Knee pain is one of the most common health issues among veterans. Service members are constantly conditioning to stay prepared for action. They also wear shoes that don’t have the best support, carry bulky rucksacks, and do a lot of heavy lifting. From boot camp and beyond, veterans are susceptible to knee conditions and damage.
One of the factors the VA uses to measure the extent of a knee injury is functional loss, which means “normal excursion, strength, speed, coordination and endurance” is limited.
How many times does a paratrooper have to land wrong to get VA disability? It’s different for everybody. That’s why the VA set up the complex rating system.
The VA rates knee pain and conditions under the musculoskeletal and muscle systems in the Schedule of Ratings, which are the rules the VA uses when rating disabilities. This article will explore the conditions and VA ratings related to knee pain.
Talk to Us About Your Claim:
In this article about VA ratings for knee pain:
Service connection for knee conditions
Vigorous training, active-duty combat, and manual labor can contribute to knee problems during military service. Veterans with knee pain may have a knee condition or injury that is eligible for VA disability benefits.
Common knee conditions in veterans include:
- Partial dislocation of the knee, called subluxation
- Instability of the knee
- Rheumatoid arthritis
- Stiffness that prevents movement, called ankylosis
- Bone infection, called osteomyelitis
- Active tuberculosis of the knee
- Water on the knee, called effusion
- Hyperextended knee or a knee that bends backwards, called genu recurvatum
Veterans can also receive disability benefits for knee problems on a secondary basis. This means that their knee problems are related to another service-connected disability.
Knee pain can also cause other health problems. Common issues caused by knee pain include musculoskeletal or neurological issues such as: hip and back problems, ankle issues, spinal issues/damage, and nerve damage
|Disability Rating||Monthly Payment (veteran only)|
How the VA rates knee conditions
VA ratings for knee pain range from 0% to 60%. The more pain or lack of mobility in the knee, the higher the rating.
If there is too much wear and tear on the knee and it requires surgery, a veteran may be granted a temporary 100% rating following surgery.
Many of the VA ratings for knees involve a measurement of flexion (how much the knee can bend) and extension (how much the knee can straighten). Normal flexion is usually between 135 and 140 degrees. Normal extension is between 0 and -10 degrees.
Here are the available ratings for knee conditions based on limited range of motion, which are listed under the musculoskeletal system in the Schedule of Ratings.
|Diagnostic code||Description||VA rating|
|Knee ankylosis (5256)||Extremely unfavorable, in flexion at an angle of 45° or more|
In flexion between 20° and 45°
In flexion between 10° and 20°
Favorable angle in full extension, or in slight flexion between 0° and 10°
|Leg, limitation of flexion (5260)||Flexion limited to 15°|
Flexion limited to 30°
Flexion limited to 45°
Flexion limited to 60°
|Leg, limitation of extension (5261)||Extension limited to 45°|
Extension limited to 30°
Extension limited to 20°
Extension limited to 15°
Extension limited to 10°
Extension limited to 5°
The VA also rates muscular injuries that affect flexion and extension of the knee. The ratings are 0%, 10%, 20%, 30%, and 40% and are evaluated using the VA’s definition of slight, moderate, moderately severe, and severe disabilities of the muscle.
Arthritis is another cause of knee pain in veterans. The VA rates arthritis under diagnostic code 5002 (unless it is caused by gout or traumatic injury) at 20%, 40%, 60%, and 100% depending on severity.
Meniscus issues are also a common factor in disability ratings for the knee. The meniscus is cartilage that acts as a shock absorber. A veteran with recurrent episodes of locking, pain, and effusion (fluid on the knee) are eligible for a 20% rating.
Knee impairments that involve instability or dislocation (called subluxation) are rated under diagnostic code 5257 as follows:
|Diagnostic code||Description||VA rating|
|Recurrent subluxation or instability||If there is an unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribes both an assistive device and bracing for walking. |
If there is a sprain, incomplete ligament tear, or repaired complete ligament tear causing persistent instability, and a medical provider prescribes a brace and/or assistive device for walking.
If there is a sprain, incomplete ligament tear, or complete ligament tear (repaired, unrepaired, or failed repair) causing persistent instability, without a prescription from a medical provider for an assistive device or bracing for ambulation
|Patellar instability||A diagnosed condition involving the patellofemoral complex (pain in the front of your knee) with recurrent instability after surgical repair that requires a prescription by a medical provider for a brace and either a cane or a walker. |
A diagnosed condition involving the patellofemoral complex with recurrent instability after surgical repair that requires a prescription by a medical provider for a brace, cane, or walker.
A diagnosed condition involving the patellofemoral complex with recurrent instability (with or without history of surgical repair) that does not require a prescription for a brace, cane, or walker.
If a veteran requires knee resurfacing or knee replacement surgery (diagnostic code 5055), the VA pays at the 100% rate for 4 months following the surgery.
The bilateral factor
A veteran’s VA disability benefits can increase if knee pain is in both knees. The bilateral factor allows a veteran to receive a higher rating if the same joint or limb on both sides of the body has service-related injuries.
The ratings of each condition on the two sides of the body will be combined. Additionally, there will be another 10% of that combined rating added.
C&P exam for the knees
Zack Evans, a VA-certified disability benefits lawyer, said veterans should be honest about their knee pain and instability during compensation and pension (C&P) exams.
“Whenever you’re in a C&P exam, they’re measuring these limitations. They are measuring your functional loss. Pain is an element of functional loss,” Evans said. “Do not tough it out and remain silent during your knee examination because you will pay for it on your rating.”
It may also help leading up to your exam to record how often you have flare-ups with your knee condition. Information like that can help your rating if you share it with a C&P examiner.
During the exam, the doctor will ask you to demonstrate an extension or flexion of the knee. This test, commonly referred to as range of motion testing, will demonstrate how much pain you are in and how much your condition may affect your day-to-day life and help the VA determine what rating to assign you.
Filing for benefits
If you have knee problems related to your military service, you deserve VA compensation. If your service-connected knee problems have created other injuries or conditions, you deserve more than what you are receiving. If you need help filing a VA disability claim, the team at Woods and Woods is happy to help you navigate the application process and help you file at no cost to you.
Woods and Woods can help
Going back and forth with the VA can be tiring and frustrating, especially if you are experiencing constant pain or health issues. If you have struggled with paperwork, communicating with the VA, or receiving the proper VA ratings for your knee pain, Woods and Woods can help. We are dedicated to helping veterans win the compensation they are entitled to.
All of our attorneys are VA-certified. Call us and join the thousands of veterans we have helped to receive the VA disability benefits they deserve.
Talk to Us About Your Claim:
FREQUENTLY ASKED QUESTIONS
Veterans who develop health issues caused by a service-connected condition may be granted another disability rating for the secondary condition.
Pain itself does not receive a rating by the VA. The highest rating a veteran can receive for a knee condition is 60%. If you need knee resurfacing or replacement, you will be granted a 100% rating for 4 months after the surgery.