EDUCATIONAL TOOL ONLY. Not legal or medical advice. Not affiliated with the VA.
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Avascular Necrosis of the Hip
DC 5250 | 38 CFR § 4.71a, DC 5250 |
Avascular Necrosis of the Hip is rated by the U.S. Department of Veterans Affairs under DC 5250 of 38 CFR § 4.71a, DC 5250 across 8 severity tiers (90% / 70% / 60% / 40% / 30%…). Service connection requires (1) a current diagnosis, (2) an in-service event, injury, or exposure, and (3) a medical nexus opinion linking the two under 38 C.F.R. § 3.303.
OVERVIEW
Death of bone tissue in the femoral head from disrupted blood supply, leading to progressive joint collapse and severe hip pain
RATING CRITERIA (8 LEVELS)
90%
DC 5250 "Hip, ankylosis of: Unfavorable, extremely unfavorable ankylosis, the foot not reaching ground, crutches necessitated" = 90%. (Verbatim § 4.71a DC 5250.) End-stage AVN (Ficat V) with collapsed femoral head + acetabular destruction + crutch dependency.
70%
DC 5250 "Hip, ankylosis of: Intermediate" = 70%. (Verbatim § 4.71a DC 5250.) Late-stage AVN with ankylosis but maintained weight-bearing.
60%
DC 5250 "Hip, ankylosis of: Favorable, in flexion at an angle between 20° and 40°, and slight adduction or abduction" = 60%. (Verbatim § 4.71a DC 5250.) Spontaneous ankylosis from severe AVN.
40%
DC 5252 "Thigh, limitation of flexion of: Flexion limited to 10°" = 40%. (Verbatim § 4.71a DC 5252.) Pre-ankylosis severe AVN with marked flexion limitation.
30%
DC 5252 "Flexion limited to 20°" = 30%. (Verbatim § 4.71a DC 5252.) Ficat III-IV with progressive ROM loss.
20%
DC 5252 "Flexion limited to 30°" = 20%; DC 5253 "Limitation of abduction, motion lost beyond 10°" = 20%. (Verbatim § 4.71a.)
10%
DC 5252 "Flexion limited to 45°" = 10%; DC 5251 "Extension limited to 5°" = 10%; DC 5253 "Limitation of adduction, cannot cross legs" = 10% OR "Limitation of rotation, cannot toe-out more than 15°" = 10%; OR — DC 5003 single-joint fallback with painful motion / swelling = 10%. (Verbatim § 4.71a.)
0%
AVN documented on imaging (Ficat 0-I, no collapse) without compensable ROM AND without objectively-confirmed painful-motion findings. NOTE: even Ficat I AVN typically progresses — consider establishing baseline + advance progression-monitoring.
KEY EVIDENCE TO GATHER
-Service treatment records showing injury or complaints
-Imaging (X-ray, MRI, CT)
-Range of motion measurements
-Flare-up documentation per Sharp v. Shulkin
-Buddy statements describing limitations
-Prescription history
-Physical therapy records
-Employment impact documentation
C&P EXAM TIPS (6)
1.Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation.
2.Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.
3.Tell the examiner about flare-ups: frequency, duration, estimated ROM loss. Sharp v. Shulkin (2017) requires estimates.
4.Request active, passive, weight-bearing, and non-weight-bearing ROM testing per Correia v. McDonald (2016).
5.If you use assistive devices (brace, cane), bring them.
6.Describe daily activity impact: work, sleep, household tasks.
SOURCES & EDITORIAL
Rating criteria reference 38 C.F.R. Part 4 (Schedule for Rating Disabilities). This entry has not yet undergone editorial review against the live regulation text — consult the authoritative source directly before relying on the criteria shown.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026