Knee Instability VA Rating (DC 5257)

Overview

DC 5257 addresses the knee giving way — recurrent subluxation (the joint slipping out of alignment) or lateral instability (side-to-side laxity).

The regulation grades it by descriptive severity rather than by degrees of motion, which makes the clinical findings in the record decisive.

Because instability is a different impairment than motion loss, VA General Counsel precedent addresses assigning it in addition to a motion-based evaluation where both are shown.

How to Establish Service Connection

• Direct: documented in-service knee injury, ligament sprain or tear, airborne or load-bearing duty, or repeated knee complaints in service treatment records.
• Secondary under 38 CFR § 3.310: instability developing in the opposite knee after years of altered gait from a service-connected lower-extremity or back condition.
• Post-surgical: instability remaining after in-service or post-service ligament repair of a service-connected knee.

Rating Criteria

Paraphrased from 38 CFR § 4.71a, Diagnostic Code 5257

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Evidence Checklist

• Orthopedic or physical-therapy notes recording positive Lachman, anterior/posterior drawer, or varus/valgus stress testing.
• Prescription or issuance records for a knee brace, sleeve, or assistive device.
• MRI or operative reports identifying ligament injury or laxity.
• Treatment notes and lay statements describing falls or buckling episodes, their frequency, and what activity they interrupted.

Common Secondary Conditions

Conditions frequently service-connected as secondary to Knee Instability:

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.

• →The examination worksheet has a specific section for joint stability testing; if it is left blank or marked not tested, that gap is visible on the face of the report.
• →Describe how often the knee gives way and in what circumstances rather than only stating that it feels unstable.

Frequently Asked Questions