★ Musculoskeletal
ACL and Knee Ligament Tear VA Rating
38 CFR § 4.71a, Diagnostic Codes 5257, 5260, 5261; 38 CFR § 3.310
Overview
Cruciate (ACL, PCL) and collateral (MCL, LCL) injuries are rated by residual impairment, not by the name of the torn structure.
The most common pathway is DC 5257 for recurrent subluxation or lateral instability, graded slight, moderate, or severe.
Reconstruction often restores stability while leaving stiffness, pain, or motion loss — which shifts the evaluation toward the motion codes.
Post-traumatic arthritis is a recognized long-term consequence of ligament injury and is evaluated under its own code when it develops.
How to Establish Service Connection
- Direct: documented in-service tear, surgical repair during service, or a knee injury in the service treatment records with continuing symptoms.
- Aggravation: a pre-service ligament injury noted at entrance that measurably worsened during service beyond natural progression.
- Secondary under 38 CFR § 3.310: opposite-knee ligament injury or arthritis attributed by a clinician to instability and altered mechanics from the service-connected side.
Rating Criteria
Paraphrased from 38 CFR § 4.71a, Diagnostic Codes 5257, 5260, 5261; 38 CFR § 3.310
| Rating | Criteria |
|---|---|
| 10% | Slight recurrent subluxation or lateral instability; or flexion limited to 45°; or extension limited to 10°; or painful motion under 38 CFR § 4.59. |
| 20% | Moderate recurrent subluxation or lateral instability; or flexion limited to 30°; or extension limited to 15°. |
| 30% | Severe recurrent subluxation or lateral instability; or flexion limited to 15°; or extension limited to 20°. |
| 40%–50% | Extension limited to 30° (40%) or 45° (50%) under DC 5261. |
See what each percentage pays in 2026 and how it combines with your current rating →
Evidence Checklist
- MRI and operative reports identifying the torn ligament and the repair performed.
- Stress-testing findings (Lachman, pivot shift, drawer, varus/valgus) recorded across visits.
- Post-surgical physical therapy notes showing the motion actually regained.
- Brace prescriptions and records of subsequent giving-way episodes or re-injury.
Common Secondary Conditions
Conditions frequently service-connected as secondary to ACL and Knee Ligament Tear:
What the C&P Exam Documents
General information about how this condition is typically evaluated. This is not coaching on what to say and is not a substitute for medical or legal advice.
- →Reconstruction does not end the inquiry; the examination should document what stability and motion look like now, not at the time of surgery.
- →If the knee still gives way after repair, that history belongs in the record with dates and circumstances.
Frequently Asked Questions
Useful Tools & Topics
Have a ACL and Knee Ligament Tear claim or denial?
Four fields. A VA-accredited claims agent reviews it and responds within 3–5 business days. Contingent fees apply only to awarded past-due benefits on appeals — never on initial claims.
Requesting a consultation does not create representation and is not a guarantee of any outcome. Representation begins only after a written fee agreement and VA Form 21-22a are signed.
Educational content only — not legal advice and not medical advice. Rating criteria on this page are summarized in plain English from 38 CFR Part 4; consult VA.gov or the current Code of Federal Regulations for official criteria. This page provides general education about how the VA rates this condition; it is not individualized advice, does not establish a representation relationship, and should not be used to self-diagnose, self-treat, or decide a course of action without speaking to a qualified clinician and a VA-accredited representative. Outcomes depend on each veteran's individual facts, evidence, and the adjudicator's judgment; no specific rating, effective date, or other result is guaranteed. Oakridge Claims is a private business and is not affiliated with, endorsed by, or operated by the US Department of Veterans Affairs.
Related Conditions
Knee Conditions
Limitation of flexion/extension, instability, and meniscus ratings.
Knee Instability (Subluxation)
Recurrent subluxation or lateral instability rated separately from range of motion under DC 5257.
Knee Meniscal Tear (Cartilage Injury)
Dislocated or removed semilunar cartilage rated under DC 5258 (20%) or DC 5259 (10%) — often combined with limitation of motion ratings.
Knee Arthritis (Degenerative / Traumatic)
X-ray confirmed knee arthritis rated under DC 5003/5010 when motion loss is non-compensable.