Table of Contents
- Factors Impacting VA Ratings For Knee Issues
- Common Knee Problems Eligible For VA Disability Benefits
- Limitation of Flexion of the Knee (Diagnostic Code 5260)
- Limitation of Extension of the Knee (Diagnostic Code 5261)
- Instability of the Knee (Diagnostic Code 5257)
- Ankylosis of the Knee (Diagnostic Code 5256)
- Total Knee Replacements (Diagnostic Code 5055)
When you suffer from knee pain, it can significantly impact your quality of life. If you have knee pain related to your military service, you can be eligible for VA disability benefits. Before making a disability claim, it is important to understand how the VA rates knee problems based on their severity.
Factors Impacting VA Ratings For Knee Issues
A higher VA knee pain rating is assigned to knee injuries that are more serious and disabling. Several factors determine VA knee pain ratings, including:
- Type of injury
- Severity of the diagnosed knee condition
- Range of motion the knee has
- Severity of pain in the knee
Common Knee Problems Eligible For VA Disability Benefits
When applying for disability benefits, several disability ratings are available to determine the severity of knee pain. Some of the conditions for which you can receive VA disability benefits include:
Limitation of Flexion of the Knee (Diagnostic Code 5260)
Range of motion pertains to knee movements towards the body. Knee problems are the most common disability claim for veterans, with limitations of flexing the knee getting ratings ranging from 10% to 30%.
As long as a veteran can prove that they are experiencing painful motion when their knee is moved, the VA will award them a 10% disability rating even if they do not meet the specific diagnostic criteria.
Limitation of Extension of the Knee (Diagnostic Code 5261)
An extended knee refers to a knee that cannot straighten all the way and is only limited in extension. According to the diagnostic code 5261, knee pain is rated as 0%, 10%, 20%, 30%, 40%, and 50% disabled. Typically, the more difficult it is to straighten a knee (or the more limited the ability to extend it), the higher the disability rating.
The range of motion measurements for each disability rating is similar to the limitations of flexion of the knee. When the leg can be straightened only to within 45 degrees, it is given a rating of 50%. On the other hand, if it can only be straightened to 10 degrees, it is rated 10%.
Instability of the Knee (Diagnostic Code 5257)
An unstable knee moves too much in either direction or dislocates repeatedly. Damaged cartilage and tendons can no longer be properly support the knee joint.
Depending on the degree of instability present in the knee, the VA assigns a disability rating of 0%, 10%, 20%, or 30%. To receive the maximum rating, a knee must be unstable enough to give out or dislocate frequently.
Ankylosis of the Knee (Diagnostic Code 5256)
The degree of disability assigned to ankylosis, abnormal stiffening, and immobility of the knee will depend on how much flexion is restricted. The more restriction experienced by a veteran, the higher the rate of disability.
Total Knee Replacements (Diagnostic Code 5055)
This code is used if a prosthesis has replaced the entire joint. A veteran will be eligible for 100% compensation for one year after surgery. The subsequent rating will be based on the performance in a C&P exam, with a minimum of 30%.
An individual with partial knee replacement does not have their own diagnostic code and is rated based on their symptoms.
A Compensation and Pension examination (C&P) will be held after the one-year grace period to determine the severity of the knee pain condition. Veterans will receive a new rating following the exam based on the rating criteria.
If a veteran's knees are weak and painful, they are evaluated at 60%. When pain is mild but limits the range of motion, it is classified under Diagnostic Code 5256, 5261, or 5262 depending on the residual symptoms. A total knee replacement should have a minimum rating of 30%, regardless of how much movement it has.
Are you interested in learning more about the various options and programs that help people with disabilities? Read more of Disability Help’s resources on our website!