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Knee conditions are rated by the U.S. Department of Veterans Affairs across 8 diagnostic codes (DC 5256-5263) under 38 C.F.R. § 4.71a. Under VAOPGCPREC 23-97 and 9-98, multiple DCs can apply to ONE knee simultaneously \u2014 for example separate ratings for limitation of flexion (DC 5260), limitation of extension (DC 5261), and instability (DC 5257). Each knee is rated independently; the bilateral factor under 38 C.F.R. § 4.26 applies when both knees are rated. DeLuca functional-loss factors (DeLuca v. Brown, 1995), Sharp flare-up ROM estimation (Sharp v. Shulkin, 2017), and Correia active/passive/weight-bearing testing (Correia v. McDonald, 2017) all apply.
The knee is one of the most commonly rated joints in VA disability. It can be rated under multiple diagnostic codes simultaneously under VAOPGCPREC 23-97 and VAOPGCPREC 9-98. For example, a veteran can receive separate ratings for limitation of flexion (DC 5260), limitation of extension (DC 5261), AND instability (DC 5257) for the same knee.
Per M21-1, Part IV.ii.2.A, the DeLuca factors (pain, weakness, fatigability, incoordination) must be considered. Per Sharp v. Shulkin (2017), examiners must estimate ROM during flare-ups. Per Correia v. McDonald (2017), active, passive, and weight-bearing ROM must be tested. Each knee is rated independently and the bilateral factor under 38 C.F.R. § 4.26 applies when both knees are rated.
Under 38 C.F.R. § 3.310 | Per M21-1, Part IV.ii.1.C