Knee and Leg Impairments: What Qualifies?

The physical demands of service, including marching, handling heavy equipment, and other strenuous activities, put veterans at greater risk of developing knee and leg impairments while serving or after discharge. Such conditions can be caused by the chronic stress of military duty, an acute injury sustained during combat or training, a motor vehicle accident, or any number of incidents that can occur while in service. Even knee and leg injuries that pre-date your service could be subject to VA disability compensation if your injury was made worse by your time in the military. Regardless of what caused your condition, if your knee or leg injury is related in any way to your military service, you may be eligible for VA disability compensation for your condition(s).

There are many knee and leg conditions eligible for service connection. Generally, any limitation in ordinary function such as limited range of motion or painful movement is likely to be eligible for service connection and compensation. When evaluating a knee condition for service connection during a Compensation and Pension (C&P) exam, the VA’s examiners use a Disability Benefits Questionnaire (DBQ) to determine your degree of disability for the given body part. The DBQ for knee and lower leg impairments includes the following as potential diagnoses for compensable conditions:

-Knee strain

-Knee tendonitis/tendonosis

-Knee meniscal tear

-Knee anterior cruciate ligament tear

-Knee posterior cruciate ligament tear

-Patellar or quadriceps tendon rupture

-Knee joint osteoarthritis

-Knee joint ankylosis

-Knee fracture (including patellar fracture)

-Stress fracture of tibia

-Tibia and/or Fibula fracture

-Recurrent patellar dislocation

-Recurrent patellar dislocation

-Recurrent patellar dislocation

-Patellar dislocation

-Knee cartilage restoration surgery

-Shin splints (including tibia and or fibula stress fracture and/or exertional compartment syndrome)

-Patellofemoral pain syndrome

Because orthopedic conditions affecting the knee and legs are rated and compensated differently depending on the diagnosis and degree of disability, it’s important that you work with your doctor or an orthopedic specialist to determine the correct diagnosis for your condition. You also want to record your symptoms as early as they begin to appear, regardless of whether or not you have access to specialty orthopedic care. Recording your symptoms with your physician can help create a record of the condition’s timeline, which is important even if you don’t yet have a formal diagnosis from a specialist. Additionally, understanding the condition causing your knee or leg problems will also help you get the most effective treatment. 

Service Connection for Knee or Leg Impairments: What Evidence is Needed

As stated earlier, if your knee or leg condition(s) began during or were made worse by your military service, you may be eligible for service connection and VA disability benefits. To prove service connection to the VA, assembling your service medical records, VA medical records, military personnel files reflecting an in-service accident, diagnosis, or change of duty due to knee issues, and any other private medical records you have will help you establish a connection between your condition and your military service. Make sure to have a physician use a goniometer as soon as possible in order to gain an accurate measurement of any mobility loss in your knee, as the degree of immobility is important for the disability rating process. Sworn declarations from family members, friends, fellow service members, or others familiar with your condition can also help verify that the condition was caused or made worse by your military service. Ultimately, a physician’s medical opinion that your knee condition is at least as likely as not a result of an in-service injury or condition is the best evidence to prove service connection. 

As evidenced by the rating schedules below, the highest possible schedular disability rating for any given lower leg condition is 40 percent, and the highest possible schedular disability rating for any knee impairment in 60 percent. This is because of the so-called “amputation rule.” An amputation of the leg below the knee is generally rated as 40 percent disabling, and above the knee as 60 percent disabling, so any knee or leg condition that falls short of amputation cannot be assigned a schedular rating higher than that. One notable exception to this rule is in the case of a total knee replacement, which is rated as 100 percent disabling for one year following the procedure. 

How the VA Rates Knee and Leg Impairments

Under 38 CFR § 4.71a, the VA assigns schedular ratings for the various musculoskeletal conditions that can be subject to VA disability compensation. The rating schedules for some of the most common service-connected knee and leg conditions are below:

Diagnostic Code 5055, Knee replacement (prosthesis)

Prosthetic replacement of knee joint:

For 1 year following implantation of prosthesis: 100%

With chronic residuals consisting of severe painful motion or

weakness in the affected extremity: 60%

With intermediate degrees of residual weakness, pain or limitation

of motion rate by analogy to diagnostic codes 5256, 5261, or 5262.

Minimum rating: 30%

Diagnostic Code 5256, Knee, ankylosis of:

Extremely unfavorable, in flexion at an angle of 45° or more: 60%

In flexion between 20° and 45°: 50%

In flexion between 10° and 20°: 40%

Favorable angle in full extension, or in slight flexion between 0° and 10°: 30%

Diagnostic Code 5257, Knee, other impairment of:

Recurrent subluxation or lateral instability:

Severe: 30%

Moderate: 20%

Slight: 10%

Diagnostic Code 5258, Cartilage, semilunar, dislocated:

With frequent episodes of

“locking,” pain, and effusion into the joint: 20%

Diagnostic Code 5259, Cartilage, semilunar, removal of, symptomatic: 10%

Diagnostic Code 5260, Leg, limitation of flexion of:

Flexion limited to 15°: 30%

Flexion limited to 30°: 20%

Flexion limited to 45°: 10%

Flexion limited to 60°: 0%

Diagnostic Code 5261, Leg, limitation of extension of:

Extension limited to 45°: 50%

Extension limited to 30°: 40%

Extension limited to 20°: 30%

Extension limited to 15°: 20%

Extension limited to 10°: 10%

Extension limited to 5°: 0%

Diagnostic Code 5262, Tibia and fibula, impairment of:

Nonunion of, with loose motion, requiring brace: 40%

Malunion of:

With marked knee or ankle disability: 30%

With moderate knee or ankle disability: 20%

With slight knee or ankle disability: 10%

Diagnostic Code 5263, Genu recurvatum

Acquired, traumatic, with weakness and

insecurity in weight-bearing objectively demonstrated: 10%

Helpful definitions

Prosthetic replacement – a total replacement of the named joint

Subluxation – dislocation of the knee cap

Hyperextension – an excessive straightening of the leg at the knee joint, putting stress on the knee structures and the back of the knee joint 

Developing Your Claim For Service Connection For A Knee Or Leg Impairment

By far the best evidence is medical evidence (1) diagnosing you with a knee or leg condition that began in service or was made worse during your military service and (2) specifying the severity of the condition. Such evidence usually comes from an orthopedic specialist or primary care physician who has been treating your condition. Even if you do not have access to treatment with an orthopedic specialist or a doctor that has experience treating knee and leg conditions, you still need to report your symptoms to your doctor so that there is medical evidence documenting the severity of the pain and loss of mobility that you experience. 

This medical evidence is very important because the VA will almost certainly refer you to a Compensation & Pension (C&P) examination with one of its examining doctors, who often spend as little time as possible reviewing your records, interviewing you, and completing the DBQ for your condition. Having favorable medical evidence already in your claims file improves the likelihood that the examining doctor will adopt the findings of your treating doctor regarding your diagnosis and the severity of your knee or leg pain. Additionally, in the event that the C&P examiner misrepresents the severity of your knee or leg condition, there will already be favorable medical evidence in your file showing the true severity of your condition, which can help combat unfavorable C&P exam findings.

Lastly, veterans need to be forthright about their symptoms when speaking with the VA’s C&P examining physician. It is important to articulate clearly the pain and swelling that you are experiencing, not to mention any resultant functional limitations. 

Contact Our Office About Your Knee or Leg Impairments Claim

If you are looking for assistance in filing a claim for service connection for your knee or leg condition(s), or you are hoping to improve the schedular disability rating of your already service-connected knee or leg condition(s), please do not hesitate to give us a call at the number above. Our experienced veterans attorneys are ready and available to assist you with your claim and help you get the compensation you have earned.