C&P Exam for Femur, impairment of (DC 5255)
Which form the examiner uses
For femur, impairment of (DC 5255), the C&P examiner completes the following Disability Benefits Questionnaire (DBQ):
- DBQ MUSC Hip and Thigh (public PDF on VA.gov)
DBQs are Department of Veterans Affairs Form 21-0960 series documents. Public DBQs are hosted on benefits.va.gov. A handful are examiner-only and are not posted publicly.
What the examiner records
The fields below are reproduced from the DBQ form the examiner completes for this diagnostic code. This is the structural map of the form, showing what the examiner is asked to measure, observe, and record. It is a factual reproduction of the public DBQ, not advice on how to answer.
This DBQ evaluates hip and thigh conditions including range of motion, ankylosis, femur impairment, and surgical procedures.
How DC 5255 maps to this DBQ: for this diagnostic code specifically, the examiner typically completes sections I-IV, VI-VIII, and XI-XIII of this form. Sections VI-VII are the condition-specific sections for this code. Sections V and IX-X cover unrelated conditions on this DBQ and are skipped.
DIAGNOSIS (Section I)
- List the claimed conditions that pertain to this questionnaire:
- The Veteran does not have a current diagnosis associated with any claimed conditions listed above.
- Osteoarthritis, hip — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Hip joint replacement — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Hip joint resurfacing — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Trochanteric pain syndrome (includes trochanteric bursitis) — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Femoral acetabular impingement syndrome (includes labral tears) — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Iliopsoas tendinitis — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Femoral neck stress fracture — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Avascular necrosis, hip — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Ankylosis of hip joint — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Degenerative arthritis, other than posttraumatic — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Arthritis, gonorrheal — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Arthritis, pneumococcic — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Arthritis, streptococcic — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Arthritis, syphilitic — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Arthritis, rheumatoid (multi-joints) — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Post-traumatic arthritis — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Arthritis, typhoid — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Other specified forms of arthropathy (excluding gout) (specify) — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Osteoporosis, residuals of — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Osteomalacia, residuals of — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Bones, neoplasm, benign — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Osteitis deformans — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Gout — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Bursitis — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Myositis — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Heterotopic ossification — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Tendinopathy (select one if known): Tendinitis / Tendinosis / Tenosynovitis — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Inflammatory other types (specify) — Side affected: Right / Left / Both; ICD Code; Date of diagnosis
- Other (specify) — Other diagnosis #1: Side affected, ICD Code, Date of diagnosis
- Other diagnosis #2: Side affected, ICD Code, Date of diagnosis
- Other diagnosis #3: Side affected, ICD Code, Date of diagnosis
MEDICAL HISTORY (Section II)
- 2A. Describe the history (including onset and course) of the Veteran's hip or thigh condition (brief summary):
- 2B. Does the Veteran report flare-ups of the hip or thigh? Yes / No
- If yes, document the Veteran's description of the flare-ups he/she experiences, including the frequency, duration, characteristics, precipitating and alleviating factors, severity and/or extent of functional impairment he or she experiences during a flare-up of symptoms.
- 2C. Does the Veteran report having any functional loss or functional impairment of the joint or extremity being evaluated on this questionnaire, including but not limited to after repeated use over time? Yes / No
- If yes, document the Veteran's description of functional loss or functional impairment in his/her own words.
RANGE OF MOTION (ROM) AND FUNCTIONAL LIMITATION (Section III)
- 3A. Initial ROM measurements — All normal / Abnormal or outside of normal range / Unable to test / Not indicated
- If ROM is outside of 'normal' range, but is normal for the Veteran (for reason other than a hip/thigh condition, such as age, body habitus, neurologic disease), please describe:
- If abnormal, does the range of motion itself contribute to a functional loss? Yes / No
- Can testing be performed? Yes / No
- If this is the unclaimed joint, is it: Damaged / Undamaged
- Active ROM — Flexion endpoint (125 degrees): degrees
- Active ROM — Extension endpoint (30 degrees): degrees
- Active ROM — Abduction endpoint (45 degrees): degrees
- Active ROM — Adduction endpoint (25 degrees): degrees
- Active ROM — External rotation endpoint (60 degrees): degrees
- Active ROM — Internal rotation endpoint (40 degrees): degrees
- If noted on examination, which ROM exhibited pain (select all that apply): Flexion / Extension / Abduction / Adduction / External Rotation / Internal Rotation
- If any limitation of motion is specifically attributable to pain, weakness, fatigability, incoordination, or other; please note the degree(s) in which limitation of motion is specifically attributable to the factors identified and describe.
- Flexion degree endpoint (if different than above)
- Extension degree endpoint (if different than above)
- Abduction degree endpoint (if different than above)
- Adduction degree endpoint (if different than above)
- External Rotation degree endpoint (if different than above)
- Internal Rotation degree endpoint (if different than above)
- Does a limitation in adduction prevent the Veteran from crossing his/her legs? Yes / No
- Passive ROM — Flexion endpoint (125 degrees): degree / Same as active ROM
- Passive ROM — Extension endpoint (30 degrees): degree / Same as active ROM
- Passive ROM — Abduction endpoint (45 degrees): degree / Same as active ROM
- Passive ROM — Adduction endpoint (25 degrees): degree / Same as active ROM
- Passive ROM — External rotation endpoint (60 degrees): degree / Same as active ROM
- Passive ROM — Internal rotation endpoint (40 degrees): degree / Same as active ROM
- If noted on examination, which ROM exhibited pain (passive) (select all that apply): Flexion / Extension / Abduction / Adduction / External Rotation / Internal Rotation
- Does a limitation in passive adduction prevent the Veteran from crossing his/her legs? Yes / No
- Is there evidence of pain? Yes / No — weight-bearing / nonweight-bearing / active motion / passive motion / on rest/non-movement / causes functional loss / does not result in/cause functional loss
- Is there objective evidence of crepitus? Yes / No
- Is there objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue? Yes / No
- 3B. Is the Veteran able to perform repetitive-use testing with at least three repetitions? Yes / No
- Is there additional loss of function or range of motion after three repetitions? Yes / No
- Flexion endpoint after three repetitions (125 degrees): degrees
- Extension endpoint after three repetitions (30 degrees): degrees
- Abduction endpoint after three repetitions (45 degrees): degrees
- Adduction endpoint after three repetitions (25 degrees): degrees
- External rotation endpoint after three repetitions (60 degrees): degrees
- Internal rotation endpoint after three repetitions (40 degrees): degrees
- Does limitation in adduction after observed repetitive use prevent the Veteran from crossing his/her legs? Yes / No
- Select factors that cause this functional loss: Pain / Fatigability / Weakness / Lack of endurance / Incoordination / Other / N/A
- 3C. Is the Veteran being examined immediately after repeated use over time? Yes / No
- Does procured evidence (statements from the Veteran) suggest pain, fatigability, weakness, lack of endurance, or incoordination which significantly limits functional ability with repeated use over time? Yes / No
- Select factors that cause this functional loss (repeated use over time): Pain / Fatigability / Weakness / Lack of endurance / Incoordination / Other / N/A
- Estimate range of motion — Flexion endpoint after repeated use over time (125 degrees): degrees
- Estimate range of motion — Extension endpoint after repeated use over time (30 degrees): degrees
- Estimate range of motion — Abduction endpoint after repeated use over time (45 degrees): degrees
- Estimate range of motion — Adduction endpoint after repeated use over time (25 degrees): degrees
- Estimate range of motion — External rotation endpoint after repeated use over time (60 degrees): degrees
- Estimate range of motion — Internal rotation endpoint after repeated use over time (40 degrees): degrees
- Please cite and discuss evidence. (Must be specific to the case and based on all procurable evidence.)
- Does limitation in adduction after repeated use over time prevent the Veteran from crossing his/her legs? Yes / No
- 3D. Is the examination being conducted during a flare-up? Yes / No
- Does procured evidence (statements from the Veteran) suggest pain, fatigability, weakness, lack of endurance, or incoordination which significantly limits functional ability with flare-ups? Yes / No
- Select factors that cause this functional loss (flare-ups): Pain / Fatigability / Weakness / Lack of endurance / Incoordination / Other / N/A
- Estimate range of motion during flare-ups — Flexion endpoint (125 degrees): degrees
- Estimate range of motion during flare-ups — Extension endpoint (30 degrees): degrees
- Estimate range of motion during flare-ups — Abduction endpoint (45 degrees): degrees
- Estimate range of motion during flare-ups — Adduction endpoint (25 degrees): degrees
- Estimate range of motion during flare-ups — External rotation endpoint (60 degrees): degrees
- Estimate range of motion during flare-ups — Internal rotation endpoint (40 degrees): degrees
- Please cite and discuss evidence. (Must be specific to the case and based on all procurable evidence.)
- Does limitation in adduction during flare-ups prevent the Veteran from crossing his/her legs? Yes / No
- 3E. In addition to those addressed above, are there additional contributing factors of disability? Please select all that apply and describe: None / Interference with standing / Disturbance of locomotion / Less movement than normal / Weakened movement / Instability of station / Interference with sitting / Swelling / Deformity / More movement than normal / Atrophy of disuse / Other, describe
- Please describe additional contributing factors of disability:
MUSCLE ATROPHY (Section IV)
- 4A. Does the Veteran have muscle atrophy? Yes / No
- 4B. If yes, is the muscle atrophy due to the claimed condition in the diagnosis section? Yes / No — If no, provide rationale:
- 4C. Specify location of atrophy (e.g. '10cm above or below the hip'):
- Circumference of more normal side: cm
- Circumference of atrophied side: cm
ANKYLOSIS (Section V)
- 5A. Is there ankylosis of the hip and/or thigh? Yes / No
- If yes, indicate the severity of ankylosis: Unfavorable, extremely unfavorable ankylosis, foot not reaching ground, crutches needed / Intermediate, between favorable and unfavorable / Favorable, in flexion at an angle between 20 and 40 degrees, and slight abduction or adduction
FEMUR OR FLAIL HIP JOINT IMPAIRMENT (Section VI)
- 6A. Does the Veteran have malunion or non union of femur, flail hip joint or leg length discrepancy? Yes / No
- Fracture of shaft or neck (anatomical), with nonunion with loose motion (spiral or oblique fracture)
- Fracture of shaft or neck (anatomical), resulting in nonunion without loose motion; weight-bearing preserved with aid of brace
- Fracture of surgical neck with false joint
- Malunion of the femur
- Flail hip joint
- Leg length discrepancy (shortening of any bones of the lower extremity)
- Measurements: Right leg: cm / inch
- Measurements: Left leg: cm / inch
- For any leg length discrepancy, please describe the relationship to the conditions listed in the diagnosis section above:
SURGICAL PROCEDURES (Section VII)
- 7A. Indicate any surgical procedures that the Veteran has had performed (check all that apply): No surgery
- Hip joint resurfacing — Date of surgery:
- Total hip joint replacement — Date of surgery:
- Total hip joint replacement residuals: None / Moderately severe residuals of weakness, pain or limitation of motion / Markedly severe residuals of weakness, pain or limitation of motion following implantation of prosthesis / Following implantation of prosthesis with painful motion or weakness such as to require the use of crutches / Other, describe:
- Arthroscopic ligament repair — Date of surgery:
- Other surgery not described (specify below): Date of surgery / Type of surgery:
- Residuals of arthroscopic or other hip surgery — Describe residuals:
OTHER PERTINENT PHYSICAL FINDINGS, COMPLICATIONS, CONDITIONS, SIGNS, SYMPTOMS, AND SCARS (Section VIII)
- 8A. Does the Veteran have any other pertinent physical findings, complications, conditions, signs or symptoms related to any conditions listed in the diagnosis section above? Yes / No — If yes, describe (brief summary)
- 8B. Does the Veteran have any scars or other disfigurement (of the skin) related to any conditions or to the treatment of any conditions listed in the diagnosis section above? Yes / No
ASSISTIVE DEVICES (Section IX)
- 9A. Does the Veteran use any assistive devices as a normal mode of locomotion, although occasional locomotion by other methods may be possible? Yes / No
- Wheelchair — Frequency of use: Occasional / Regular / Constant
- Brace for ambulation — Frequency of use: Occasional / Regular / Constant
- Crutches — Frequency of use: Occasional / Regular / Constant
- Cane(s) — Frequency of use: Occasional / Regular / Constant
- Walker — Frequency of use: Occasional / Regular / Constant
- Other, describe: — Frequency of use: Occasional / Regular / Constant
- 9B. If the Veteran uses any assistive devices, specify the condition, indicate the side, and identify the assistive device used for each condition.
REMAINING EFFECTIVE FUNCTION OF THE EXTREMITIES (Section X)
- 10A. Due to the Veterans hip or thigh condition(s), is there functional impairment of an extremity such that no effective functions remain other than that which would be equally well served by an amputation with prosthesis (functions of the lower extremity include balance and propulsion, etc.)? Yes, functioning is so diminished that amputation with prosthesis would equally serve the Veteran / No
- If yes, indicate extremities for which this applies: Right lower / Left lower
- 10B. For each checked extremity, identify the condition causing loss of function, describe loss of effective function and provide specific examples (brief summary):
DIAGNOSTIC TESTING (Section XI)
- 11A. Have imaging studies been performed in conjunction with this examination? Yes / No
- 11B. If yes, is degenerative or post-traumatic arthritis documented? Yes / No — Indicate side: Right / Left / Both
- 11C. If yes provide type of test or procedure, date and results (brief summary):
- 11D. Are there any other significant diagnostic test findings or results related to the claimed condition(s) and/or diagnosis(es), that were reviewed in conjunction with this examination? Yes / No — If yes, provide type of test or procedure, date and results (brief summary):
- 11E. If any test results are other than normal, indicate relationship of abnormal findings to diagnosed conditions:
FUNCTIONAL IMPACT (Section XII)
- 12A. Regardless of the Veteran's current employment status, do the conditions listed in the diagnosis section impact his/her ability to perform any type of occupational task (such as standing, walking, lifting, sitting, etc.)? Yes / No
- If yes, describe the functional impact of each condition, providing one or more examples:
REMARKS (Section XIII)
- 13A. Remarks (if any - please identify the section to which the remark pertains when appropriate).
Rating Levels for DC 5255
The following tiers are reproduced from 38 CFR Part 4, the VA Schedule for Rating Disabilities. Toggle between the official VA criteria and a Plain English explanation.
Plain-English summaries are AI-generated to explain the official criteria. The official 38 CFR language is the binding legal standard. When in doubt, ask a VSO.
Evidence cited in published BVA decisions for DC 5255
The counts below are aggregated from published Board of Veterans Appeals decisions for this diagnostic code. Each row reports how often a given evidence type was discussed in the decision text, broken down by outcome. This is a factual aggregate of the public record, not a prediction or recommendation about any specific claim.
- Service treatment records: appeared in 1 granted decision (0 denied, 1 remanded; 2 total)
- VA examination: appeared in 0 granted decisions (1 denied, 2 remanded; 3 total)
- Private medical opinion: appeared in 0 granted decisions (0 denied, 1 remanded; 1 total)
- Buddy / lay statements: appeared in 0 granted decisions (0 denied, 2 remanded; 2 total)
- Nexus letter: appeared in 0 granted decisions (0 denied, 1 remanded; 1 total)
- Medical literature: appeared in 0 granted decisions (0 denied, 1 remanded; 1 total)
What the Board discussed in granted decisions for DC 5255
The themes below were extracted by clustering 500 grant-factor sentences from published Board of Veterans Appeals decisions for this diagnostic code. Frequencies indicate how often each theme appeared in the sample. This is a factual aggregate of the public record, not advice or strategy for any specific claim.
- 27% Benefit of doubt statutory standard cited or restatedThe Board or decision recited the legal standard that when positive and negative evidence is in approximate balance on a material issue, VA shall give the benefit of the doubt to the claimant.134 of 500 sample sentences
- 22% Evidence in equipoise, benefit of doubt applied, claim grantedThe Board found the evidence at least in relative equipoise on a material issue and resolved the benefit of the doubt in the Veteran's favor to grant or increase the rating.112 of 500 sample sentences
- 21% Preponderance against claim, benefit of doubt inapplicableThe Board found the preponderance of evidence weighed against the claim and therefore concluded the benefit of the doubt doctrine was not for application and the claim was denied.104 of 500 sample sentences
- 11% Medical nexus opinion noting at-least-as-likely-as-not relationshipAn examiner or clinician opined that a current disability was at least as likely as not caused by, related to, or aggravated by service or a service-connected condition.57 of 500 sample sentences
- 7% Specific rating level awarded with benefit of doubt appliedThe Board cited the benefit of the doubt doctrine as the basis for assigning a particular disability percentage rating under a specific diagnostic code for a femur, hip, or related condition.35 of 500 sample sentences
- 4% Secondary service connection established, benefit of doubt resolved favorablyThe Board found the evidence in equipoise as to whether a disability was proximately due to or aggravated by a service-connected condition and resolved the benefit of the doubt in the Veteran's favor to grant secondary service connection.18 of 500 sample sentences
- 3% TDIU granted on equipoise or benefit of doubt basisThe Board found the evidence at least in equipoise that service-connected disabilities rendered the Veteran unable to secure or maintain substantially gainful employment and awarded a total disability rating accordingly.16 of 500 sample sentences
- 3% Functional limitation and pain credited, benefit of doubt applied to ratingThe Board accorded significant probative value to the Veteran's credible reports of pain, weakness, and functional limitation and applied the benefit of the doubt to find the disability picture more nearly approximated a higher rating.16 of 500 sample sentences
- 2% Board noted benefit of doubt considered but doctrine inapplicable where law dispositiveThe Board noted that it considered the benefit of the doubt doctrine but observed the doctrine does not apply where the law rather than the facts is dispositive, or where evidence is not in approximate balance.8 of 500 sample sentences
Disclaimer: This page reproduces public Department of Veterans Affairs forms (DBQs) and verbatim text from 38 CFR Part 4 (the VA Schedule for Rating Disabilities). It is informational only and is not legal or medical advice. For guidance on a specific claim, contact a VA-accredited representative.