EDUCATIONAL TOOL ONLY. Not legal or medical advice. Not affiliated with the VA.
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Knee Strain/Instability
DC 5257 | 38 CFR § 4.71a, DC 5257 |
Knee Strain/Instability is rated by the U.S. Department of Veterans Affairs under DC 5257 of 38 CFR § 4.71a, DC 5257 across 4 severity tiers (0% / 10% / 20% / 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. This condition is frequently rated as secondary to Hip Condition - Right or Hip Condition - Left under 38 C.F.R. § 3.310.
OVERVIEW
Knee pain with recurrent subluxation or lateral instability causing giving way, buckling, and limited weight-bearing ability
RATING CRITERIA (4 LEVELS)
0%
Flexion limited to 60 degrees or extension limited to 5 degrees (DC 5260/5261).
10%
Flexion limited to 45 degrees (DC 5260); or extension limited to 10 degrees (DC 5261); or slight recurrent subluxation/instability (DC 5257).
20%
Flexion limited to 30 degrees (DC 5260); or extension limited to 15 degrees (DC 5261); or moderate subluxation/instability (DC 5257).
30%
Flexion limited to 15 degrees (DC 5260); or extension limited to 20 degrees (DC 5261); or severe subluxation/instability (DC 5257).
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
SECONDARY CONDITIONS (28 MAPPED)
DC
Altered gait stresses hip joints
DC
Abnormal mechanics damage hip joints
DC
Compensatory gait patterns stress lower back
DC
Altered gait affects ankle mechanics
DC
Gait changes stress ankle joints
DC
Altered weight distribution stresses feet
DC
Reduced mobility leads to weight gain
DC
Chronic pain and mobility limitations
DC
Favoring one knee overloads the other
DC
Ipsilateral kinetic chain stress
DC
Contralateral compensation stress
DC
Antalgic gait stresses spine
DC
Overcompensation damages other knee
DC
Same-side kinetic chain dysfunction
DC
Contralateral compensation
DC
Gait deviation stresses spine
DC
Favoring injured knee places compensatory stress on opposite knee
DC
Altered gait mechanics transfer stress to ipsilateral hip
DC
Weight shifting to avoid pain stresses contralateral hip
DC
Antalgic gait causes spinal misalignment and disc stress
DC
Compensatory foot positioning stresses ankle joint
DC
Altered gait causes lumbar nerve impingement
DC
Favoring injured knee places compensatory stress on opposite knee
DC
Altered gait mechanics transfer stress to ipsilateral hip
DC
Weight shifting to avoid pain stresses contralateral hip
DC
Antalgic gait causes spinal misalignment and disc stress
DC
Compensatory foot positioning stresses ankle joint
DC
Altered gait causes lumbar nerve impingement
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