Knee Instability (Subluxation and Lateral Instability)
Knee instability is rated under Diagnostic Code 5257. This covers recurrent subluxation or lateral instability (when the knee gives out) and patellar instability (kneecap dislocation). Veterans can receive separate ratings for instability AND ROM limitations. However, only one instability rating per knee is allowed. There must be objective evidence of a prescribed assistive device (brace, cane, crutches, walker) to rate above 10%.
VA Rating Levels
Knee gives out regularly due to sprain, incomplete ligament tear, or complete ligament tear (repaired, unrepaired, or failed repair), without a prescription for an assistive device or bracing for walking.
Knee gives out regularly due to sprain, incomplete ligament tear, or repaired complete ligament tear, and a medical provider prescribes a brace and/or assistive device for walking. OR unrepaired or failed repair of complete ligament tear with persistent instability and a prescription for either an assistive device or bracing.
Unrepaired or failed repair of complete ligament tear causing the knee to give out regularly, and a medical provider prescribes both an assistive device (cane, crutches, walker) AND bracing for walking.
Exam Tips & Key Evidence
- →An instability rating can be awarded separately from your range-of-motion ratings for the same knee, giving you two ratings for one joint.
- →To qualify for anything above 10%, you'll need documented evidence of a prescribed assistive device. Make sure to get that prescription on record.
- →Only one instability rating per knee is allowed, whether the issue is subluxation, lateral instability, or patellar instability.
- →Patellar instability has its own set of criteria under the same diagnostic code, based on whether a surgical repair was attempted.
Commonly Related Conditions
38 CFR Reference
38 CFR 4.71a, Diagnostic Code 5257