Knee Conditions VA Rating

Overview

Knee ratings break down into limitation of flexion (DC 5260), limitation of extension (DC 5261), and instability (DC 5257).

Meniscus tears and removal have their own diagnostic codes (5258, 5259).

VA permits separate ratings for instability and limitation of motion in the same knee — this is a frequently missed combination.

In Depth

38 CFR § 4.71a, Plate II lists normal knee motion as flexion 0 to 140 degrees and extension to 0 degrees. Knee disabilities are most often rated under DC 5260 (limitation of flexion) and/or DC 5261 (limitation of extension), with instability addressed separately under DC 5257 and meniscus pathology under DC 5258 (dislocated semilunar cartilage with locking) or DC 5259 (symptomatic removal of semilunar cartilage).

A key structural feature of knee ratings is that flexion limitation, extension limitation, and instability are treated as distinct impairments that can be rated separately in the same knee without violating the anti-pyramiding rule in 38 CFR § 4.14, because each code captures a different functional loss (bend, straighten, and give-way, respectively). This means a single knee can carry two — sometimes three — separate percentage evaluations that are then combined using VA's combined ratings table, not simply added.

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.

Meniscus tears and post-meniscectomy residuals have their own codes. DC 5258 (dislocated semilunar cartilage with frequent episodes of 'locking,' pain, and effusion) provides a single 20% evaluation, while DC 5259 (symptomatic removal of semilunar cartilage) provides a single 10% evaluation. Because these are description-based rather than degree-based codes, documentation of locking episodes, effusion, or the surgical removal itself — rather than range-of-motion figures — is what drives the evaluation under those specific codes.

Knee replacement (total knee arthroplasty) is rated under DC 5055, similar in structure to hip replacement: a 100% rating for the first year following surgery, followed by a minimum 30% rating after the mandatory post-surgical examination, with intermediate percentages available based on residual weakness, pain, and limitation of motion. Knee conditions are also frequent secondary claims — both to and from the opposite knee, hip, ankle, and lumbar spine, based on altered gait and compensatory loading.

How to Establish Service Connection

• In-service injury, jump school records, or repetitive-strain MOSs (infantry, airborne, mechanic) are common bases.
• Secondary: knee conditions caused by an altered gait from a service-connected ankle, hip, or back.

Rating Criteria

Paraphrased from 38 CFR § 4.71a, DC 5260 (flexion), 5261 (extension), 5257 (instability), 5258/5259 (meniscus)

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

Knee Range of Motion Chart

38 CFR § 4.71, Plate II · rated under DCs 5256–5263

• Limitation of flexion (DC 5260) and limitation of extension (DC 5261) can be rated separately for the same knee when both are compensable — this is not pyramiding under 38 CFR § 4.14 (VAOPGCPREC 9-2004).
• Instability or recurrent subluxation is rated separately under DC 5257 (10%/20%/30%) in addition to a limitation-of-motion rating.
• Painful motion that does not meet a compensable limitation still supports a 10% rating under 38 CFR § 4.59 when there is arthritis or joint pathology.
• 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

• MRI or X-ray imaging.
• Goniometer measurements of flexion and extension.
• Documentation of giving way / instability — brace use is strong evidence.

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.

• ★Ask that examination reports separately record flexion and extension in degrees, since DC 5260 and DC 5261 are each keyed to their own set of thresholds.
• ★If instability, buckling, or giving-way is a symptom, make sure it is documented separately from range-of-motion limitation — brace or hinge-brace prescriptions are strong supporting evidence for a DC 5257 evaluation.
• ★For meniscus symptoms, treatment notes describing locking episodes and effusion (swelling) support DC 5258; a surgical operative report documenting meniscectomy supports DC 5259.
• ★If a total knee replacement is involved, keep the operative report and the mandatory post-surgical exam together in the file, since they establish the DC 5055 timeline.
• ★Where gait compensation from one knee affects the opposite knee, hip, or back, a nexus opinion addressing the specific biomechanical mechanism supports a secondary claim.

Illustrative Scenarios

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

Common pitfalls VA sees

• Assuming only one rating is possible per knee — VA can assign separate evaluations for limitation of motion (DC 5260/5261) and instability (DC 5257) in the same knee when both are independently documented.
• Not documenting locking or effusion episodes when a meniscus tear is present, since DC 5258 depends on those specific findings rather than range-of-motion degrees.
• Treating any knee surgery as qualifying for the DC 5055 100%/30%-floor structure — that specific pathway is for total knee replacement (prosthetic implantation), not arthroscopy or meniscus repair alone.
• Filing a same-knee increase claim without any current treatment or examination evidence describing today's degree of limitation.
• Leaving opposite-knee or hip/back secondary theories unaddressed by a nexus opinion when gait compensation is suspected.

Common Secondary Conditions

Conditions frequently service-connected as secondary to Knee 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 separate measurements of flexion and extension; note for the examiner exactly where pain limits further motion.
• →Mention any instability, buckling, or use of a brace — this points the exam toward assessing DC 5257 in addition to range-of-motion codes.
• →Describe any locking, catching, or swelling episodes if a meniscus tear is suspected or diagnosed.
• →If you had a total knee replacement, bring the operative report so the examiner has the surgical date and details relevant to the DC 5055 timeline.

Frequently Asked Questions