EDUCATIONAL TOOL ONLY. Not legal or medical advice. Not affiliated with the VA.
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Leg Amputation Below Knee
DC 5165 | 38 CFR § 4.71a, DC 5164 |
Leg Amputation Below Knee is rated by the U.S. Department of Veterans Affairs under DC 5165 of 38 CFR § 4.71a, DC 5164 across 2 severity tiers (60% / 40%). 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
Amputation of the leg below the knee (transtibial), requiring prosthetic use and causing gait impairment and balance difficulties
RATING CRITERIA (2 LEVELS)
60%
DC 5163-5164 verbatim — Higher-level rating for problematic stumps: (a) DC 5163 Leg amputation with defective stump, thigh amputation recommended: 60 percent. (b) DC 5164 Leg amputation not improvable by prosthesis controlled by natural knee action: 60 percent. Both footnote 2 SMC entitled.
40%
DC 5165-5167 verbatim — THREE pathways yield 40%: (a) DC 5165 Leg amputation at a lower level, permitting prosthesis — the standard below-knee amputation; per § 4.71a amputation rule, combined eval below the knee cannot exceed this 40%. (b) DC 5166 Forefoot amputation proximal to metatarsal bones (more than one-half metatarsal loss). (c) DC 5167 Foot, loss of use of. Footnote 2 SMC entitled for all three.
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