VA Rating for Knee Pain: Codes, Degrees and Separate Ratings
The VA rates knee pain mainly by how far the knee bends (DC 5260) and straightens (DC 5261), plus any instability (DC 5257), meniscus problems (DC 5258 or 5259), or a replacement (DC 5055). Flexion limited to 45 degrees is 10%, to 30 degrees is 20%, and to 15 degrees is 30%. One knee can carry more than one rating when the symptoms do not overlap. Here is how each code works in 2026.
TL;DR
- Knee codes are DC 5256 to 5263 in 38 CFR 4.71a. Limited flexion (5260) pays 10% at 45 degrees, 20% at 30 degrees, 30% at 15 degrees.
- Limited extension (5261) pays 10% at 10 degrees up to 50% at 45 degrees. VA General Counsel opinion 9-2004 allows separate flexion and extension ratings for the same knee.
- Since February 7, 2021, instability (5257) is rated 10%, 20% or 30% based on the type of ligament damage and whether a provider prescribed a brace or an assistive device.
- Painful motion earns at least the minimum compensable rating for the joint (38 CFR 4.59). For the knee, that is 10%.
- A total knee replacement (5055) is 100% for 4 months after the initial one-month convalescence rating, then at least 30%. Two rated knees get the bilateral factor (38 CFR 4.26).
How does the VA rate knee pain?
The VA rates the knee by what it can and cannot do. The main tools are range of motion, stability, and specific injuries like cartilage damage. All knee codes are in 38 CFR 4.71a under "The Knee and Leg."
For VA purposes, normal knee motion is 0 degrees of extension (fully straight) to 140 degrees of flexion (38 CFR 4.71, Plate II). The ratings kick in as you lose motion in either direction.
What are the VA ratings for knee flexion and extension?
Flexion is bending the knee. Extension is straightening it. They are rated under different codes.
| DC 5260: flexion limited to | Rating | DC 5261: extension limited to | Rating |
|---|---|---|---|
| 60 degrees | 0% | 5 degrees | 0% |
| 45 degrees | 10% | 10 degrees | 10% |
| 30 degrees | 20% | 15 degrees | 20% |
| 15 degrees | 30% | 20 degrees | 30% |
| 30 degrees | 40% | ||
| 45 degrees | 50% |
Extension is measured as how far the knee is from straight. A knee that stops 10 degrees short of straight has extension limited to 10 degrees.
Can I get separate ratings for the same knee?
Yes, when each rating covers a different problem. The rule against pyramiding (38 CFR 4.14) only bars rating the same symptom twice. Three sources open the door:
- VAOPGCPREC 23-97 and 9-98. VA's General Counsel held that a knee with arthritis and instability can be rated separately under DC 5003 or the motion codes and under DC 5257. Opinion 9-98 adds that painful motion under 38 CFR 4.59 can support the arthritis rating even when measured motion is not compensable.
- VAOPGCPREC 9-2004. Limited flexion (5260) and limited extension (5261) of the same knee can be rated separately.
- Lyles v. Shulkin, 29 Vet. App. 107 (2017). The court held those opinions are not the only combinations allowed. Other knee codes, such as a meniscus rating under 5258 alongside a motion rating, can be assigned separately as long as the symptoms do not overlap.
In practice, the VA often assigns one knee rating and stops. If your exam shows both limited bending and limited straightening, or instability plus painful motion, check whether each one was rated.
How is knee instability rated under DC 5257?
The VA rewrote DC 5257 in its musculoskeletal update effective February 7, 2021. The old "slight, moderate, severe" labels are gone. Ratings now depend on the ligament damage and on what a medical provider prescribed.
| Rating | Recurrent subluxation or instability (ligament) |
|---|---|
| 10% | Sprain, incomplete ligament tear, or complete tear (repaired, unrepaired, or failed repair) causing persistent instability, with no prescription for a brace or assistive device |
| 20% | (a) Sprain, incomplete tear, or repaired complete tear causing persistent instability, with a prescribed brace and/or assistive device; or (b) unrepaired or failed repair of a complete tear causing persistent instability, with a prescribed assistive device or brace |
| 30% | Unrepaired or failed repair of a complete ligament tear causing persistent instability, with a prescribed assistive device (cane, crutches, walker) and a brace |
DC 5257 now also covers patellar (kneecap) instability. It pays 10% with recurrent instability and no prescribed device, 20% after surgical repair with a prescribed brace, cane or walker, and 30% after surgical repair with a prescribed brace plus a cane or walker.
The word "prescribes" matters. A brace you bought at the pharmacy on your own does not meet the 20% or 30% criteria. If your provider tells you to use a brace or cane, ask that it be written in your record.
How are meniscus tears rated? (DC 5258 and 5259)
- DC 5258, 20%: semilunar cartilage (meniscus) dislocated, with frequent episodes of locking, pain, and effusion (fluid) into the joint.
- DC 5259, 10%: meniscus removed, and still symptomatic.
Under Lyles, a meniscus rating can sit alongside a motion rating when the symptoms are different. Locking and effusion are not the same as limited flexion.
What does 38 CFR 4.59 painful motion do for a knee?
Section 4.59 says the VA intends "to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint." For the knee, the minimum compensable rating is 10%.
So a knee that bends to 130 degrees with pain may still qualify for 10%, even though 130 degrees is far from the 45 degrees in DC 5260. The court has held 4.59 is not limited to arthritis (Burton v. Shinseki, 25 Vet. App. 1 (2011)).
Section 4.59 also sets the testing standard. Joints should be tested for pain on active and passive motion, in weight-bearing and non-weight-bearing, and against the opposite knee if it is undamaged. Correia v. McDonald, 28 Vet. App. 158 (2016), made that testing a requirement for an adequate exam. DeLuca v. Brown and Sharp v. Shulkin require the examiner to consider flare-ups and repeated use. Our C&P exam tips explain how to describe flare-ups accurately.
Get the C&P Exam Prep Kit ($47) to prepare for the knee exam, with checklists tied to what the examiner has to record.
How is a knee replacement rated? (DC 5055)
| DC 5055 stage | Rating |
|---|---|
| 4 months following implantation of prosthesis or resurfacing | 100% |
| Total replacement with chronic residuals of severe painful motion or weakness | 60% |
| Intermediate residuals | Rated by analogy to DC 5256, 5261 or 5262 |
| Minimum, total replacement only | 30% |
The 4-month 100% period starts after the one-month total rating for convalescence under 38 CFR 4.30 (Note 5). Before 2021, the 100% period was one year, so older guides may show outdated numbers. A partial resurfacing has no minimum after the 100% period and is rated under DCs 5256 to 5262.
What are the other knee codes?
- DC 5256, ankylosis (knee frozen in place): 30% to 60%, based on the angle.
- DC 5262, tibia and fibula: nonunion with loose motion requiring a brace is 40%. Malunion is rated under the knee or ankle codes. Shin splints (medial tibial stress syndrome) are rated 0% to 30%.
- DC 5263, genu recurvatum: 10% for an acquired, traumatic backward bend of the knee with objectively shown weakness.
- DC 5003, degenerative arthritis: rated on limitation of motion. When motion is not compensable, it pays 10% per major joint with painful or limited motion.
How does the bilateral factor work for two knees?
When both legs have a compensable disability, 38 CFR 4.26 combines the two ratings, then adds 10% of that value. Example: 10% right knee and 10% left knee combine to 19%. Add 1.9 (10% of 19) and you get 20.9, which is treated as 21 in the rest of the math. That same rule applies to a knee on one side and a hip or ankle on the other.
Plug your numbers into the VA disability calculator. Knee problems also lead to secondary claims for the hip, back, or the other knee. See the secondary conditions guide and the back pain rating guide.
Frequently asked questions
What is the VA rating for knee pain with full range of motion?
A painful knee can still qualify for 10%, the minimum compensable rating for the joint, under 38 CFR 4.59. The pain must be documented, for example by the examiner noting pain on motion.
Can I get two ratings for one knee?
Yes, if the symptoms are different. Flexion and extension can be rated separately (VAOPGCPREC 9-2004), instability can be rated with arthritis or motion loss (VAOPGCPREC 23-97, 9-98), and Lyles v. Shulkin allows other combinations that do not overlap.
Do I need a prescribed brace for a higher instability rating?
For 20% or 30% under DC 5257, yes. The current text requires that a medical provider prescribe a brace, an assistive device, or both. Without a prescription, persistent instability rates 10%.
How long is the 100% rating after a knee replacement?
Four months under DC 5055, starting after the one-month convalescence rating under 38 CFR 4.30. After that, a total replacement is rated at least 30%.
What is normal knee range of motion for the VA?
0 degrees of extension to 140 degrees of flexion, per Plate II in 38 CFR 4.71.
Sources
- 38 CFR 4.71a, Schedule of ratings, musculoskeletal system (eCFR)
- 38 CFR 4.71, Measurement of joint motion, Plate II (eCFR)
- 38 CFR 4.59, Painful motion (eCFR)
- 38 CFR 4.26, Bilateral factor (eCFR)
- 38 CFR 4.14, Avoidance of pyramiding (eCFR)
- Musculoskeletal final rule, 85 FR 76453, effective Feb. 7, 2021 (Federal Register)
- VA claim exam (C&P exam), va.gov