Knee Replacement vs Knee Instability: VA Rating Comparison
How the VA rates Knee Replacement (diagnostic code 5055) compared with Knee Instability (diagnostic code 5257), 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 Replacement
| 100% | If you have had knee replacement surgery or knee resurfacing surgery (a procedure where the damaged surfaces of the knee joint are replaced), you automatically qualify for this rating for the first 4 months following surgery while you are recovering. |
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| 60% | You have a knee replacement or resurfacing surgery and experience severe ongoing problems as a result. These chronic residuals (long-lasting complications) must include either severe pain when moving the knee or significant weakness in that leg that affects your daily activities and mobility. |
| 30% | This is the minimum (floor) rating for a total knee replacement, you cannot be rated below 30% once you've had the entire knee joint replaced with a prosthesis. It applies only to full knee replacements, not partial procedures like resurfacing. If your residual symptoms warrant a higher rating under another knee code, that higher rating applies instead. |
Knee Instability
| 30% | Your knee keeps slipping out of place (subluxation) or is unstable because you have a completely torn ligament that either wasn't surgically repaired or the surgery didn't work. Your doctor has prescribed both an assistive walking device like a cane, crutches, or walker AND a knee brace that you need to use together when walking. |
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| 20% | You qualify for 20% on either of two paths. PATH A: you have a sprain, an incomplete ligament tear, or a fully torn ligament that was successfully repaired by surgery, and your knee is still unstable enough that your doctor has prescribed a brace and/or a walking aid (cane, crutches, walker). PATH B: you have a fully torn ligament that was never repaired or the repair failed, and your doctor has prescribed either a brace OR a walking aid (not both — both gets you to 30%). |
| 10% | You have a knee injury involving damaged ligaments - either a sprain (stretched ligament), partial tear, or complete tear of a ligament that may or may not have been surgically repaired. This injury causes your knee to feel unstable or give way during normal activities, but your symptoms are manageable enough that your doctor hasn't prescribed you a cane, crutches, walker, or knee brace to help you walk. |
| 30% | You have an unstable kneecap (patella) condition where your kneecap keeps sliding out of place or dislocating, even after you've had surgery to try to fix it. A doctor must have prescribed you a knee brace AND either a cane or walker because your knee is so unstable that you need these devices to move around safely. |
| 20% | Your kneecap (patella) keeps slipping out of place or feels unstable even after you've had surgery to fix it. A doctor must prescribe you a brace, cane, or walker to help you move around safely because of this ongoing knee instability. |
| 10% | Your kneecap (patella) frequently slips out of place or feels unstable when you move, and this has been diagnosed by a doctor as a problem with how your kneecap sits in the groove of your thigh bone (patellofemoral complex). The instability happens repeatedly but is not severe enough that your doctor has prescribed a brace, cane, or walker to help you get around, whether or not you've had surgery to try to fix the problem. |
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 Replacement and Knee Instability 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 Replacement and Knee Instability can be rated separately depends on the symptoms documented in the evidence. See the pyramiding guide.
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