KEY TAKEAWAYS
- VA rates knee pain mainly on how far the knee bends and straightens. Flexion limited to 45° is 10%, to 30° is 20% and to 15° is 30%; extension limited to 10° is 10%, rising to 50% at 45°.
- One knee can carry several separate ratings: one for limited bending, one for limited straightening and one for instability, as long as each covers different symptoms.
- Since February 7, 2021, instability under diagnostic code 5257 turns on a diagnosed ligament or kneecap problem and whether a provider prescribed a brace, cane, crutches or a walker. The top rating is 30%.
- A total knee replacement is rated 100% for four months after a one-month surgical rating, then never lower than 30%. Before 2021 the 100% period was a full year.
- A painful knee is entitled to at least the minimum compensable rating, 10%, under 38 CFR 4.59. In 2026 a 10% rating pays $180.42 a month.
- How VA Rates Knee Pain
- Limitation of Motion: Diagnostic Codes 5260 and 5261
- Painful Motion, Flare-Ups and the C&P Exam
- Knee Instability: Diagnostic Code 5257
- Meniscus Tears and Cartilage: Codes 5258 and 5259
- Other Knee Codes: Ankylosis, Shin and Leg Bone, Genu Recurvatum
- Total Knee Replacement: Diagnostic Code 5055
- How Knee Ratings Stack Up
- Secondary Conditions: Back, Hip and the Other Knee
- Filing a Knee Claim or Asking for an Increase
- Frequently Asked Questions
Knees are one of the most common reasons veterans file a disability claim, and one of the easiest to under-rate. Years of rucking, airborne landings and running on pavement leave many veterans with knees that ache, click, give way or won’t fully straighten. VA can rate all of that, but only the parts the evidence shows, and only under the right diagnostic codes. A knee that should carry 30% across three ratings often ends up at a single 10% because the exam missed a flare-up or nobody mentioned the brace. This guide walks through every knee code in the rating schedule, how the ratings stack, and what to bring to your exam.
How VA Rates Knee Pain
VA rates knees under the musculoskeletal part of its rating schedule, 38 CFR 4.71a. There is no single “knee pain” rating. Instead, the rater looks at what is actually wrong with the joint and picks the code that fits: lost motion, instability, damaged cartilage, a frozen joint or a replacement.
Most knee claims are decided on range of motion. The examiner measures how far your knee bends (flexion) and how far it straightens (extension) with a goniometer. On VA’s standard chart, a normal knee moves from 0° (fully straight) to 140° (fully bent). The closer your measurements get to straight-locked or unable-to-bend, the higher the rating.
Pain alone is not a diagnosis, but painful motion counts. VA’s own rule in 38 CFR 4.59 says the intent of the schedule is to recognize painful, unstable or malaligned joints as entitled to at least the minimum compensable rating for that joint. For the knee, that minimum is 10%.
If you have more than one condition, VA combines the ratings rather than adding them. Our VA disability ratings guide explains the combined ratings table and how VA rounds the result.
Limitation of Motion: Diagnostic Codes 5260 and 5261
These two codes do most of the work in knee claims. Code 5260 rates how far you can bend the knee; code 5261 rates how far you can straighten it.
| Code 5260: flexion limited to | Rating |
|---|---|
| 60° | 0% |
| 45° | 10% |
| 30° | 20% |
| 15° | 30% |
| Code 5261: extension limited to | Rating |
|---|---|
| 5° | 0% |
| 10° | 10% |
| 15° | 20% |
| 20° | 30% |
| 30° | 40% |
| 45° | 50% |
Read the extension table carefully, because it runs the opposite way from what most people expect. “Extension limited to 10°” means your knee stops 10° short of straight. A knee that won’t straighten past 30° is badly limited and rates 40%.
Many veterans measure well on paper. A knee that bends to 110° doesn’t meet the 0% line for flexion, which starts at 60°. That doesn’t end the claim. It means the rating has to come from painful motion, flare-ups, instability or another code, which is why the rest of this guide matters.
You Can Get Both Ratings for One Knee
VA’s General Counsel held in precedent opinion VAOPGCPREC 9-2004 that separate ratings may be assigned for limited flexion under 5260 and limited extension under 5261 of the same knee. They measure different movements, so rating both isn’t double counting. A knee that bends only to 45° and won’t straighten past 10° can carry two 10% ratings.
Painful Motion, Flare-Ups and the C&P Exam
The number the examiner writes down is only the start. Three rules decide whether that number reflects how your knee works on a bad day.
- Functional loss. Under 38 CFR 4.40 and 4.45, VA must consider pain, weakness, fatigability, incoordination and swelling, not just the angle on the goniometer. The Court of Appeals for Veterans Claims applied this in DeLuca v. Brown (1995): the rating has to account for additional loss of motion from pain and repeated use.
- Full joint testing. In Correia v. McDonald (2016), the court held that the exam should test the joint on active and passive motion, weight-bearing and non-weight-bearing, and compare it to the opposite joint if that one is undamaged. That wording comes straight from 4.59.
- Flare-ups. In Sharp v. Shulkin (2017), the court said an examiner can’t skip a flare-up opinion just because your knee wasn’t flaring that day. The examiner has to ask you how often flares happen, how long they last and how much motion you lose, and estimate the effect.
Describe your worst days in specific terms: “Two or three times a month, after a long shift on my feet, I can’t bend past 90° and I can’t do stairs for a day or two.” Vague answers like “it hurts sometimes” give the examiner nothing to estimate. Our guide to the VA C&P exam covers how to prepare and what to do if the exam goes badly.
If the report leaves out flare-ups or only tests one way, that’s a common reason to ask for a new exam. VA publishes the Knee and Lower Leg Disability Benefits Questionnaire the examiner fills out, so you can see what should be covered before you go.
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Knee Instability: Diagnostic Code 5257
Code 5257 covers a knee that gives way, whether from a torn ligament such as an ACL or MCL or from a kneecap that slips out of place. VA rewrote this code in its musculoskeletal update, effective February 7, 2021. The old version used “slight, moderate or severe” instability, which left a lot to the rater’s judgment. The new one ties the rating to your diagnosis and to what your provider prescribed.
Ligament Instability
| Finding | Rating |
|---|---|
| Unrepaired or failed repair of a complete ligament tear causing persistent instability, and a provider prescribes both an assistive device (cane, crutches or walker) and bracing | 30% |
| A sprain, incomplete tear or repaired complete tear causing persistent instability, with a prescribed brace and/or assistive device; or an unrepaired or failed complete tear with either an assistive device or bracing | 20% |
| A sprain or tear (repaired, unrepaired or failed repair) causing persistent instability, with no prescription for a brace or assistive device | 10% |
Patellar (Kneecap) Instability
| Finding | Rating |
|---|---|
| Recurrent instability after surgical repair that requires a prescribed brace and either a cane or a walker | 30% |
| Recurrent instability after surgical repair that requires a prescribed brace, cane or walker | 20% |
| Recurrent instability, with or without surgery, that doesn’t require a prescribed brace, cane or walker | 10% |
The word that trips people up is prescribes. A knee sleeve you bought at a drugstore doesn’t move you from 10% to 20%. A brace your VA or private doctor ordered and documented does. If you rely on a brace or cane every day and it isn’t in your records, raise it with your provider before your exam.
For patellar instability, the “surgical repair” has to address the parts of the kneecap complex that cause the instability: the quadriceps tendon, the kneecap or the patellar tendon. An arthroscopy to remove loose bodies or a joint aspiration doesn’t count.
Instability Plus Arthritis
Instability and arthritis are different problems, so they can be rated separately. VA’s General Counsel said so in VAOPGCPREC 23-97 and VAOPGCPREC 9-98: a veteran with knee arthritis and instability can receive a rating for each without violating the rule against pyramiding, as long as there’s at least some limitation of motion, even at the 0% level.
Meniscus Tears and Cartilage: Codes 5258 and 5259
The meniscus is the C-shaped cartilage that cushions the knee. Torn or removed meniscus has its own two codes, and VA left both unchanged in 2021.
| Code | Condition | Rating |
|---|---|---|
| 5258 | Dislocated semilunar cartilage with frequent episodes of locking, pain and effusion (fluid) into the joint | 20% |
| 5259 | Removal of semilunar cartilage, symptomatic | 10% |
The 20% rating under 5258 needs all three symptoms on a frequent basis: locking, pain and swelling. If you’ve had a meniscectomy and still have symptoms, 5259 pays 10%.
Can a meniscus rating stack with motion ratings? Sometimes. In Lyles v. Shulkin (2017), the court held that a separate meniscus rating is allowed if none of the symptoms overlap and it’s based on additional disabling symptoms. If your painful motion is already behind your 5260 rating, VA won’t also pay for that pain under 5259. Locking and effusion are different, so they may support their own rating.
Other Knee Codes: Ankylosis, Shin and Leg Bone, Genu Recurvatum
These codes apply less often, but they pay more when they fit.
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| Code | Condition | Ratings |
|---|---|---|
| 5256 | Ankylosis (knee frozen in place). Favorable angle in full extension or slight flexion under 10°: 30%. Between 10° and 20°: 40%. Between 20° and 45°: 50%. Extremely unfavorable, 45° or more: 60% | 30% to 60% |
| 5262 | Tibia and fibula. Nonunion with loose motion requiring a brace: 40%. Malunion is rated under the knee or ankle codes, whichever gives the higher rating. Shin splints (medial tibial stress syndrome) treated for at least 12 months: 0% to 30% | 0% to 40% |
| 5263 | Genu recurvatum (knee bends backward), acquired or traumatic, with weakness and insecurity in weight-bearing objectively shown | 10% |
Arthritis shows up in many knee claims too. Degenerative arthritis confirmed by X-ray is rated on limitation of motion under 5260 and 5261. If the motion loss is too small to rate, VA assigns 10% for each major joint with painful or limited motion under code 5003. Post-traumatic arthritis, code 5010, is rated the same way, by lost motion or instability.
Total Knee Replacement: Diagnostic Code 5055
A knee replacement brings the most predictable rating in the knee schedule. After surgery, you’re first rated 100% for a month under the convalescence rule, 38 CFR 4.30. Then:
| Stage after replacement | Rating |
|---|---|
| 4 months after the month-long surgical rating | 100% |
| Chronic residuals: severe painful motion or weakness | 60% |
| Intermediate residuals: rated by analogy to codes 5256, 5261 or 5262 | Varies |
| Minimum for a total replacement | 30% |
The 100% period used to last a year. The 2021 update cut it to four months for both knee and hip replacements, and that’s the rule today. A partial or resurfacing procedure also gets the four months at 100%, but it has no 30% minimum afterward; it’s rated on motion and instability under codes 5256 through 5262.
Plan for the drop. If you’ve been receiving 100% while recovering, your payment will fall when the four months end, and VA will propose the new rating based on a follow-up exam. Our page on the 100% VA disability rating explains how temporary and permanent 100% ratings differ.
How Knee Ratings Stack Up
Because one knee can carry several ratings, the combined result is often higher than any single code. Here’s how it works with VA’s combined ratings math.
| Example: one knee | Ratings | Combined |
|---|---|---|
| Painful motion only | 10% | 10% |
| Limited flexion plus limited extension | 10% + 10% | 20% (combined value 19) |
| Limited flexion, limited extension and instability | 10% + 10% + 10% | 30% (combined value 27) |
| Limited flexion plus ligament instability with prescribed brace | 10% + 20% | 30% (combined value 28) |
VA also has a bilateral factor, 38 CFR 4.26. When both legs have compensable disabilities, VA combines the right and left ratings and then adds 10% of that value before combining with anything else. Two 10% knees combine to 19, plus 1.9 for the bilateral factor, which gives 20.9 and rounds to 21. It sounds small, but at the edge of a rating band it can move you up a level.
VA won’t rate the same symptom twice, a rule called pyramiding (38 CFR 4.14). So the stacking above works only when each rating is for something different: bending, straightening, giving way, locking. The rater has to explain the split, and if you see one rating where the evidence supports two, that’s a strong ground for a higher-level review.
What Knee Ratings Pay in 2026
Rates below are VA’s veteran-alone rates effective December 1, 2025. At 30% and above, you get more with a spouse or dependents.
| Combined rating | Monthly (veteran alone) |
|---|---|
| 10% | $180.42 |
| 20% | $356.66 |
| 30% | $552.47 |
| 40% | $795.84 |
| 50% | $1,132.90 |
| 60% | $1,435.02 |
To estimate your total with every rating combined, use our VA disability compensation calculator.
Secondary Conditions: Back, Hip and the Other Knee
A bad knee changes how you walk, and that can wear out other joints. VA can service-connect a condition on a secondary basis under 38 CFR 3.310 if a medical opinion says your service-connected knee caused it or made it worse. Common examples:
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- Lower back pain from an altered gait. See our guide to the VA rating for lower back pain.
- Hip problems on the same side or the opposite side, from favoring one leg.
- The other knee, from carrying more weight for years. If both knees end up rated, the bilateral factor applies.
- Ankle and foot problems from changes in how you stand and step.
- Nerve pain such as sciatica, if a back condition develops and compresses a nerve.
The link has to come from a medical professional, ideally with reasoning: what your gait looks like, how long you’ve compensated and why that strains the other joint. Our list of VA secondary conditions covers how to build that kind of claim.
Filing a Knee Claim or Asking for an Increase
- Get the diagnosis on paper. Strain, ligament tear, meniscus tear, arthritis, patellofemoral syndrome or a replacement. An MRI or X-ray report helps.
- Show the link to service. Service treatment records, a profile, a line-of-duty report or a buddy statement about the injury. If the knee started hurting later, a medical opinion connecting it to your duties.
- Document the devices. Make sure any prescribed brace, cane, crutches or walker is in your medical records. Under 5257, that prescription changes the rating.
- Keep a flare-up log for a month or two before your exam: how often, how long, what triggers it and what you couldn’t do.
- File online at VA.gov with VA Form 21-526EZ, or file an intent to file first to protect your effective date while you gather evidence.
Already rated and getting worse? A knee that now needs a brace, has had surgery or won’t bend as far as it did at your last exam may support an increase. Our guide to a VA disability rating increase explains how to file and the risk of a reduction if VA finds you improved.
A free accredited representative can help you organize the evidence. See our page on VA disability claim assistance for where to find one without paying a claims consultant.
RELATED READING
VA Disability Rating for Lower Back Pain →
The spine rules that apply when a bad knee leads to back trouble.
VA Loan Guide: Eligibility, Benefits and How to Apply →
A disability rating of 10% or more waives the VA funding fee on a home loan.
How VA combines every rating you have into one percentage.
Frequently Asked Questions
Yes. Under 38 CFR 4.59, a painful joint is entitled to at least the minimum compensable rating, which is 10% for the knee. The examiner also has to consider flare-ups and pain on repeated use, so tell them how much motion you lose on bad days. If the report says your motion is normal but doesn’t address pain or flares, you can ask for a new exam through a higher-level review or supplemental claim.
Yes, as long as each rating covers a different problem. VA can rate limited bending under code 5260 and limited straightening under 5261 separately, and add a rating for instability under 5257. A meniscus rating can also stack if its symptoms, such as locking and swelling, don’t overlap with the others. What VA won’t do is pay twice for the same symptom.
It can, if a medical provider prescribed it and the knee has a diagnosed ligament or kneecap problem causing instability. Under code 5257, instability without a prescribed brace or assistive device is 10%; with a prescribed brace it’s generally 20%; and a complete tear that was never repaired or failed repair, with both a brace and a cane, crutches or walker, is 30%. A brace you bought yourself without a prescription doesn’t count.
After surgery you receive a one-month total rating for convalescence, then 100% for four more months under code 5055. After that, VA rates the remaining symptoms: 60% for severe painful motion or weakness, or a rating based on motion and instability for milder residuals. A total replacement is never rated below 30%. Before February 7, 2021, the 100% period lasted a year.
It can, as a secondary condition. If a doctor says your service-connected knee caused or worsened a back, hip or other knee problem, usually by changing how you walk, VA can grant service connection under 38 CFR 3.310. The medical opinion needs to explain why, not just state it. A short note saying the conditions are related is often not enough.
VA combines ratings rather than adding them, but for both legs it also adds a bilateral factor. Two 10% knees combine to 19, and the bilateral factor adds 10% of that, for 20.9, which counts as 21 before VA combines it with your other ratings. That extra point is small on its own but can push your final rating into the next 10% band.
This guide is provided by USMilitary.org, an independent educational resource. We are not affiliated with the Department of Veterans Affairs. Rating criteria come from the VA Schedule for Rating Disabilities, 38 CFR Part 4, as in effect in October 2026, and payment amounts from VA’s compensation rates effective December 1, 2025. Your rating depends on your own medical evidence; an accredited representative can help you apply these rules to your claim.
