The 38 CFR knee rating chart is spread across nine diagnostic codes in 38 CFR 4.71a, each covering a different kind of knee impairment and each with its own percentage tiers. A single knee can be rated under more than one code when the symptoms don’t overlap, so the practical question is rarely “which code applies” but “which combination of codes applies.” The tables below give you every knee percentage the VA uses, followed by the rules that decide how they stack.
Limited Flexion: Diagnostic Code 5260
Flexion is how far the knee bends. A healthy knee bends to roughly 140 degrees. DC 5260 rates the loss:1eCFR. 38 CFR 4.71a – Musculoskeletal System
- 0% — flexion limited to 60 degrees
- 10% — flexion limited to 45 degrees
- 20% — flexion limited to 30 degrees
- 30% — flexion limited to 15 degrees
Thirty percent is the ceiling under this code. A measurement that falls between two thresholds rates at the next less severe tier, so flexion limited to 35 degrees sits between the 10% mark (45 degrees) and the 20% mark (30 degrees) and rates at 10%.
Limited Extension: Diagnostic Code 5261
Extension is how far the leg straightens; a fully straight leg is 0 degrees. DC 5261 goes higher than the flexion code because losing the ability to straighten the leg cripples walking and standing:1eCFR. 38 CFR 4.71a – Musculoskeletal System
- 0% — extension limited to 5 degrees
- 10% — extension limited to 10 degrees
- 20% — extension limited to 15 degrees
- 30% — extension limited to 20 degrees
- 40% — extension limited to 30 degrees
- 50% — extension limited to 45 degrees
Each rating maps to a specific angle. A leg that won’t straighten past 20 degrees rates 30%; past 30 degrees, 40%. The 50% maximum describes a leg essentially locked in a bent position.
Instability and Subluxation: Diagnostic Code 5257
DC 5257 covers lateral instability and recurrent subluxation, meaning the knee shifts or partially dislocates. It’s evaluated separately from range of motion, so a rating here can be added to a rating under DC 5260 or 5261.2Board of Veterans’ Appeals. Board of Veterans Appeals Decision A22001725
- 10% — slight
- 20% — moderate
- 30% — severe
The regulation doesn’t define slight, moderate, or severe with numbers, so the examiner’s clinical judgment and your documented history do the work. A knee that occasionally feels loose might land at 10%. A knee that gives way often enough to cause falls, or one where a doctor has prescribed a brace or cane, generally supports 20% or 30%. If a mobility aid has been prescribed, make sure that prescription is in the medical record before the C&P exam.
Meniscal Conditions: Diagnostic Codes 5258 and 5259
Meniscus damage is rated under two codes, depending on whether the cartilage is still there:3Board of Veterans’ Appeals. Board of Veterans Appeals Citation Nr 20005117
- DC 5258 — 20%, and only 20%, for dislocated meniscal cartilage with frequent locking, pain, and joint effusion (fluid buildup). All three elements are required.
- DC 5259 — 10%, and only 10%, for symptomatic residuals after a meniscectomy.
These codes rate the mechanical problem itself. If a torn meniscus also limits flexion or extension, the motion loss can be rated separately under DC 5260 or 5261 as long as the symptoms being rated aren’t the same.
Ankylosis: Diagnostic Code 5256
Ankylosis means the joint is frozen in one position. It’s the most severe knee condition the VA rates, and the percentage depends on the fixed angle:1eCFR. 38 CFR 4.71a – Musculoskeletal System
- 30% — favorable angle, full extension or slight flexion between 0 and 10 degrees
- 40% — flexion between 10 and 20 degrees
- 50% — flexion between 20 and 45 degrees
- 60% — extremely unfavorable, flexion at 45 degrees or more
A favorable angle keeps the leg close to straight, which still allows some awkward walking. Above 45 degrees the leg is effectively unusable for normal gait, hence the 60% ceiling.
Total Knee Replacement: Diagnostic Code 5055
After a total knee replacement, DC 5055 assigns a temporary 100% rating for four months. That period runs after any initial one-month convalescence rating under 38 CFR 4.30, so a veteran typically sees about five months at 100% before reassessment.1eCFR. 38 CFR 4.71a – Musculoskeletal System
Once the 100% period ends, the residuals are rated:
- 60% — chronic severe painful motion or weakness in the affected leg
- 30% — the minimum floor for a total replacement, applied even when residuals are mild
- Intermediate cases — rated by analogy under DC 5256, 5261, or 5262, whichever produces the highest result
The 30% floor applies only to total replacements. Knee resurfacing procedures don’t carry a minimum; residuals are rated under the standard knee codes and can land anywhere from 0% upward.
A temporary 100% rating under 38 CFR 4.30 is also available after knee surgery when recovery involves unhealed surgical wounds, cast immobilization, or house confinement. That temporary rating runs one to three months, with extensions in severe cases.4Veterans Affairs. Temporary Disability Rating After Surgery or Cast
Arthritis Confirmed by X-Ray: Diagnostic Code 5003
DC 5003 handles degenerative arthritis confirmed by imaging. The default rule is to rate the arthritis by whatever motion loss it causes under DC 5260 or 5261. The provision that matters most, though, kicks in when imaging shows arthritis but measured motion doesn’t reach even the 0% threshold under those codes. In that situation, DC 5003 authorizes 10% for each major joint or group of minor joints, up to 20% when two or more joint groups are involved.
Many veterans have knee arthritis with pain and stiffness that fall short of the flexion or extension thresholds. Without DC 5003 they would receive nothing. With it, they get at least 10% per knee.
Painful Motion Floor: 38 CFR 4.59
38 CFR 4.59 requires that painful motion of a joint with arthritis confirmed on X-ray be rated at least at the minimum compensable level for that joint. For a knee with documented arthritis and any painful motion, a 0% rating is almost certainly wrong; the correct floor is 10%. Under 38 CFR 4.40, a body part that becomes painful on use “must be regarded as seriously disabled,” and weakness carries the same weight as limited motion.5eCFR. 38 CFR 4.40 – Functional Loss
Stacking Codes on the Same Knee
The anti-pyramiding rule at 38 CFR 4.14 blocks the VA from compensating the same symptom twice under different codes.6eCFR. 38 CFR 4.14 – Avoidance of Pyramiding It does not block separate ratings for distinct impairments. This is where most veterans lose money on a knee claim.
A VA General Counsel opinion confirmed that arthritis and instability in the same knee support separate ratings under DC 5003 (or the motion codes) and DC 5257, because limited motion and joint instability are different functional problems.7U.S. Government Publishing Office. Federal Register Volume 62 Issue 230 – VAOPGCPREC 23-97 A separate General Counsel opinion allows individual compensable ratings for both limited flexion under DC 5260 and limited extension under DC 5261 in the same leg.
A single knee with arthritis, instability, and a meniscal tear could carry three separate ratings when the symptoms under each code are distinct. The VA should identify every applicable code on its own, but it often doesn’t. A rating decision that lists only one diagnostic code for a knee with multiple types of impairment is worth challenging.
The Bilateral Factor When Both Knees Are Service-Connected
Under 38 CFR 4.26, service-connected disabilities affecting both knees get a mathematical boost. The VA combines the two knee ratings using the standard combined ratings table, then adds 10% of that combined value before merging the result with any other disabilities.8eCFR. 38 CFR 4.26 – Bilateral Factor
Example: a left knee at 20% and a right knee at 10% combine to roughly 28%. Ten percent of 28 is 2.8, bringing the bilateral value to about 30.8% before rounding and combination with other ratings. Small on paper, but enough to push a combined rating over a 10% threshold that translates into higher monthly pay. If both knees are service-connected and the bilateral factor wasn’t applied, that’s a correctable error.
Getting the Exam Right
Every knee rating starts with a Disability Benefits Questionnaire completed either by your own doctor or by a VA-contracted examiner at a Compensation and Pension exam. Range of motion has to be measured with a goniometer, not estimated.9eCFR. 38 CFR 4.46 – Accurate Measurement The exam must test both active and passive motion, and both weight-bearing and non-weight-bearing positions. An exam that only measured active motion while you were seated on a table is inadequate, and you can request a new one.
The examiner should also document functional loss from pain, weakness, fatigue, and lack of endurance, note the point in the arc of motion where pain begins, and account for additional loss on repeated use and during flare-ups. If none of that appears in the exam report, the rating is likely too low. A well-documented private DBQ from an orthopedic specialist can be submitted alongside the VA exam and carries real weight in the decision.10U.S. Department of Veterans Affairs. Knee and Lower Leg Disability Benefits Questionnaire
Imaging is what proves arthritis, cartilage tears, and bone-on-bone contact. Without it, DC 5003 and the 4.59 painful-motion floor don’t apply. Get the X-ray or MRI into the record before the exam, not after.