How the VA rates knee conditions

The knee is unusual in the rating schedule: it is the joint most likely to earn more than one rating at a time. Motion, instability, and cartilage damage are rated under different codes, and the VA's own lawyers have said they can stack. Most first-time claims collect exactly one.

Last reviewed August 2026 · Not legal advice, VA.gov always controls

Knee conditions are rated in 38 CFR § 4.71a under a cluster of codes between DC 5255 and DC 5263. Which code applies depends on what is wrong, and a knee with a torn meniscus, arthritis, and a loose ligament has three things wrong. The schedule was revised in February 2021, so guidance older than that may describe criteria that no longer exist; check the current text at eCFR.

Limitation of motion: two codes, two directions

A normal knee bends (flexes) to 140° and straightens (extends) fully to 0°. The schedule rates loss in each direction separately.

Read those flexion numbers again. A knee that only bends to 45° is a knee that cannot sit in a normal chair comfortably, and it rates 10%. Compensable motion loss in the knee requires serious restriction, which is why so many knee claims come back at 10% on painful motion and no higher.

The VA General Counsel held in VAOPGCPREC 9-2004 that limitation of flexion and limitation of extension in the same knee are rated separately, because they are different disabilities. A knee with flexion to 45° and extension stuck at 10° is two 10% ratings, not one.

The painful-motion floor

Most service-connected knees do not meet the compensable thresholds above. They still get 10%, because § 4.59 says a joint that is painful on motion is entitled to at least the minimum compensable rating for that joint. Arthritis shown on X-ray with painful or limited motion is rated the same way under DC 5003. This is the 10% most knee claims receive, and it is the floor, not the ceiling.

The same rules that govern spine exams govern knees: under DeLuca, the examiner must account for additional motion lost during flare-ups and after repeated use, and under Correia, must test active and passive motion, weight-bearing and not. Say where the pain starts, stop where pain or weakness actually stops you, and describe your flare-ups in degrees of lost function if you can ("after a day on my feet I can't bend it enough to get into the truck"). Read the spine guide for the full treatment of these rules; they transfer directly.

Instability: DC 5257

A knee that gives way, buckles, or slips out of joint is rated under DC 5257, "recurrent subluxation or lateral instability," and this is a separate rating from motion loss. General Counsel opinion VAOPGCPREC 23-97, reinforced by VAOPGCPREC 9-98, established that a veteran with both arthritis (rated on motion or painful motion) and instability in the same knee gets both ratings. It is not pyramiding, because instability and limited motion are distinct impairments.

The 2021 revision rewrote the 5257 criteria. The old "slight, moderate, severe" tiers are gone. The current 10%, 20%, and 30% levels turn on how persistent the instability is and on whether a brace, cane, or other assistive device has been prescribed for it, with the 30% tier reserved for persistent instability requiring both. The practical consequence is that a knee brace you bought at the drugstore does not help the rating, and a knee brace a doctor prescribed and documented does. If your knee gives way, ask the treating provider to write the brace order and note the instability in the record.

Cartilage, replacement, and the rest

• DC 5258, dislocated semilunar cartilage (meniscus) with frequent episodes of locking, pain, and effusion into the joint: 20%. This is a single-tier code, and under the current criteria it is generally rated instead of, not in addition to, motion loss from the same cartilage damage; read the notes at eCFR.
• DC 5259, symptomatic removal of semilunar cartilage: 10%. If you had a meniscectomy and the knee still hurts, this applies.
• DC 5055, knee replacement: 100% for the first four months after the prosthesis (starting after the surgical convalescence period), then a minimum of 30% for the rest of your life, with 60% available for chronic residuals of severe painful motion or weakness. The 100% period is automatic and the 30% floor is permanent.
• DC 5256, ankylosis (a knee frozen in place): 30% to 60% depending on the angle.
• DC 5262, tibia and fibula impairment with knee disability: 10% to 40%.

Service connection for knees

Knee injuries are well documented in most service records: a twist on a ruck, a parachute landing, a fall off a vehicle, a profile for "knee pain," physical therapy, an MRI. Pull every one. Degenerative arthritis on X-ray within a year of separation is also a chronic-disease presumptive under § 3.309(a). For a knee that went bad years later, the common theories are direct connection through documented in-service injury or the cumulative load of the job, or secondary connection to another service-connected lower-extremity condition: an ankle, a foot, a hip, or the other knee, through altered gait. The secondary conditions guide covers what that opinion needs to say.

The knee is also a common primary for secondaries. A service-connected knee that changes how you walk is the standard basis for later hip, back, and opposite-knee claims. If you have one service-connected knee and the other one is starting to go, that is a claim, not a coincidence.

The checklist

1. Current imaging (X-ray for arthritis, MRI for ligament or meniscus), with the diagnosis in words.
2. Range-of-motion measurements in both directions, flexion and extension, taken to the point of pain.
3. Documentation of instability: the provider's note that the knee gives way, any positive Lachman or drawer test, and a prescription for a brace or cane.
4. Surgical history: meniscectomy, ACL repair, replacement, with dates.
5. A flare-up log and lay statements on what the knee stops you from doing: stairs, kneeling, standing through a shift, getting out of a car.
6. Each impairment listed as its own claimed condition on the 21-526EZ: "left knee limitation of motion" and "left knee instability," not just "left knee."