CLAIM RECON INTEL

DC 5257 | 38 C.F.R. § 4.71a | M21-1, Part IV.ii.2

OVERVIEW

Knee instability (recurrent subluxation or lateral instability) is rated under DC 5257. Critically, instability is rated SEPARATELY from limitation of motion under VAOPGCPREC 23-97. A veteran can receive both a ROM-based rating AND an instability rating simultaneously without pyramiding.

RATING CRITERIA (3 LEVELS)

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.