Total Knee Replacement
Total knee replacement is rated under Diagnostic Code 5055. After the procedure, the veteran receives a temporary 100% rating for approximately 4 months (plus 1 bonus month under 38 CFR 4.30), followed by a minimum 30% rating for total knee replacement. Knee resurfacing uses the same code but does not have a guaranteed minimum rating after the temporary 100% period, so a reexamination is required. Any other musculoskeletal knee evaluations (ankylosis, instability, ROM) will be discontinued on the date of the procedure.
VA Rating Levels
Minimum rating after the temporary 100% period ends (total knee replacement only).
Chronic residuals consisting of severe painful motion or weakness in the affected extremity.
Temporary rating for approximately 4 months (plus 1 bonus month) following the replacement surgery.
Exam Tips & Key Evidence
- →The temporary 100% rating includes a bonus month under 38 CFR 4.30, so you're looking at roughly five months of total disability from the date of admission.
- →Once the temporary 100% period ends, you can always file an increase claim if you feel a higher rating is justified.
- →All other musculoskeletal knee evaluations, including instability and range of motion, are discontinued on the date of your procedure.
- →Don't forget that any scars from the surgery may qualify for their own separate rating.
Commonly Related Conditions
38 CFR Reference
38 CFR 4.71a, Diagnostic Code 5055