Common Knee Injuries and VA Disability Ratings

Veteran's Knee

Introduction

The knee is the largest joint in the human body and is comprised of four bones: the femur (upper leg bone), the tibia (shin bone) and the fibula (calf bone). The patella (kneecap) sits in front of your knee joint and helps to protect it from injury.

The knee joint itself is a hinge joint, meaning that it moves back and forth like a door hinge. It’s ball-and-socket shaped, which gives it more flexibility than other joints in your body.

The meniscus is located between the two bones in the knee joint. This piece of cartilage helps absorb shock as you move around.

Introduction
Types of Knee Injury
Other Considerations
Special Monthly Compensation (SMC) for Knee Injuries
VA Ratings for Knee Injuries
Ankylosis of the Knee
Other Knee Injuries
Limitation of Flexion of the Leg
Limitation of Extension of the Leg
Impairment of the Tibia and Fibula
Genu Recurvatum of the Knee
Conclusion

Types of Knee Injuries

Knee injuries are common among people serving in the military. Injuries can range from a minor sprain to a severe tear. The main types of knee injuries are:

  • Stress fractures (a crack in the bone)
  • Sprains (inflamed ligaments around the knee)
  • Dislocations (something that has popped out of place)
  • Tears or ruptures of ligaments, tendons, or muscles around the knee

The soft tissue knee injuries listed above can be further categorized as follows:

  • Degenerative arthritis: This type of injury occurs when the cartilage between the bones in your knee becomes worn down, causing pain and inflammation.
  • Meniscus tear: The meniscus is a cushioning material that helps distribute the force applied to your knee joints. When this tissue tears, it causes pain, swelling and stiffness in your knees.
  • Injury to ligaments and tendons: These are the soft tissue bands that connect your femur (upper leg bone) to your tibia (lower leg bone). When one or more of these ligaments are damaged, they can prevent you from bending or straightening your knee properly.

Other Considerations for Knee Injuries

When assessing a knee disability claim, the VA uses symptoms and the impairment caused by these symptoms. If your knee injury has left you with an inability to walk or climb stairs, then you may receive an increased rating for these symptoms by proving that they have lasted at least six months and are more severe than what is listed in the VA rating schedule.

In addition to physical limitations, such as not being able to walk or climb stairs without assistance, other factors that can help support an increased rating include:

  • Pain that interferes with sleep
  • Pain that interferes with daily activities or work activities

Special Monthly Compensation (SMC) for Knee Injuries

The purpose of SMC is to provide additional compensation for certain veterans with service-connected disabilities or impairments that are rated at 50 percent or higher.

For example, let’s say you have a knee injury that was service-related and was permanently rated at 70 percent. You also received an SMC award based on the rating of your knee injury. This means you would be receiving $1,076 per month (the monthly amount paid by Social Security). If you were also eligible for special monthly compensation because your overall disability rating is higher than 50 percent, then the VA would pay this benefit in addition to the Social Security check.

Ankylosis of the Knee (Diagnostic Code 5256)

Ankylosis is the abnormal stiffening or reduction in the range of motion of a joint. Veterans with service connected ankylosis in their knee(s) qualify for disability ratings as follows:

  • Extreme ankylosis preventing extension beyond 45 degrees  – 60%
  • Severe ankylosis limiting the knee’s range from 20 to 45 degrees – 50%
  • Moderate ankylosis limiting the knee’s range from 10 to 20 degrees – 40%
  • Minor ankylosis limiting the knee’s range from 0 to 10 degrees – 30%

Other Knee Injuries (Diagnostic Code 5257)

The VA provides cover for a range of other knee injuries under this diagnostic code. Disability ratings granted vary depending on the type of condition and its impact:

    • Unrepaired complete ligament tear causing persistent instability and for which a doctor has prescribed an assistive device such as a cane, crutch(es) or walker  – 30%
    • Recurrent patellar instability following knee surgery for which a doctor has prescribed a brace AND either a cane or a walker  – 30%
    • Unrepaired incomplete ligament tear causing persistent instability and for which a doctor has prescribed an assistive device such as a cane, crutch(es) or walker  – 20%
  • Recurrent patellar instability following knee surgery for which a doctor has prescribed a brace, cane or walker  – 20%
  • A sprain, a complete or incomplete ligament tear that does not require any assistive walking device  – 10%
  • Recurrent patellar instability following knee surgery for which does not require a brace, cane or walker  – 20%

Limitation of Flexion of the Leg (Diagnostic Code 5260)

Veterans who have a service connected injury that limits the flexion of their knee, that is the ability to bend their knee, will qualify for a disability rating as follows:

  • Flexion limited to 15 degrees – 30%
  • Flexion limited to 30 degrees – 20%
  • Flexion limited to 45 degrees – 10%
  • Flexion limited to 60 degrees – 0%

Limitation of Extension of the Leg (Diagnostic Code 5261)

Veterans who have a service connected injury that limits their ability to extend or straighten their legs will qualify for a disability rating as follows:

  • Extension limited to 45 degrees – 50%
  • Extension limited to 30 degrees – 40%
  • Extension limited to 20 degrees – 30%
  • Extension limited to 15 degrees – 20%
  • Extension limited to 10 degrees – 10%
  • Extension limited to 5 degrees – 0%

Impairment of the Tibia and Fibula (Diagnostic Code 5262)

While nonunion of the tibia and fibula with the knee complex for a service related injury should result in a 40% disability rating, the VA suggests malunion conditions be rated under the diagnostic codes detailed above.

Genu Recurvatum of the Knee (Diagnostic Code 5263)

Genu recurvatum or hyperextension of the knee involving weakness and a reduction in a veteran’s weight bearing capacity receives a VA disability rating of 10%

Conclusion

Knee injuries can be debilitating and require a lot of medical treatment. If you are a veteran who has been diagnosed with knee injuries, it is important to understand how the VA will rate them. We hope that this article has helped you learn more about how the VA rates knee disabilities.