Knee VA rating
The VA rates knee under DC 5257 / 5260 / 5261, and most ratings land in the 0–30%+ range. What decides yours is the criteria below and what your record actually documents.
What the criteria ask for at each level
DC 5257 / 5260 / 5261 — 38 CFR §4.71a
| Rating | What the record has to show |
|---|---|
| 10–30% (instability, DC 5257) | 10% persistent instability; 20% when a brace or assistive device is prescribed; 30% for unrepaired ligament damage requiring both brace and assistive device. |
| 0–30% (flexion, DC 5260) | Flexion limited to 60°=0%, 45°=10%, 30°=20%, 15°=30%. |
| 0–50% (extension, DC 5261) | Extension limited to 5°=0%, 10°=10%, 15°=20%, 20°=30%, 30°=40%, 45°=50%. |
The schedule's own words
Ratings turn on specific terms, and a record that describes the same reality in different language often reads as a lower rating. These are the words this code measures:
- instability
- gives way
- prescribed brace or assistive device
- limitation of flexion
- limitation of extension
Evidence that moves this rating
- Goniometer range-of-motion measurements (flexion AND extension)
- Brace/cane prescription in your records
- Imaging showing ligament or joint damage
What your statement has to cover
Doctors chart symptoms; they rarely chart consequences. That part is yours, and it is usually what separates a documented rating from a reported one.
- Say "my knee gives way" and describe falls or near-falls — instability is rated SEPARATELY from motion, so you can receive both ratings on the same knee.
- If you use a brace or cane, state that it was prescribed and by whom.
- Describe both knees if both are affected — paired legs earn the bilateral factor.
Our Statement Builderwalks through the questions that produce that kind of statement, in the schedule's own terms.
What knee can lead to7 documented pathways
A secondary claim runs through a condition the VA already accepts, so the argument about your service is already won. What is left is the medical link — and a nexus opinion has to name the mechanism, not just the pair.
| Can lead to | The mechanism a nexus has to state |
|---|---|
| Sleep apneavia weight gain | Knee pain limits activity; weight gain bridges to obstructive sleep apnea. |
| Degenerative arthritis | Altered gait and weight shifting accelerate arthritis in other joints. |
| GERD (acid reflux) | Long-term NSAID / pain-medication use for this condition damages the stomach lining and relaxes the esophageal sphincter — a well-established medication-side-effect pathway. |
| Lower back condition (lumbar spine) | Altered walking pattern from knee instability throws off spinal mechanics. |
| Hip condition (bursitis, arthritis, limited motion) | Limping and altered gait place abnormal stress and uneven loading on the hip joints. |
| Ankle or foot condition (incl. flat feet, plantar fasciitis) | Compensating for a bad knee overloads the ankles and feet. |
| Depression | Chronic knee pain and loss of mobility affect mental health. |
A pathway existing in the literature is not the same as your claim being granted — your records and the VA decide that. How secondary claims work covers the argument.
Before you spend money on this claim
VA ratings do not add. Each new rating applies only to the part of you the VA still counts as unimpaired, then rounds to the nearest ten — so from 70%, a new 10% condition leaves you at exactly 70% and changes your payment by nothing.
That does not make the claim worthless; it can still matter for TDIU, for SMC, or later when something else is added. But it is worth knowing before you pay for a nexus letter rather than after. Check what one more condition does at your rating — it takes a minute.