VA knee extension rating chart - DC 5261
Extension describes how far the knee straightens. A fully straight knee is generally at 0 degrees; the following entries describe a lack of full extension.
Instability: why DC 5257 is different
DC 5257 contains detailed recurrent subluxation/instability and patellar instability criteria, including ligament injury or repair history, persistent instability, and whether an appropriate medical provider prescribed braces or assistive devices. Rating levels can be 10%, 20%, or 30% depending on the qualifying criteria.
Do not infer a percentage solely because someone wears a brace or describes a knee that 'gives out.' The precise diagnosis, type of instability, surgical history, provider prescription and symptoms matter. The criteria for patellar instability differ from those for recurrent ligament-related instability.
Meniscus problems - DC 5258 and DC 5259
- DC 5258 (20%) describes dislocated semilunar cartilage with frequent episodes of locking, pain and effusion into the joint.
- DC 5259 (10%) addresses symptomatic removal of semilunar cartilage.
Separate knee evaluations can sometimes be possible when distinct manifestations are appropriately established, but VA cannot compensate the exact same symptoms twice. Review the anti-pyramiding rule in 38 CFR 4.14 and the claimant's specific evaluation history.
What about arthritis and painful motion?
Arthritis, painful motion and functional loss may be relevant under DCs 5003/5010 and the musculoskeletal provisions of 38 CFR 4.40, 4.45 and 4.59. However, pain does not always translate into a separate automatic 10% knee rating, and assigning a percentage requires the facts and the applicable code. VA must consider qualifying evidence of functional impairment, including flare-ups and repeated use, rather than relying on an isolated number without context.
What does the VA Knee and Lower Leg DBQ measure?
The official VA Knee and Lower Leg DBQ documents diagnoses, history, range-of-motion findings, repeated use, flare-ups, instability, meniscus history, surgeries, and functional impact. The form is completed by an appropriate medical professional; it is not a self-assigned rating questionnaire.
Look for both right and left knee details and clearly distinguish flexion from extension. For knee replacements, separate criteria apply under DC 5055; this page is not a complete prosthetic-knee rating calculator.
Bilateral factor and combined VA math
When compensable service-connected disabilities affect both lower extremities, 38 CFR 4.26 may require the bilateral factor. This is not simply an extra 10 percentage points added to each knee. The applicable ratings are combined in a specific way before the factor is applied and the result combined with other conditions.
Try your existing awarded ratings in the VA disability calculator. The calculator uses the same combined-rating and bilateral-factor rules as our main calculator.
Evidence checklist for a knee review
- VA rating decision and diagnostic codes.
- Latest relevant knee DBQ and range-of-motion examination.
- Relevant clinician notes, imaging, and surgical records.
- Descriptions of instability and prescriptions for assistive devices, if applicable.
- Evidence of episodes of locking, swelling or effusion where relevant.
- Functional limits and flare-up history documented in the record.
Frequently asked questions
Can VA rate both knee flexion and extension?
Potentially, when separately compensable manifestations are established without paying twice for the same impairment. Each determination is specific to the record and applicable VA rules.
Is a knee brace enough for a 20% instability rating?
No. DC 5257 has detailed criteria, which can include medical-provider prescriptions and the nature of the instability or ligament injury.
Does meniscus surgery automatically mean 10%?
Not necessarily. DC 5259 addresses symptomatic removal; the record and potential overlap with other ratings matter.
Does a 20% knee rating plus a 10% knee rating equal 30% combined?
Not under ordinary VA math. The combined ratings table and any bilateral factor must be applied to the exact awarded conditions.
Where are the official criteria?
See the knee-and-leg section of 38 CFR 4.71a and the VA Knee and Lower Leg DBQ.
Primary sources
