the 100 percent evaluation period resurfacing is evaluated under diagnostic codes 5256 through 5262, with no minimum evaluation for resurfacing.
Approval outlook
Very High (~90%) when post-surgery disability shown.
Veterans service-connected
~5,600 veterans
Typical rating awarded
~30%
Vetrify editorial estimates informed by VA published claims data (VBA Annual Benefits Report) and the VA rating schedule — not official VA statistics.
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Best Evidence to Gather
- •Your surgical operative report establishing the replacement or resurfacing date, which starts the 4-month 100 percent period.
- •Physical therapy progress notes tracking your recovery and any lasting limitations.
Strategy Tips
- •Document your knee at and after the 4-month mark, since the 100 percent evaluation runs for 4 months following implantation or resurfacing and the evaluation from that point on depends on the residuals recorded then.
- •Provide surgeon follow-up evaluations from well after the initial recovery period, since these are what determine your long-term evaluation rather than how you felt right after surgery.
- •If your knee was resurfaced rather than totally replaced, say so: the 30 percent minimum under this code is for total replacement only, and the schedule evaluates resurfacing under diagnostic codes 5256 through 5262 once the 100 percent period ends.
C&P Exam Pitfalls
- •Failure to describe current symptoms at a post-recovery exam, since the long-term evaluation depends on documenting your actual state after the 4-month period has passed.
- •Assuming the 100 percent evaluation continues past the 4 months following implantation of prosthesis or resurfacing, which is a common misunderstanding of how this code works.
Common Filing Mistakes
- •Filing for the follow-up evaluation without showing functional loss, since a knee replacement with no lasting symptoms rates significantly lower than one with ongoing severe painful motion or weakness.
- •No record of ongoing issues after the 4-month period, leaving the reduced evaluation undocumented when it is reassessed.
Onset Patterns
- •Knee replacement surgery is usually performed after years of arthritis or a significant knee injury made the joint no longer manageable through other treatment.
Secondary Conditions
Conditions commonly linked to Knee Replacement (Prosthesis). Service-connecting a secondary condition can increase your combined rating.
Common questions about Knee Replacement (Prosthesis)
- Is Knee Replacement (Prosthesis) a VA-rated disability?
- Yes. The VA rates Knee Replacement (Prosthesis) under VASRD diagnostic code 5055 (Musculoskeletal System). This code covers a total knee replacement and knee resurfacing. It carries a 100 percent evaluation for 4 months following implantation of the prosthesis or resurfacing; after that the evaluation turns on how the…
- What VA disability rating can I get for Knee Replacement (Prosthesis)?
- Possible VA ratings for Knee Replacement (Prosthesis) are 100%, 60%, 30%. Examples: 100%: For the first four months after your knee is replaced or resurfaced, this code pays 100 percent.; 60%: After the 100 percent period, severe lasting painful motion or weakness in the replaced knee.; 30%: The lowest evaluation this…
- What's the typical VA rating awarded for Knee Replacement (Prosthesis)?
- Vetrify estimates the typical rating awarded for Knee Replacement (Prosthesis) at around 30%, based on VA claims data and the rating schedule. An estimated 5,600 veterans are service-connected for Knee Replacement (Prosthesis). Estimated approval outlook: Very High (~90%) when post-surgery disability shown.
- What evidence helps prove Knee Replacement (Prosthesis) for VA disability?
- Strong evidence for a Knee Replacement (Prosthesis) claim includes: Your surgical operative report establishing the replacement or resurfacing date, which starts the 4-month 100 percent period.; Physical therapy progress notes tracking your recovery and any lasting limitations..
- What mistakes should veterans avoid when claiming Knee Replacement (Prosthesis)?
- Common pitfalls when filing for Knee Replacement (Prosthesis): Filing for the follow-up evaluation without showing functional loss, since a knee replacement with no lasting symptoms rates significantly lower than one with ongoing severe painful motion or weakness.; No record of ongoing issues after the 4-month period,…
- What conditions are commonly secondary to Knee Replacement (Prosthesis)?
- Conditions often service-connected as secondary to Knee Replacement (Prosthesis) include: Hip Pain, Low Back Pain. Filing for secondary conditions can increase a veteran's combined VA rating.
Official sources
- 38 CFR § 4.71a — Schedule of ratings — musculoskeletal system (Diagnostic Code 5055)
Rating criteria on this page are an educational summary of the cited regulation — the eCFR text is authoritative. See how Vetrify derives its numbers.
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