Knee conditions are among the most claimed VA disabilities — and among the most frequently underrated. Whether you're dealing with a torn meniscus, ACL instability, patellar damage, or simple limitation of motion from years of ruck marching and jumping, the VA has a precise set of tables that translate your exam findings into a disability percentage. This guide decodes those tables, explains the critical painful-motion rule, and shows you exactly how to maximize your knee rating — including the bilateral factor most veterans miss entirely.
The VA rates knee conditions under several diagnostic codes in 38 CFR Part 4, §4.71a. Knowing which code applies to your specific injury — and choosing the most advantageous code — is critical:
| DC | Condition | Key Feature |
|---|---|---|
| 5257 | Recurrent subluxation or lateral instability | Rated on instability severity |
| 5258 | Dislocated semilunar cartilage with locking | 10% minimum; locking episodes matter |
| 5259 | Semilunar cartilage removed, symptomatic | Post-meniscectomy symptoms |
| 5260 | Limitation of flexion of the leg | Flexion table |
| 5261 | Limitation of extension of the leg | Extension table |
| 5262 | Impairment of the tibia and fibula | Structural damage, fractures |
| 5263 | Genu recurvatum | Hyperextension deformity |
The VA is required to rate your knee under whichever code produces the highest rating for your actual condition. If your knee has both limited flexion AND instability, the VA should rate under both — but it cannot combine ratings for the same knee under two codes for the same disability. However, you can receive separate ratings for distinct disabilities of the same knee (e.g., separate codes for instability vs. limitation of extension, if they represent different anatomical issues).
Normal knee flexion is 0° to 140° (full bend). Normal extension is 0° (full straightening). Any limitation of these movements is rated using the VA's standard tables.
| Rating | Flexion Limited To |
|---|---|
| 30% | Flexion limited to 30° or less |
| 20% | Flexion limited to 45° or less (more than 30°) |
| 10% | Flexion limited to 60° or less (more than 45°) |
| 0% (non-compensable) | Flexion limited to more than 60° but less than normal (140°) |
If your C&P exam shows knee flexion to 55°, your rating under DC 5260 is 10%. If your flexion is 42°, your rating is 20%. At 28°, you rate 30%. If range of motion decreases after repetitive use — common in inflamed knees — document that too.
| Rating | Extension Limited To (Degrees from Full Extension) |
|---|---|
| 50% | Extension limited to 45° (cannot straighten past 45° of flexion) |
| 40% | Extension limited to 30° |
| 30% | Extension limited to 20° |
| 20% | Extension limited to 15° |
| 10% | Extension limited to 10° |
| 0% | Extension limited to 5° or less (almost fully straightened) |
Extension limitation means the veteran cannot fully straighten the knee. If your knee is "stuck" at 20° of flexion and you can't extend it further, that's a 20° extension limitation rated at 20%. Extension limitations are often more disabling than equivalent flexion limitations and should always be documented precisely.
Under the DeLuca v. Brown doctrine, the VA must consider range of motion after repetitive use. If your knee's range of motion decreases from 80° to 55° after walking up and down the hallway three times, that post-exercise measurement should be recorded and rated. Always ask your examiner to take measurements after repetitive motion.
This is the most powerful and most overlooked rule in knee ratings. 38 CFR §4.59 states:
"With any form of arthritis, painful motion is an important factor of disability, the facial expression, wincing, etc., on pressure or manipulation, should be carefully noted and definitely related to affected joints. Grating, in a joint, is not as significant. When noted, it should be described descriptively and distinctly from crepitation. The intent of the schedule is to recognize painful motion with joint involvement as productive of disability. It is the intention to rate at least the minimum compensable rating for the joint."
In practice, §4.59 means that if you have a painful knee — even if your range of motion is technically within normal limits — the VA must assign at least the minimum compensable rating for that joint. For knee flexion, the minimum compensable rating under DC 5260 is 10%. For knee extension under DC 5261, the minimum compensable rating is 10%.
Veterans often get rated at 0% despite reporting significant knee pain because the examiner measured normal or near-normal ROM without properly applying §4.59. If you have painful motion and received 0%, consider appealing or filing a Supplemental Claim with a private DBQ documenting the pain on motion.
DC 5257 covers recurrent subluxation (partial dislocation) and lateral instability of the knee — typically caused by ACL, PCL, MCL, or LCL tears or laxity. This is a standalone code that rates the instability itself, separate from any limitation of motion.
| Rating | Instability Severity |
|---|---|
| 30% | Severe instability |
| 20% | Moderate instability |
| 10% | Slight instability |
The terms "slight," "moderate," and "severe" are not precisely defined in the regulation, leaving room for examiner interpretation. As a general guide:
Critically, the VA can rate DC 5257 (instability) separately from DC 5260 (limitation of flexion) for the same knee — as long as they represent genuinely separate disabilities or limitations. However, pyramiding rules prohibit double-rating the same manifestation of disability. If your limitation of motion is caused by instability alone (you don't bend the knee because it gives way), the VA may only apply one code. If you have both structural instability AND independent limitation of motion from a different cause (cartilage damage, post-surgical changes), both may be rated separately.
Editorial Standards: This article was written by Marcus J. Webb, a veterans benefits researcher who has studied 38 CFR Part 4, the VA M21-1 Adjudication Manual, and thousands of BVA decisions. Content is verified against current 38 CFR regulations and VA.gov guidance. Last reviewed: April 2026. Not legal advice — for representation on your specific claim, talk to a VA-accredited attorney.