VA Diagnostic Code 5257Knee, other impairment of:
Rated from 10% to 30% under § 4.71a. Here is what the VA requires at each level.
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What each rating requires
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- 30%
Recurrent subluxation or instability: Unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribes both an assistive device (e.g., cane(s), crutch(es), walker) and bracing for ambulation
- 20%
Recurrent subluxation or instability: One of the following: (a) Sprain, incomplete ligament tear, or repaired complete ligament tear causing persistent instability, and a medical provider prescribes a brace and/or assistive device (e.g., cane(s), crutch(es), walker) for ambulation. (b) Unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribes either an assistive device (e.g., cane(s), crutch(es), walker) or bracing for ambulation
- 10%
Recurrent subluxation or instability: Sprain, incomplete ligament tear, or complete ligament tear (repaired, unrepaired, or failed repair) causing persistent instability, without a prescription from a medical provider for an assistive device (e.g., cane(s), crutch(es), walker) or bracing for ambulation
- 30%
Patellar instability: A diagnosed condition involving the patellofemoral complex with recurrent instability after surgical repair that requires a prescription by a medical provider for a brace and either a cane or a walker
- 20%
Patellar instability: A diagnosed condition involving the patellofemoral complex with recurrent instability after surgical repair that requires a prescription by a medical provider for one of the following: A brace, cane, or walker
- 10%
Patellar instability: A diagnosed condition involving the patellofemoral complex with recurrent instability (with or without history of surgical repair) that does not require a prescription from a medical provider for a brace, cane, or walker
Notes on this code
These notes are part of the regulation. They change how the levels above are applied.
- Note (1): For patellar instability, the patellofemoral complex consists of the quadriceps tendon, the patella, and the patellar tendon.
- Note (2): A surgical procedure that does not involve repair of one or more patellofemoral components that contribute to the underlying instability shall not qualify as surgical repair for patellar instability (including, but not limited to, arthroscopy to remove loose bodies and joint aspiration).
Knee — Other Impairment (VA Diagnostic Code 5257)
Musculoskeletal System · 38 CFR § 4.71a
Understanding This Rating
VA Diagnostic Code 5257 covers "other impairment" of the knee, which specifically addresses two types of knee problems: recurrent subluxation or instability and patellar instability.
- Recurrent subluxation or instability refers to a knee that gives way or shifts out of place, often connected to a ligament sprain, an incomplete ligament tear, or a complete ligament tear (whether it was repaired, left unrepaired, or where a repair failed).
- Patellar instability refers to a diagnosed condition involving the patellofemoral complex — which, per VA notes, consists of the quadriceps tendon, the patella, and the patellar tendon — that causes recurrent instability.
A key factor in how VA rates these conditions is whether a medical provider has prescribed a brace and/or an assistive device (such as a cane, crutches, or a walker) to help you walk.
Rating Levels
VA evaluates this condition along two separate tracks. Below are the criteria described in the rating schedule.
Recurrent Subluxation or Instability
| Rating | What the criteria describe |
|---|---|
| 30% | Unrepaired or failed repair of a complete ligament tear causing persistent instability, where a medical provider prescribes both an assistive device (e.g., cane(s), crutch(es), walker) and bracing for ambulation. |
| 20% | Either: (a) a sprain, incomplete ligament tear, or repaired complete ligament tear causing persistent instability, with a provider prescribing a brace and/or an assistive device; or (b) an unrepaired or failed repair of a complete ligament tear causing persistent instability, with a provider prescribing either an assistive device or bracing. |
| 10% | A sprain, incomplete ligament tear, or complete ligament tear (repaired, unrepaired, or failed repair) causing persistent instability, without a provider's prescription for an assistive device or bracing for ambulation. |
Patellar Instability
| Rating | What the criteria describe |
|---|---|
| 30% | A diagnosed condition involving the patellofemoral complex with recurrent instability after surgical repair that requires a provider's prescription for a brace and either a cane or a walker. |
| 20% | A diagnosed condition involving the patellofemoral complex with recurrent instability after surgical repair that requires a provider's prescription for one of the following: a brace, cane, or walker. |
| 10% | A diagnosed condition involving the patellofemoral complex with recurrent instability (with or without a history of surgical repair) that does not require a provider's prescription for a brace, cane, or walker. |
What the VA Looks For
When rating a knee under Diagnostic Code 5257, the VA considers:
- The type and status of the injury — whether it involves a sprain, an incomplete ligament tear, or a complete ligament tear, and whether that tear was repaired, left unrepaired, or where a repair failed.
- Persistent instability — evidence that the knee continues to be unstable.
- Prescribed medical support — whether a medical provider has prescribed a brace, an assistive device (cane, crutches, walker), or both, and in what combination.
- For patellar instability specifically — whether the condition involves the patellofemoral complex and whether there is a history of surgical repair.
Important note on surgical repair (Note 2): For patellar instability, a surgical procedure that does not involve repair of one or more patellofemoral components contributing to the underlying instability does not count as surgical repair. This includes, but is not limited to, arthroscopy to remove loose bodies and joint aspiration.
This information summarizes the rating criteria found in 38 CFR § 4.71a, Diagnostic Code 5257. It is provided for general educational purposes. Individual ratings depend on your specific medical evidence as evaluated by the VA.
These criteria are a rendering of § 4.71a, diagnostic code 5257. The official version is the one that governs your rating.
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