Knee VA Rating 2026 — Flexion, Extension, Instability, and Replacement

Knee conditions are one of the most common VA disability claims, and for good reason. Years of rucking, running on concrete, jumping out of vehicles, and kneeling in body armor take a serious toll. But the VA doesn't just hand out a single knee rating. Your knee can actually be rated under multiple diagnostic codes at the same time, which means the system is both more complex and more generous than most veterans realize.

The key is understanding how each diagnostic code works, what the C&P examiner is measuring, and where the rating thresholds fall. Let's walk through all of it.

How the VA Rates Knee Conditions

The VA evaluates knee disabilities primarily through range of motion testing and stability testing. Your C&P examiner will use a goniometer (the hinged measuring tool) to determine how far your knee bends and straightens, and will perform physical manipulation to check for instability. These measurements map directly to specific diagnostic codes in the VA's rating schedule.

The four main diagnostic codes for knee conditions are:

• DC 5260 — Limitation of flexion (how far you can bend)
• DC 5261 — Limitation of extension (how far you can straighten)
• DC 5257 — Recurrent subluxation or lateral instability
• DC 5055 — Knee replacement (total arthroplasty)

What makes the knee unique in VA ratings is that you can receive separate ratings under multiple codes for the same knee. Limited flexion and limited extension can be rated separately. Instability can be rated on top of both. This is unusual in the VA system and is something many veterans and even some VSOs miss.

DC 5260: Limited Knee Flexion

Flexion is how far you can bend your knee. Normal flexion is about 140 degrees. When your flexion is limited—meaning you can't bend your knee as far as you should be able to—the VA rates it under DC 5260.

Here's how the rating levels break down:

Flexion Limited To	VA Rating	2026 Monthly Pay
60 degrees	0%	$0.00
45 degrees	10%	$180.42
30 degrees	20%	$356.66
15 degrees	30%	$552.47

A few things to note. The maximum rating under DC 5260 alone is 30%. To get a 10% rating, your flexion has to be limited to 45 degrees or less, which means you've lost roughly two-thirds of your normal range of motion. Even a 0% rating (flexion limited to 60 degrees) is still worth having on record because it establishes service connection and can be increased later if the condition worsens.

The DeLuca Factors

The VA doesn't just look at your range of motion on a single test. Under DeLuca v. Brown, the examiner must also consider pain, fatigue, weakness, lack of endurance, and incoordination during repetitive use. If your knee bends to 50 degrees on the first rep but only makes it to 42 degrees after three repetitions, that additional functional loss should be documented and can push you into a higher rating tier.

DC 5261: Limited Knee Extension

Extension is how far you can straighten your knee. Normal extension is 0 degrees (a fully straight leg). When you can't fully straighten your knee, it's rated under DC 5261.

Extension Limited To	VA Rating	2026 Monthly Pay
5 degrees	0%	$0.00
10 degrees	10%	$180.42
15 degrees	20%	$356.66
20 degrees	30%	$552.47
30 degrees	40%	$795.84
45 degrees	50%	$1,132.90

Extension ratings can go higher than flexion ratings—up to 50%. That makes sense when you think about it. If you can't straighten your leg, it affects your ability to walk, stand, and perform basic daily functions far more severely than limited bending.

Separate Ratings for Flexion and Extension

Here's where it gets interesting. VA General Counsel Opinion VAOPGCPREC 9-2004 established that limited flexion and limited extension of the same knee can be rated separately. So if your knee flexion is limited to 45 degrees (10% under DC 5260) and your extension is limited to 10 degrees (10% under DC 5261), you'd get two separate 10% ratings for that one knee.

This is not automatic. The examiner has to document both limitations, and the rater has to apply both codes. If your decision only shows one code, it's worth asking your VSO whether a separate rating under the other code applies.

DC 5257: Knee Instability

Instability is a completely separate issue from range of motion. The VA rates recurrent subluxation (the kneecap shifting out of place) and lateral instability (the knee giving way sideways) under DC 5257.

Severity	VA Rating	2026 Monthly Pay
Slight	10%	$180.42
Moderate	20%	$356.66
Severe	30%	$552.47

The critical thing about DC 5257 is that it can be rated in addition to your range of motion rating. VAOPGCPREC 23-97 established that a veteran can receive separate ratings for arthritis with limited motion (DC 5260 or 5261) and for instability (DC 5257) in the same knee. So a single knee could potentially carry three separate ratings: one for limited flexion, one for limited extension, and one for instability.

Documenting Instability

During your C&P exam, the examiner will perform tests like the Lachman test, anterior drawer test, and varus/valgus stress tests. If you experience your knee giving out, buckling, or shifting during daily activities, make sure you tell the examiner. Instability can be intermittent, and it might not show up during a single exam if you're having a good day. Your lay statements about how often your knee gives out carry weight in the rating decision.

DC 5055: Total Knee Replacement

If your knee condition progresses to the point of requiring a total knee replacement (arthroplasty), DC 5055 provides a specific rating framework:

• 100% for one year following the surgery
• Minimum 30% after re-evaluation
• 60% with chronic residuals consisting of severe painful motion or weakness
• Intermediate ratings of 40% or 50% based on specific residual symptoms

That automatic 100% rating for a full year is significant. At the 2026 rate, that's $3,938.58 per month for a single veteran with no dependents. After the one-year mark, the VA will schedule a re-evaluation to determine your ongoing level of impairment. Even if your recovery goes well, the floor is 30%, which still provides $552.47 per month.

The Bilateral Factor: Both Knees

Knee problems rarely stay on one side. If both knees are service-connected, the VA applies the bilateral factor. Here's how it works: the VA combines the ratings for both knees, then adds 10% of that combined value back in before combining with your other conditions.

The bilateral factor is one of the reasons knee claims are so valuable. When both knees are affected, the combined rating is meaningfully higher than it would be for two unrelated conditions on different parts of the body. If you have a problem with one knee, the other knee almost certainly compensates and bears extra load, so make sure to claim both if applicable.

Secondary Conditions to Knee Disabilities

A bad knee doesn't just affect your knee. It changes how you walk, how you distribute weight, and how your entire musculoskeletal system functions. Common secondary conditions to knee disabilities include:

• Hip conditions — Altered gait from a knee condition commonly leads to hip pain and arthritis. The opposite hip bears extra load when you favor the injured knee.
• Ankle conditions — The ankle on the affected side or the opposite side can develop problems from compensatory movement patterns.
• Lumbar spine conditions — An altered gait changes your spinal mechanics. Many veterans develop lower back problems secondary to knee conditions.
• Opposite knee — If one knee is injured, the other knee picks up the slack. Over time, this leads to degeneration in what was originally the "good" knee.
• Mental health conditions — Chronic pain and loss of mobility can contribute to depression and anxiety.

Each of these secondary conditions is its own separate rating. Filing secondary claims can significantly increase your overall combined rating. You'll need a nexus letter from a medical professional linking the secondary condition to your service-connected knee disability.

C&P Exam Tips for Knee Claims

Your C&P exam is the single most important factor in your knee rating. Here's how to approach it:

Before the Exam

• Don't take pain medication the morning of your exam. You want the examiner to see your knee at its actual functional level, not its medicated level.
• Don't warm up or stretch before the exam. Arrive as you are on a normal day.
• Bring a written statement describing your worst days, how often your knee gives out, what activities you've had to stop doing, and how the condition has progressed.

During the Exam

• Be honest about your pain level. Don't exaggerate, but don't downplay it either. Many veterans reflexively minimize their symptoms.
• Describe functional impact: "I can't kneel to play with my kids," "I have to use the handrail on every staircase," "My knee buckles about twice a week."
• If repetitive motion increases your pain or reduces your range of motion, say so. The examiner should document this for DeLuca factors.
• Report flare-ups. Describe frequency, duration, and severity of your worst episodes.

2026 VA Disability Rates for Common Knee Ratings

Here's a quick reference for what the most common knee-related combined ratings pay in 2026 (veteran alone, no dependents):

Rating	2026 Monthly Pay	2026 Annual Pay
10%	$180.42	$2,165.04
20%	$356.66	$4,279.92
30%	$552.47	$6,629.64
40%	$795.84	$9,550.08
50%	$1,132.90	$13,594.80
60%	$1,435.02	$17,220.24
70%	$1,808.45	$21,701.40
80%	$2,102.15	$25,225.80
90%	$2,362.30	$28,347.60
100%	$3,938.58	$47,262.96

Remember, these rates increase with dependents. A veteran with a spouse and children at 100% receives substantially more. Use our calculator to see your exact amount based on your specific situation.