Hip Conditions VA Rating

Overview

Hip ratings use multiple diagnostic codes depending on the type of motion affected: flexion (DC 5252), extension (DC 5251), rotation/abduction/adduction (DC 5253), ankylosis (DC 5250), and impairment of the femur (DC 5254–5255).

Hip replacement (DC 5054) gets 100% for one year post-surgery, then a minimum 30% schedular rating — 60% to 70% when residuals are markedly severe (chronic painful motion, weakness, or limitation of motion).

Osteoarthritis of the hip is rated under DC 5003 based on limitation of motion of the joint; when motion is non-compensable, 10% applies for X-ray evidence of arthritis in a single major joint.

Avascular necrosis, labral tears, and trochanteric bursitis are often secondary to long-term weight-bearing wear from service or to gait change from another service-connected joint.

In Depth

38 CFR § 4.71a describes normal hip range of motion in Plate II as flexion 0 to 125 degrees, abduction 0 to 45 degrees, and adduction to 25 degrees, with internal and external rotation each to approximately 40–45 degrees depending on measurement technique. The hip diagnostic codes (DC 5250–5255) assign percentages based on how far measured motion falls short of those figures, and separately address ankylosis, flail hip, malunion/nonunion of the femur, and impairment following hip replacement.

Hip replacement is addressed by its own code, DC 5054. VA assigns a 100% rating for the first 12 months following implantation of the prosthesis, then reassesses at a mandatory examination. After that examination, the minimum schedular rating is 30%, with higher ratings — up to 90% — available where there is markedly severe residual weakness, pain, or limitation of motion. A veteran whose residual symptoms are mild does not drop below the 30% floor set by the regulation for that diagnostic code.

Under 38 CFR § 4.59, painful, unstable, or malaligned joints are considered entitled to at least the minimum compensable rating for that joint. 38 CFR §§ 4.40 and 4.45 direct VA to consider additional functional loss from pain, weakness, fatigability, and incoordination — including loss that only shows up after repeated use or during a flare-up (DeLuca v. Brown). Correia v. McDonald further requires that range-of-motion testing address active motion, passive motion, weight-bearing, and non-weight-bearing where those distinctions are medically applicable, so an exam that records only one type of motion may be incomplete.

Hip conditions are also common secondary claims. An altered gait from a service-connected knee, ankle, or lumbar spine condition can place asymmetric load on the opposite or same-side hip over years, and avascular necrosis or labral pathology can develop as a result. Establishing the secondary pathway generally requires a nexus opinion addressing the specific mechanism — gait compensation, offloading, or biomechanical change — rather than simply noting that both conditions exist in the same veteran.

Because several hip diagnostic codes exist for different motions (flexion under DC 5252, extension under DC 5251, adduction/abduction under DC 5253, and femur impairment under DC 5255), VA generally assigns the single evaluation that best reflects the disability rather than combining every code for the same joint, to avoid pyramiding under 38 CFR § 4.14. Distinct impairments — for example, femur malunion plus a documented separate scar from surgery — can still support separate evaluations.

How to Establish Service Connection

• Direct: documented hip injury, hip pointer, stress fracture, or chronic hip complaints in service treatment records.
• Secondary: hip osteoarthritis or labral damage caused by years of altered gait compensating for a service-connected knee, ankle, foot, or low back condition.
• Aggravation: a pre-existing hip condition (e.g., early arthritis, childhood hip dysplasia) permanently worsened by service beyond its natural progression.
• Presumptive-era exposure: avascular necrosis has been associated with high-dose corticosteroid treatment and, in some records, with diving or parachuting injuries — document the occupational context.

Rating Criteria

Paraphrased from 38 CFR § 4.71a, Diagnostic Codes 5250–5255

See what each percentage pays in 2026 and how it combines with your current rating →

Hip Range of Motion Chart

38 CFR § 4.71, Plate II · rated under DCs 5250–5255

• Hip replacement is rated separately under DC 5054 — 100% for one year after surgery, then a minimum 30% with higher evaluations for painful motion or weakness.
• Flail hip joint (DC 5254) carries an 80% evaluation and hip ankylosis (DC 5250) ranges from 60% to 90% depending on the fixed position.
• Measurements are taken with a goniometer, both actively and passively, and VA must consider additional loss of function from pain, weakness, fatigability, and incoordination (38 CFR §§ 4.40 and 4.45, DeLuca v. Brown).
• If flare-ups reduce motion below the measured range, the examiner is expected to estimate that additional loss — describe frequency, duration, and severity of flare-ups at the exam (Sharp v. Shulkin).

Evidence Checklist

• Imaging with measurements: weight-bearing X-rays showing joint-space narrowing, osteophytes, subchondral sclerosis, or cysts; MRI for labral tears, avascular necrosis, or occult fracture.
• C&P range-of-motion measurements with a goniometer, including where pain begins (38 CFR § 4.59) and repeated-use testing for flare-up loss (DeLuca v. Brown).
• Service treatment records documenting in-service hip complaints, or a nexus opinion linking the current diagnosis to service duties (heavy ruck loads, parachute jumps, running in formation).
• Gait analysis or physical therapy notes documenting antalgic gait, Trendelenburg sign, or leg-length discrepancy — this also supports secondary back and knee claims.
• Treatment history showing escalation: NSAIDs → physical therapy → injections (corticosteroid or viscosupplementation) → arthroscopy → replacement.
• Surgical records and post-op notes if a replacement or resurfacing has been performed, including any revisions or complications.
• Employment evidence: accommodations, job modification, or inability to perform prolonged standing, lifting, or climbing relevant to TDIU.

Evidence Templates

Common formats of evidence the VA looks for in this type of claim. These describe what the documents typically include — they are not legal forms or medical opinions, and Oakridge Claims does not draft them.

Evidence VA Commonly Cites in These Claims

Descriptive summary of evidence types frequently referenced in rating decisions for this condition. Not a checklist of actions to take — every claim is decided on its own facts.

• ★Make sure examination reports record flexion, extension, abduction, and rotation in degrees rather than descriptive terms like 'limited' — the hip codes are built entirely around measured degrees.
• ★If a hip replacement is involved, keep the surgical date, prosthesis operative report, and the mandatory post-surgical examination all in the file, since the 100%-then-30%-floor structure under DC 5054 depends on that timeline.
• ★For secondary hip claims tied to a service-connected knee, ankle, or back condition, a nexus opinion should specifically describe the gait or loading mechanism connecting the two joints.
• ★Where pain limits motion beyond what a single static measurement shows, treatment records describing flare-ups, use of a cane or brace, or difficulty with stairs and prolonged standing help document functional loss under §§ 4.40 and 4.45.
• ★If the exam only tested active motion, ask (or have your provider note) whether passive, weight-bearing, and non-weight-bearing motion were also tested, consistent with Correia v. McDonald.

Illustrative Scenarios

These are hypothetical educational examples — not actual case results, predictions, or guarantees of outcomes.

Common pitfalls VA sees

• Assuming any hip surgery automatically qualifies for the DC 5054 100%/30%-floor structure — that specific pathway applies to total hip replacement (prosthetic implantation), not every hip procedure.
• Submitting exam reports that describe pain or stiffness narratively without degree measurements, which the hip diagnostic codes cannot be applied to precisely.
• Treating a secondary hip claim as automatic because a knee or back condition is already service-connected, without a nexus opinion addressing the specific mechanism.
• Not documenting a cane, walker, or brace prescription when one is in use — assistive-device use is often relevant to describing functional severity.
• Overlooking that abduction/adduction and flexion/extension are separate diagnostic codes; an exam that measures only one plane of motion may understate the disability picture.

Common Secondary Conditions

Conditions frequently service-connected as secondary to Hip Conditions:

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.

• →Expect the examiner to measure flexion, extension, abduction, adduction, and rotation with a goniometer; ask that pain onset be noted at the exact degree it begins, not just the maximum you can reach.
• →If you use a cane, walker, or brace, bring it to the exam and mention how often you rely on it.
• →Describe flare-ups (after long walks, cold weather, prolonged standing) in terms of frequency, duration, and how much additional motion you lose during them.
• →If you had a hip replacement, bring the operative report and any follow-up notes so the examiner has the surgical history and timeline.

Frequently Asked Questions