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38 CFR 4.71a / DC 5257-5261 · Musculoskeletal

Knee VA Rating

The VA rates knee conditions under three independent diagnostic codes covering instability, limited flexion, and limited extension. Each can be rated separately for the same knee. Bilateral knee conditions trigger an additional bilateral factor.

10–30%Instability (DC 5257)$180.42–$552.47/mo
10–30%Limited flexion (DC 5260)$180.42–$552.47/mo
10–50%Limited extension (DC 5261)$180.42–$1,132.90/mo
+10%Bilateral factor (both knees)Applied before combining

The Three Knee Rating Codes

Unlike many VA conditions with a single diagnostic code, knee disabilities are rated under several codes in 38 CFR 4.71a. The VA rates each finding independently and the resulting ratings combine under the standard whole-person formula.

DC 5257Recurrent Subluxation or Lateral Instability
30%Severe$552.47/moFrequent episodes of giving way, requiring brace or assistive device.
20%Moderate$356.66/moOccasional instability episodes with objective evidence of laxity.
10%Slight$180.42/moInfrequent instability or mild laxity documented on examination.
DC 5260Limited Flexion of the Leg

Rated on how far the knee can bend (flex). Normal knee flexion is approximately 140 degrees. Under the painful motion rule (38 CFR 4.59), rating is based on where pain begins, not the anatomical limit.

30%Flexion limited to 15 degrees$552.47/mo
20%Flexion limited to 30 degrees$356.66/mo
10%Flexion limited to 45 degrees$180.42/mo
DC 5261Limited Extension of the Leg

Rated on how fully the knee can straighten (extend). Normal extension is 0 degrees. A leg that cannot fully straighten is both functionally limiting and objectively measurable, which is why this code can reach 50%.

50%Extension limited to 5 degrees$1,132.90/mo
40%Extension limited to 10 degrees$795.84/mo
30%Extension limited to 15 degrees$552.47/mo
20%Extension limited to 20 degrees$356.66/mo
10%Extension limited to 30 degrees$180.42/mo
Highest potential single-code knee rating

The Bilateral Factor

When both knees are service-connected, the bilateral factor under 38 CFR 4.26 applies. The VA combines both knee ratings first, then adds 10% of that combined value before folding everything else in.

Example: left knee 20%, right knee 10%. Combined value of those two is 28%. The bilateral factor adds 10% of 28% = 2.8 points, bringing the bilateral subtotal to approximately 30.8% before combining with other conditions. This extra step meaningfully increases your final combined rating.

The bilateral factor also applies to paired arm conditions, paired eye conditions, and paired ear conditions. Use the calculator to see the exact effect on your combined rating.

Knee Replacement (Arthroplasty)

Total knee arthroplasty is rated under DC 5055. The VA assigns a temporary 100% rating for one year following the surgery date. After the one-year period, the rating is based on residual impairment:

  • With chronic residuals consisting of severe painful motion or weakness: 30%
  • With intermediate degrees of residual weakness, pain, or limitation of motion: 20%
  • With slight residual weakness, pain, or limitation of motion: 10%

Veterans should request a C&P exam review shortly after the one-year mark to ensure the residual rating accurately reflects ongoing functional impairment. Do not assume the 100% will automatically convert to an appropriate residual rating.

How to Service-Connect a Knee Condition

Direct Service Connection

A documented in-service knee injury (training accident, combat injury, fall) or chronic overuse from MOS duties (long road marches, airborne operations, repeated heavy lifting) establishes the in-service event. Service treatment records showing knee complaints or treatment during service are key evidence.

Continuity of Symptomatology

If knee symptoms were present in service and have been continuous since separation, even without a formal diagnosis at the time, service connection may be established through continuity of symptomatology under 38 CFR 3.303(b).

Secondary Connection

A knee condition can be secondary to a service-connected back condition, hip condition, or the opposite knee. Gait changes from any of these can accelerate knee degeneration. A nexus opinion is required.

Secondary Conditions to a Knee Rating

Hip Degeneration

Altered gait from a knee condition overloads the hip joint. Secondary hip DJD can be rated at 10-60% per hip.

Contralateral Knee

Overloading the opposite knee to compensate qualifies as secondary. Rated independently and triggers the bilateral factor.

Back / Lumbar Spine

Abnormal gait from knee disability causes compensatory lumbar strain over time. See the back pain guide for rating criteria.

Ankle

Altered biomechanics from knee conditions can cause or worsen ankle degeneration. Rated per ankle at 10-20%.

Depression / Anxiety

Chronic pain and mobility limitation from knee conditions are documented causes of depression. Rated 0-100% on the mental health scale.

SourcesLast reviewed: May 2026

Knee VA Rating FAQ

What is the maximum VA rating for a knee condition?
The maximum schedular rating for a single knee is typically 60%, reached through a combination of limited extension (50% under DC 5261) plus instability or other ratable findings. Each knee is rated separately, and bilateral conditions trigger the bilateral factor.
Can both knees be rated separately?
Yes. Each knee is rated independently. When both are service-connected, the bilateral factor under 38 CFR 4.26 adds 10% to the combined value of the paired ratings before they are folded into your overall combined rating.
What is the VA rating for a torn ACL or meniscus?
There is no separate diagnostic code for ACL or meniscus injuries. They are rated based on resulting functional impairment: instability (DC 5257, 10-30%), limited flexion (DC 5260), or limited extension (DC 5261). Multiple impairments are rated under separate codes.
Does knee replacement affect my VA rating?
A total knee replacement is rated 100% for one year post-surgery. After that, residual impairment (limited motion, weakness, pain) determines the rating, typically 30% for mild residuals and higher for significant functional limitation.
Can I get separate ratings for the same knee?
Yes, within limits. Limited flexion (DC 5260), limited extension (DC 5261), and instability (DC 5257) can each be rated separately for the same knee as long as each is independently documented and not duplicating the same functional loss.
What secondary conditions can I claim with a knee rating?
Common secondary conditions include hip degeneration (altered gait loads the hip differently), back pain (compensating posture strains the lumbar spine), and contralateral knee degeneration (overloading the opposite knee). Each requires a medical nexus opinion.