Knee Flexion Limitation vs Knee Extension Limitation: VA Rating Comparison
How the VA rates Knee Flexion Limitation (diagnostic code 5260) compared with Knee Extension Limitation (diagnostic code 5261), under 38 CFR Part 4. This is a factual side-by-side of the rating criteria, the kind veterans look up when two conditions sound similar.
Rating criteria side by side
Knee Flexion Limitation
| 30% | Your leg can only bend forward 15 degrees at the knee or hip joint (flexion means bending a joint to bring two body parts closer together). To put this in perspective, a normal leg can bend about 120-140 degrees, so this represents severe limitation where you can barely bend your leg at all from a straight position. |
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| 20% | You can only bend your leg forward at the hip or knee to a maximum of 30 degrees (flexion means bending a joint). For comparison, a normal leg can typically bend about 90 degrees or more at the hip and over 130 degrees at the knee, so this represents a severe limitation in your ability to bend your leg. |
| 10% | You cannot bend your leg forward more than 45 degrees (flexion means bending a joint forward). A normal leg can bend about 120-130 degrees at the hip, so this rating applies when your leg movement is significantly restricted and you can only lift your leg less than halfway to what's considered normal range of motion. |
| 0% | You can only bend your leg forward to 60 degrees (flexion means bending a joint forward). A normal leg can bend about 120-135 degrees at the knee, so this rating applies when your leg movement is significantly restricted and you can only achieve less than half of normal bending range. |
Knee Extension Limitation
| 50% | Your leg cannot straighten out beyond 45 degrees from a bent position. This means when you try to extend (straighten) your leg fully, it gets stuck at about a 45-degree angle and cannot reach the normal straight position that a healthy leg can achieve. |
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| 40% | Your leg can only straighten out to 30 degrees, which means you cannot fully extend or straighten your leg. Extension refers to the movement of straightening your leg from a bent position, and normal full extension would be 0 degrees (completely straight). |
| 30% | Your knee can only straighten to within 20 degrees of being completely straight. This means when you try to fully extend your leg, it stops well short of the normal straight position that a healthy knee can achieve (which is 0 degrees or completely straight). |
| 20% | Your leg cannot straighten out fully and stops at 15 degrees short of being completely straight. This means when you try to extend your leg (straighten it out from a bent position), there's significant limitation in how far it can go, leaving it noticeably bent even when you're trying your hardest to make it straight. |
| 10% | Your leg can only straighten out to 10 degrees past a bent position. Extension means your ability to straighten your leg fully (like when you're standing up straight or lying flat), and this rating applies when your knee or hip joint is so stiff or damaged that it stops moving at just 10 degrees of straightening. |
| 0% | Your leg can only straighten out to within 5 degrees of being completely straight. Extension refers to your ability to fully straighten your leg at the knee joint, and this rating applies when you're missing just those last 5 degrees of motion from a normal, fully extended position. |
Criteria are summarized in plain language. The controlling text is the Schedule for Rating Disabilities, 38 CFR Part 4. Full criteria for each are on the Knee Flexion Limitation and Knee Extension Limitation code pages.
Can both be rated at the same time?
The VA generally does not rate the same disability twice. Under the anti-pyramiding rule (38 CFR 4.14), two conditions are rated separately only when they cause distinct, non-overlapping symptoms. When the symptoms overlap, the VA assigns a single rating under whichever code best fits. Whether Knee Flexion Limitation and Knee Extension Limitation can be rated separately depends on the symptoms documented in the evidence. See the pyramiding guide.
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