VA rating guide · Joints
Knee VA Rating: Bending, Buckling and Surgery
A knee that won’t bend all the way, stops short of straight and gives out on stairs can be several separate problems on a VA decision. Each one has its own code, and each can carry its own percentage when the evidence supports it.
- Flexion and extension scales
- Brace and cane prescriptions
- Meniscus and arthroscopy
- Knee replacement timeline
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One Knee, Several Possible Ratings
The VA measures a knee from fully straight (0 degrees) to fully bent (140 degrees), then asks four separate questions. How far does it bend? How close does it come to straight? Does it give way? Has the cartilage been torn or removed? Each question has its own diagnostic code in 38 CFR 4.71a.
VA's General Counsel has said a knee can carry separate ratings for limited bending and limited straightening, and separate ratings for motion loss and instability. The boundary is pyramiding: 38 CFR 4.14 bars paying twice for the same symptom, so each rating has to rest on a different problem.
A quick example. A knee that bends only to 40 degrees, stops 10 degrees short of straight and buckles on stairs could hold 10% for flexion, 10% for extension and 10% for instability. Those combine to 27, which rounds to 30%, for one knee.
Painful motion counts as well. 38 CFR 4.59 treats a painful joint from a healed injury as worth at least the minimum compensable rating for that joint, and the examiner should estimate the extra motion you lose during flare-ups and after repeated use. When both knees are service connected, the bilateral factor adds a little more as the ratings combine.
Bending: The Flexion Scale
Normal is 140 degrees. Under this table alone, the knee has to stop at 45 degrees or less before a compensable rating applies.
Straightening: The Extension Scale
This number is how far short of straight the knee stops. Missing 10 degrees is worth 10%, and the scale climbs to 50%.
Extension loss tends to show up after ligament reconstruction, cartilage damage and arthritis, and it changes your stride because the leg never fully locks out. Ask the examiner to measure both directions on both knees. 38 CFR 4.59 calls for comparing against the opposite joint when it's undamaged, so your healthy side shows what normal looks like for you.
Giving Way: Braces, Canes and Prescriptions
Since February 7, 2021, instability ratings depend on the type of ligament damage and on whether a medical provider prescribed a brace or a walking aid.
The prescription is the hinge. A sleeve from the drugstore or a cane you picked up yourself won't lift you past 10%, however much you rely on it. If you need support to walk safely, tell your provider, and make sure the prescription and the reason for it end up in your chart.
A kneecap that slips or dislocates is scored under separate patellar instability levels inside the same code, based on whether it was surgically repaired and what has been prescribed. Either way, records carry the claim: exam findings, imaging, and treatment notes that describe the knee giving way.
Torn Cartilage, Scopes and Knee Replacements
Meniscus damage
Two codes cover the semilunar cartilage. Code 5258 rates a dislocated meniscus that keeps causing locking, pain and fluid in the joint at 20%. Code 5259 rates cartilage that was surgically removed and still causes symptoms at 10%. Whether either can sit alongside a motion rating depends on overlap: locking and swelling are different problems from lost motion, but pain already counted under one code can't be counted again under another.
Knee replacement (code 5055)
A replacement or resurfacing of a service-connected knee brings a 100% rating for four months after the implant, starting once the one-month convalescence rating ends. At 2026 rates that is $3,938.58 a month for a veteran with no dependents. After the four months:
- Total replacement: 30% at minimum, up to 60% for severe painful motion or weakness, with results in between scored by analogy to the ankylosis, extension or tibia codes
- Resurfacing: rated on the regular knee codes, with no minimum
Once a knee is rated under the replacement code, the separate flexion, extension and instability ratings for that knee stop. After the surgery, file for the temporary 100% rating and send the operative report and discharge summary. The VA doesn't start it on its own.
Knee Claims: What Veterans Ask
My knee bends almost all the way but it hurts. Am I stuck at 0%?
Not necessarily. 38 CFR 4.59 recognizes a painful joint from a healed injury as worth at least the minimum compensable rating for that joint, and the examiner should estimate motion lost during flare-ups. Describe where the pain starts and what a bad week looks like.
Does a knee brace I bought myself help my instability rating?
Only up to a point. A store-bought brace can help you get around, but the two upper instability levels look for a provider's prescription for a brace or a walking aid. If nothing has been prescribed, the knee tops out at 10% under this code.
I had a meniscus scoped in service. What should I claim?
Claim the knee condition and ask that the cartilage codes be considered if part of the meniscus was removed and the knee still locks, swells or hurts. Painful or unstable surgical scars can be rated on their own under the skin codes.
Can my bad knee lead to other ratings?
Yes, with a medical opinion. Favoring one knee for years can strain the other knee, the hips and the lower back, and each can be rated as secondary to the service-connected knee.
Can Wisconsin veterans get free help with a knee claim?
Yes. Wisconsin's county veterans service offices help veterans file at no cost, and so do accredited groups such as the American Legion, DAV and VFW. If you want a second look at your exam report or records, our free case review is another option.
Wisconsin Veterans: Let’s Look at Your Claim Together
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