Most veterans with service-connected knee injuries don't know that VA rates knee limitation under two separate diagnostic codes that measure different motions.
DC 5260 — Limitation of Flexion
| Maximum Flexion | VA Rating |
|---|---|
| 60° | 10% |
| 45° | 20% |
| 30° | 30% |
| 15° | 40% |
DC 5261 — Limitation of Extension
(0° = fully straight; higher numbers = more impaired)
| Extension Limited To | VA Rating |
|---|---|
| 5–10° | 10% |
| 15° | 20% |
| 20° | 30% |
| 30° | 40% |
| 45° | 50% |
The Painful Motion Rule — 38 CFR §4.59
This is the rule most veterans miss: if there is pain on ANY motion of the knee, the VA must assign at least the minimum compensable rating (10%) regardless of your measured ROM.
If your knee hurts when you start to bend or straighten it, tell the examiner explicitly: "I have pain with this motion." Never push through pain silently.
Flare-Up Documentation
If your everyday ROM on a bad day is significantly worse than what you show during a rested exam:
- Tell the examiner your typical flare-up ROM
- Have your physician document flare-up ROM in your medical records
- Keep a pain journal with ROM notes taken on high-pain days
Secondary Claims
Service-connected knee conditions commonly cause secondary conditions under 38 CFR §3.310:
- Hip conditions (altered gait)
- Lumbar spine DDD (compensatory stress)
- Ankle/foot (altered mechanics)
- Depression or PTSD (chronic pain)
File each secondary condition separately.
The Bilateral Factor
If both knees are service-connected, claim the bilateral factor under 38 CFR §4.26 — this adds 10% to the combined bilateral value before combination with other ratings.
Full threshold tables and painful motion language: outset-solutions.com/va-claims
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