Knee VA Rating: Flexion, Extension, Instability and How Separate Ratings Work

The Playbook › Condition guides

Knee problems are one of the most frequently claimed conditions, and one of the most often under-rated. The reason is that a single knee can be rated under several diagnostic codes at the same time: one for how far it bends, one for how far it straightens, one for instability, and one for meniscus problems. Many veterans receive a single 10% and never learn the others exist.

Range of motion

A normal knee bends to 140 degrees and straightens fully to 0 degrees.

Limited flexion, Diagnostic Code 5260

Limited extension, Diagnostic Code 5261

Extension “limited to 10 degrees” means the knee stops 10 degrees short of straight. Loss of extension is rated more heavily than loss of flexion because a knee that will not straighten affects walking far more.

Most knees bend well past 45 degrees, so on the numbers alone many would be rated 0%. That is where the painful motion rule comes in.

Painful motion

VA’s rules say that a joint that is actually painful, unstable, or malaligned because of a healed injury or arthritis is entitled to at least the minimum compensable rating for that joint. For the knee, that is 10%. This is why so many knee ratings are 10% even with good range of motion.

As with the spine, the examiner must also account for pain on movement, loss after repeated use, and flare-ups. See back ratings for how that works at the exam.

Instability, Diagnostic Code 5257

Recurrent subluxation or lateral instability is rated at 10%, 20%, or 30%. The current criteria turn on documented ligament damage, whether there is persistent instability, and whether a medical provider has prescribed a brace, an assistive device such as a cane, or both. In general terms:

• 10% covers persistent instability from a sprain or tear where no brace or assistive device has been prescribed.
• 20% covers instability where a provider has prescribed a brace or an assistive device.
• 30% is for an unrepaired or failed repair of a complete ligament tear with persistent instability, where a provider has prescribed both a brace and an assistive device.

The practical point: if your knee gives way, tell your doctor, get it documented, and if you need a brace, get it prescribed rather than buying one yourself.

An instability rating is in addition to a rating for limited or painful motion.

Meniscus conditions

These can sometimes be assigned alongside range of motion and instability ratings, as long as the same symptom is not being compensated twice.

Knee replacement, Diagnostic Code 5055

A partial knee replacement is treated differently from a total replacement. If you have had surgery on a service-connected knee, also look at temporary 100% ratings for recovery in the rating increase guide.

How multiple ratings can add up

Take one knee with:

• Painful flexion: 10%
• Extension limited to 10 degrees: 10%
• Instability with a prescribed brace: 20%

Those three combine to about 35%, which becomes 40% when rounded on its own. The same veteran who was only examined for flexion would have 10%. Use the calculator for your own numbers.

There is a cap. The combined rating for a leg below a given level cannot exceed what VA would pay for amputation at that level. For conditions at the knee, that ceiling is 60%.

The bilateral factor

If both knees, or one knee and the opposite ankle or hip, are service connected, VA adds 10% of their combined value before combining with your other ratings. See VA math.

At the C&P exam

• Stop where pain begins in both bending and straightening.
• Describe giving way: how often, whether you have fallen, whether you use a brace or cane and who prescribed it.
• Describe locking and swelling, and how often.
• Describe flare-ups: after stairs, standing, weather changes, and how long they last.
• Wear or bring your brace.
• The examiner should test stability by hand and measure angles with a goniometer.

If the report records only flexion and says nothing about extension or stability, the exam may be inadequate. See the C&P exam guide.

Getting service connected

• Direct. An injury in service, or years of running, rucking, jumping, and kneeling with complaints in your records. Arthritis that appears to a compensable degree within a year of discharge is presumed service connected.
• Secondary. A knee condition commonly develops from favoring the other leg. See secondary conditions.

What often follows a knee condition

• Problems in the other knee, hips, and lower back from altered gait
• Ankle and foot problems. See plantar fasciitis and flat feet.
• Shoulder problems from relying on crutches or a cane. See shoulder ratings.
• Depression from chronic pain and reduced activity

Each needs its own diagnosis and a medical opinion linking it.

Last reviewed October 2026. This guide is general educational information, not legal or medical advice, and this site is not affiliated with the Department of Veterans Affairs. Rules and rates change. Confirm details on VA.gov or with an accredited representative. See our disclaimer and editorial policy.