C&P Exam for Knee, other impairment of (DC 5257)

Diagnostic code: 5257Condition: Knee, other impairment ofRegulation: 38 CFR § 4.71aDBQ: DBQ MUSC Knee and Lower Leg

Which form the examiner uses

For knee, other impairment of (DC 5257), the C&P examiner completes the following Disability Benefits Questionnaire (DBQ):

DBQ MUSC Knee and Lower Leg (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 knee and lower leg conditions including range of motion, ankylosis, joint stability, tibial/fibular impairment, meniscal conditions, and surgical procedures.

How DC 5257 maps to this DBQ: for this diagnostic code specifically, the examiner typically completes sections I-IV, VI, X, and XIII-XV of this form. Section VI is the condition-specific section for this code. Sections V, VII-IX, and XI-XII cover unrelated conditions on this DBQ and are skipped.

DIAGNOSIS (Section I)

1A. List the claimed condition(s) that pertain to this questionnaire
1B. Select diagnoses associated with the claimed condition(s) (check all that apply)
The Veteran does not have a current diagnosis associated with any claimed condition(s) listed above.
Knee strain - Side affected / ICD Code / Date of diagnosis
Knee meniscal tear - Side affected / ICD Code / Date of diagnosis
Knee anterior cruciate ligament tear - Side affected / ICD Code / Date of diagnosis
Knee posterior cruciate ligament tear - Side affected / ICD Code / Date of diagnosis
Patellar or quadriceps tendon rupture - Side affected / ICD Code / Date of diagnosis
Knee joint osteoarthritis - Side affected / ICD Code / Date of diagnosis
Knee joint ankylosis - Side affected / ICD Code / Date of diagnosis
Knee fracture (including patellar fracture) - Side affected / ICD Code / Date of diagnosis
Stress fracture of tibia - Side affected / ICD Code / Date of diagnosis
Tibia and/or fibula fracture - Side affected / ICD Code / Date of diagnosis
Recurrent patellar dislocation - Side affected / ICD Code / Date of diagnosis
Recurrent subluxation - Side affected / ICD Code / Date of diagnosis
Knee instability - Side affected / ICD Code / Date of diagnosis
Patellar instability - Side affected / ICD Code / Date of diagnosis
Knee cartilage restoration surgery - Side affected / ICD Code / Date of diagnosis
Shin splints/medial tibial stress syndrome - MTSS (including post-surgery or treatment) - Side affected / ICD Code / Date of diagnosis
Patellofemoral pain syndrome - Side affected / ICD Code / Date of diagnosis
Degenerative arthritis, other than post traumatic - Side affected / ICD Code / Date of diagnosis
Arthritis, gonorrheal - Side affected / ICD Code / Date of diagnosis
Arthritis, pneumococcic - Side affected / ICD Code / Date of diagnosis
Arthritis, streptococcic - Side affected / ICD Code / Date of diagnosis
Arthritis, syphilitic - Side affected / ICD Code / Date of diagnosis
Arthritis, rheumatoid (multi-joints) - Side affected / ICD Code / Date of diagnosis
Post-traumatic arthritis - Side affected / ICD Code / Date of diagnosis
Arthritis, typhoid - Side affected / ICD Code / Date of diagnosis
Other specified forms of arthropathy (excluding gout) - Side affected / ICD Code / Date of diagnosis / Specify
Osteoporosis, residuals of - Side affected / ICD Code / Date of diagnosis
Osteomalacia, residuals of - Side affected / ICD Code / Date of diagnosis
Bones, neoplasm, benign - Side affected / ICD Code / Date of diagnosis
Osteitis deformans - Side affected / ICD Code / Date of diagnosis
Gout - Side affected / ICD Code / Date of diagnosis
Bursitis - Side affected / ICD Code / Date of diagnosis
Myositis - Side affected / ICD Code / Date of diagnosis
Heterotopic ossification - Side affected / ICD Code / Date of diagnosis
Tendinopathy (select one if known) - Tendinitis / Tendinosis / Tenosynovitis - Side affected / ICD Code / Date of diagnosis
Inflammatory other types - Side affected / ICD Code / Date of diagnosis / Specify
Other (specify) - Other diagnosis #1 / #2 / #3 - Side affected / ICD Code / Date of diagnosis
1C. If there are additional diagnoses that pertain to knee conditions, list using above format

MEDICAL HISTORY (Section II)

2A. Describe the history, including onset and course, of the Veteran's knee and/or lower leg condition(s). Brief summary
2B. Does the Veteran report flare-ups of the knee and/or lower leg?
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?
If yes, document the Veteran's description of functional loss or functional impairment in his/her own words.
2D. Does the Veteran report or have a history of instability or recurrent subluxation of the knee?
If yes, document the Veteran's description of instability/recurrent subluxation in his/her own words.
2E. Does the Veteran report or have a history of frequent effusion of the knee?
If yes, is the frequent effusion a result of a diagnosis in Section 1? Describe below

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 'Unable to test' or 'Not indicated' please explain
If ROM is outside of 'normal' range, but is normal for the Veteran (for reason other than a knee/lower leg 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 - If yes, please explain
Can testing be performed? Yes / No - If no, provide an explanation
If this is the unclaimed joint, is it: Damaged / Undamaged
Active Range of Motion (ROM) - Flexion endpoint (140 degrees): degrees
Active Range of Motion (ROM) - Extension endpoint (0 degrees): degrees
If noted on examination, which ROM exhibited pain (select all that apply): Flexion / Extension
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)
Passive Range of Motion - Flexion endpoint (140 degrees): degrees / Same as active ROM
Passive Range of Motion - Extension endpoint (0 degrees): degrees / Same as active ROM
If noted on examination, which passive ROM exhibited pain (select all that apply): Flexion / Extension
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)
Is there evidence of pain? Yes / No - If yes, check all that apply: weight-bearing / nonweight-bearing / active motion / passive motion / on rest/non-movement / does not result in/cause functional loss / causes functional loss
Comments
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 - If yes, please explain. Include location, severity, and relationship to condition(s).
3B. Observed repetitive use ROM - Is the Veteran able to perform repetitive-use testing with at least three repetitions? Yes / No - If no, please explain
Is there additional loss of function or range of motion after three repetitions? Yes / No
If yes - Flexion endpoint (140 degrees): degrees
If yes - Extension endpoint (0 degrees): degrees
Select factors that cause this functional loss. Check all that apply: Pain / Fatigability / Weakness / Lack of endurance / Incoordination / Other / N/A
3C. Repeated use over time - 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. Check all that apply: Pain / Fatigability / Weakness / Lack of endurance / Incoordination / Other / N/A
Estimate range of motion in degrees for this joint immediately after repeated use over time - Flexion endpoint (140 degrees): degrees
Estimate range of motion in degrees for this joint immediately after repeated use over time - Extension endpoint (0 degrees): degrees
Please cite and discuss evidence. (Must be specific to the case and based on all procurable evidence.)
3D. Flare-ups - 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. Check all that apply: Pain / Fatigability / Weakness / Lack of endurance / Incoordination / Other / N/A
Estimate range of motion in degrees for this joint during flare-ups - Flexion endpoint (140 degrees): degrees
Estimate range of motion in degrees for this joint during flare-ups - Extension endpoint (0 degrees): degrees
Please cite and discuss evidence. (Must be specific to the case and based on all procurable evidence.)
3E. Additional factors contributing to disability - None / Interference with sitting / Interference with standing / Swelling / Disturbance of locomotion / Deformity / Less movement than normal / More movement than normal / nonunion of fracture / Weakened movement / Atrophy of disuse / Instability of station / 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. For any muscle atrophy due to a diagnosis listed in Section I, indicate specific location of atrophy - Right lower extremity (specify location of measurement such as '10cm above or below knee')
Circumference of more normal side: cm
Circumference of atrophied side: cm
4C. For any muscle atrophy due to a diagnosis listed in Section I, indicate specific location of atrophy - Left lower extremity (specify location of measurement such as '10cm above or below knee')
Circumference of more normal side: cm
Circumference of atrophied side: cm

ANKYLOSIS (Section V)

5A. Is there ankylosis of the knee and/or lower leg? Yes / No
If yes, indicate the severity of ankylosis: Favorable angle in full extension or in slight flexion between 0 and 10 degrees / In flexion between 10 and 20 degrees / In flexion between 20 and 45 degrees / Extremely unfavorable, in flexion at an angle of 45 degrees or more
5B. Indicate angle of ankylosis in degrees. degrees / N/A no ankylosis of knee joint
5C. If ankylosed, is there involvement of Muscle Group XIII (posterior thigh group, hamstring complex of 2-joint muscles: (1) biceps femoris; (2) semimembranosus; (3) semitendinosus)? Yes / No

JOINT STABILITY (Section VI)

6A. Is there recurrent subluxation or persistent instability? Yes / No
6B. Is there or has there been a ligament tear (sprain)? Yes / No - If yes, select one of the following: Complete ligament tear / Incomplete/partial ligament tear
6C. Was the ligament tear repaired? Yes / No - If yes, select one of the following: Complete tear repair- successful / Complete tear repair- failed
6D. Does the Veteran require a prescription (by a medical provider) of any of the following for ambulation? Yes / No - If yes, check all that apply: Cane(s) / Walker / Crutches / Brace(s)
6E. Is there recurrent patellar instability? Yes / No
6F. Has the Veteran had surgical repair of the knee for patellar instability? Yes / No - If yes, please describe
6G. Does the Veteran require a prescription (by a medical provider) of any of the following for ambulation with patellar instability? Yes / No - If yes, check all that apply: Cane(s) / Walker / Crutches / Brace(s)

TIBIAL OR FIBULAR IMPAIRMENT (Section VII)

7A. Does the Veteran currently have or has the Veteran been diagnosed with a recurrent patellar dislocation, shin splints (medial tibial stress syndrome), stress fractures, or any other tibial or fibular impairment? Yes / No
If yes, indicate condition: Stress fracture of the lower leg / Describe current symptoms
Acquired and/or traumatic genu recurvatum with objectively demonstrated weakness and insecurity in weight-bearing.
Recurrent patellar dislocation
'Shin Splints' (medial tibial stress syndrome - MTSS) - Indicate length of treatment: no treatment received / treatment for less than 12 consecutive months / requiring treatment for 12 consecutive months or more
If Veteran underwent treatment, indicate response to treatment: responsive to surgery and/or treatment / unresponsive to either shoe orthotics or other conservative treatment / unresponsive to surgery and either shoe orthotics or other conservative treatment
Leg length discrepancy (shortening of any bones of the lower extremity) - Measurements: Right leg cm / inch; Left leg cm / inch
For any leg length discrepancy, please describe the relationship to the conditions listed in the diagnosis section above

MENISCAL CONDITIONS (Section VIII)

8A. Does the Veteran currently have or has the Veteran been diagnosed with a meniscus (semilunar cartilage) condition? Yes / No
If yes, indicate severity and frequency of symptoms: No current symptoms / Meniscal dislocation / Meniscal tear / Frequent episodes of joint 'locking' / Frequent episodes of joint pain / Frequent episodes of joint effusion
For all checked boxes above, describe

SURGICAL PROCEDURES (Section IX)

9A. Indicate any surgical procedures that the Veteran has had performed (check all that apply): No surgery
Knee joint resurfacing - Date of surgery
Total knee joint replacement - Date of surgery
Total knee joint replacement residuals: None / Intermediate degrees of residual weakness, pain, or limitation of motion / Chronic residuals consisting of severe painful motion or weakness / Other residuals, describe
Meniscectomy - Date of surgery
Arthroscopic ligament repair - Date of surgery
Other surgery not described (specify below) - Date of surgery / Type of surgery
Residual signs of symptoms due to meniscectomy, arthroscopic ligament repair or other knee surgery not described above - Describe residuals

OTHER PERTINENT PHYSICAL FINDINGS, COMPLICATIONS, CONDITIONS, SIGNS, SYMPTOMS, AND SCARS (Section X)

10A. 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)
10B. 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? Yes / No

ASSISTIVE DEVICES (Section XI)

11A. Does the Veteran use any assistive devices (other than those noted in Section VI) 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 - 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
11B. 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 XII)

12A. Due to the Veterans knee or lower leg condition(s), is there functional impairment of an extremity such that no effective function remains 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
12B. 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 XIII)

13A. Have clinically relevant diagnostic imaging studies or other diagnostic procedures been performed or reviewed in conjunction with this examination? Yes / No
13B. If yes, is degenerative or post-traumatic arthritis documented? Yes / No - If yes, indicate side: Right / Left / Both
13C. If yes, provide type of test or procedure, date, and results (brief summary)
13D. Are there any other clinically relevant 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)
13E. If any test results are other than normal, indicate relationship of abnormal findings to diagnosed conditions

FUNCTIONAL IMPACT (Section XIV)

14A. 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 XV)

15A. Remarks (if any - please identify the section to which the remark pertains when appropriate).

Rating Levels for DC 5257

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 5257

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.

VA examination: appeared in 35 granted decisions (34 denied, 109 remanded; 178 total)
Private medical opinion: appeared in 24 granted decisions (9 denied, 15 remanded; 48 total)
Medical literature: appeared in 15 granted decisions (1 denied, 4 remanded; 20 total)
Buddy / lay statements: appeared in 9 granted decisions (10 denied, 10 remanded; 29 total)
Nexus letter: appeared in 4 granted decisions (7 denied, 4 remanded; 15 total)
Service treatment records: appeared in 1 granted decision (7 denied, 7 remanded; 15 total)

What the Board discussed in granted decisions for DC 5257

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.

28% Benefit of doubt doctrine cited as legal standard
The Board or decision cited the statutory or regulatory benefit of the doubt standard, noting that when evidence is in approximate balance the claimant prevails.
139 of 500 sample sentences
19% Preponderance against claim, benefit of doubt not applicable
The Board found the weight of evidence persuasively against the claim and noted the benefit of the doubt doctrine was therefore inapplicable.
94 of 500 sample sentences
16% Benefit of doubt applied to grant specific rating
The Board affirmatively applied the benefit of the doubt to resolve equivocal evidence in the Veteran's favor and assigned a specific disability rating percentage.
81 of 500 sample sentences
13% At-least-as-likely-as-not nexus opinion cited
A VA or private examiner's opinion finding a 50 percent or greater probability of service connection, secondary causation, or aggravation was recorded in the decision.
63 of 500 sample sentences
7% Evidence in equipoise on knee instability or subluxation
The Board found the evidence at least in relative equipoise on whether the Veteran's knee exhibited instability or subluxation, warranting a separate rating under DC 5257.
36 of 500 sample sentences
5% Evidence in equipoise on service connection or nexus
The Board found the lay and medical evidence at least in approximate balance regarding whether a current disability was incurred in or related to active service.
27 of 500 sample sentences
4% Benefit of doubt applied for separate knee rating under DC 5257
Resolving evidentiary doubt in the Veteran's favor, the Board granted a separate 10, 20, or 30 percent rating for knee instability or subluxation under Diagnostic Code 5257.
21 of 500 sample sentences
3% Functional loss and painful motion documented in support of rating
The Board noted evidence of pain on motion, functional loss, or limited range of motion as factual support for assigning or increasing a knee disability rating.
16 of 500 sample sentences
3% Private or VA medical opinion on knee disability etiology cited
A private or VA examiner's opinion on the etiology or secondary relationship of a knee condition was recorded as probative evidence in the decision.
14 of 500 sample sentences
2% Evidence in equipoise on rating level for knee disability
The Board found the evidence at least in relative equipoise as to whether the Veteran's knee disability more nearly approximated criteria for a higher schedular rating percentage.
9 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.