38 CFR Part 4 — 38 CFR § 4.71a
Knee replacement (prosthetic joint)
dc-5055-knee-replacement
Musculoskeletal
Diagnostic code
5055
Why your DC matters: DC 5055 is the exact code the VA uses to rate this condition. It determines which symptoms unlock which percentage, what evidence the rater looks for, and which secondaries are most likely to be approved.
Last verified against 38 CFR (eCFR Part 4):
Rating criteria (38 CFR Part 4)
Diagnostic code 5055 — Knee replacement (prosthetic joint) — is listed under 38 CFR § 4.71a in 38 CFR Part 4. The paragraphs below summarize how this code is used; the official schedule text controls exact percentages, formulas, and notes.
Schedule summary (educational, not a substitute for the regulation): 4 months at 100% following implantation per the schedule; 30% minimum for total replacement thereafter, with 60% available for severe painful motion or weakness.
Exact rating criteria: Open Part 4 in the eCFR (link under “Official source” below). Locate your diagnostic code number (5055) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “5055”. Copy the verbatim rating table, including any parenthetical notes, exceptions, and cross-references, for the version of Part 4 that applies to your effective date.
Effective dates & which schedule version applies
Which diagnostic code, percentage, and effective date apply depends on the facts of your claim and the version of the rating schedule in force for the period being decided. Generally, VA applies the schedule in effect at the specified time under 38 U.S.C. § 5110 and implementing rules, subject to exceptions (e.g., protected ratings, liberalizing law changes—see regulation and VA manual policy as applicable).
For older claims, the **current** eCFR may not match the text that applied years ago. If your decision references a prior percentage or code, compare against the Part 4 text **as of** your claim’s relevant dates; historical Federal Register / CFR snapshots may be needed for precise comparison.
The “Last verified” date on this page is when we last checked this educational summary against the electronic CFR—not the date of any VA policy or your personal claim decision.
Notes for your claim
Evidence: Show that your diagnosis and severity match the factors the schedule names for DC 5055 (e.g., measurements, frequency, treatment, functional loss), with medical and lay evidence as appropriate.
C&P exams: Results should reflect the schedule’s requirements (correct joints measured, correct formulas). If the exam omits required findings, consider submitting records or requesting clarification.
If you disagree with the DC, percentage, or effective date, review the Part 4 text for your period and consider a supplemental claim or appeal with a VA-accredited representative.
This site does not provide legal advice.
Official source
38 CFR Part 4 (eCFR) — locate diagnostic code 5055 in the subpart for your body system (use Find in Page if needed).
Total knee arthroplasty under DC 5055 has a unique two-phase rating: 100% automatic for 4 months after surgery (verbatim from the schedule), then a residuals-based rating (minimum 30%) thereafter. The play has two parts: (1) make sure you got the post-op 100% window + retro pay correctly, and (2) push for the strongest possible residuals rating once the 4-month window ends. Veterans regularly accept the minimum 30% when their actual residuals support 60% (severe painful motion or weakness). Note: the '13-month' figure that circulates informally is from older VA practice — the current schedule language is 4 months at 100%, same as DC 5054 (hip).
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 100% | Prosthetic replacement of knee joint — automatic 100% for 4 months following implantation. | Operative report + surgical date. The 100% rating runs for the 4 months following implantation of the prosthesis per the schedule language. |
| 60% | Following the 4-month 100% window — with chronic residuals consisting of severe painful motion or weakness in the affected extremity. | ROM measurements showing significant limitation; pain scale documentation; gait abnormality; assistive device use. |
| 30% | Following the 4-month 100% window — minimum rating after total knee replacement, regardless of residuals. | Operative report alone establishes the 30% floor. |
What Qualifies Under DC 5055?
Service-connected knee + prosthetic replacement
Total or partial knee arthroplasty performed for a service-connected knee condition. The underlying knee condition must be SC'd; the replacement automatically rates under DC 5055.
Two-phase rating schedule
DC 5055 structure:
- • 100% — Automatic for 4 months following implantation (per the schedule)
- • 60% — Severe painful motion or weakness following the 4-month window
- • 30% — Minimum rating thereafter (permanent floor, total replacement only)
Below 30% rated by analogy
If residuals are minimal after a total replacement, VA rates 'by analogy' to limitation of flexion (DC 5260), extension (DC 5261), instability (DC 5257), or ankylosis (DC 5256) — but the rating cannot be less than 30%. Partial resurfacing has no 30% floor.
Language Your Rater Needs to See
These are the exact (or near-exact) regulatory phrases that unlock specific tiers. If your DBQ or C&P report doesn't use this vocabulary, the rater may default to a lower percentage even when symptoms qualify.
“Chronic residuals consisting of severe painful motion or weakness”
60% gate. 'Severe' means substantial functional loss — measurable ROM deficit, pain on motion, instability, weakness preventing daily tasks. Push the orthopedist or PT to chart severity explicitly.
“For 4 months following implantation of prosthesis or resurfacing”
Verbatim from DC 5055. The 4-month 100% window is AUTOMATIC after total knee replacement. If you got 30% straight after surgery, you're missing the 4 months of 100% pay.
“Minimum 30% rating following total knee replacement”
Permanent minimum. After the 4-month window, regardless of how well the knee functions, VA cannot rate below 30% for the replaced joint. Note: per the schedule, partial knee resurfacing has no 30% minimum — residuals rate under 5256-5262.
Evidence Checklist — Specific to This Condition
Operative report from the knee replacement
CRITICALDate of surgery + prosthesis type. Establishes the 4-month 100% window start date.
Post-op physical therapy records
CRITICALROM progression, pain scores, functional milestones. Documents residuals quality.
Current orthopedic + PT evaluation
CRITICALROM in degrees, strength testing (manual muscle testing or dynamometer), pain on motion, instability. Drives the 30 vs. 60% residuals tier.
Assistive device use
IMPORTANTCane, walker, knee brace. Each is functional-loss evidence supporting 60%.
Imaging (x-ray, sometimes CT)
SUPPORTINGDocuments prosthesis position, loosening, alignment. Loosening or component failure escalates rating.
C&P Exam Tips
Bring most recent ortho/PT evaluation
Goniometric ROM measurements + strength values are objective evidence the examiner can cite directly.
Describe pain on motion in concrete terms
'Pain at 90° flexion that limits stair climbing.' Specific functional impact supports 'severe painful motion.'
Bring your assistive device(s) to the exam
Cane, knee brace, walker — show them. Don't leave them in the car.
Don't say 'My knee feels great'
Even if you're functioning well, describe the residuals — stiffness in cold weather, pain after walking, weakness when climbing stairs.
Common Mistakes That Cost Veterans Points
Missing the 4-month 100% post-op retro pay
If you weren't rated 100% for the 4 months following surgery, file supplemental immediately. The 4-month 100% window is automatic per DC 5055.
Accepting 30% residuals without ROM evaluation
30% is the floor, not the ceiling. If you have severe painful motion or weakness, you're at 60%. Get current PT/ortho measurements.
Not filing the surgical scar
TKA scars are large and often painful. DC 7804 (painful scar) rates separately.
Tactical Plays
⚡ Verify you got the 4-month 100% post-op rating + retro pay
The 4-month 100% rating after TKA is automatic per DC 5055. If your decision letter shows 30% immediately after surgery without the 4-month window, file supplemental NOW citing DC 5055.
⚡ Push for 60% residuals — don't accept the 30% floor
30% is the minimum, not the typical rating. With current PT documentation of pain on motion + weakness + ROM deficit, 60% is reachable. Get a comprehensive ortho + PT evaluation BEFORE the residuals exam.
⚡ Audit altered-gait secondaries
Post-TKA gait changes drive hip, back, contralateral knee, and ankle complaints. Each can rate separately if documented.
Secondary Conditions to File With This One
Painful surgical scar
STRONGDC 7804
TKA scar is large; if painful or unstable, rate separately under DC 7804.
Contralateral knee overuse
MODERATEDC 5260 / 5261
Compensating for the replaced knee accelerates degeneration in the opposite knee; pursue if symptomatic.
Hip / low back pain from altered gait
MODERATEDC 5237 / 5250
Altered gait post-TKA can drive hip/back complaints; secondary pathway available if documented.
Depression secondary to chronic pain
MODERATEDC 9434
Chronic post-surgical pain → depression is well-established chain.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
100% — single, no dependents
Base rating
$3,938.58
TOTAL
$3,938.58/mo
Post-op window (4 months automatic after TKA).
30% — single, no dependents
Base rating
$552.47
TOTAL
$552.47/mo
Minimum residuals tier after 4-month 100% window.
60% — single, no dependents
Base rating
$1,435.02
TOTAL
$1,435.02/mo
Severe painful motion or weakness post-TKA.
60% TKA residuals + 10% DC 7804 painful scar
Base rating
$1,435.02
TOTAL
$1,435.02/mo
Combined ~64% rounds to 60%. Scar adds value but rounds down at this combination.
Bilateral 60% TKA (both knees)
Base rating
$2,102.15
TOTAL
$2,102.15/mo
Two 60% knees combine to ~76% then +7.6 bilateral factor = ~80% rounded. Common in late-stage osteoarthritis veterans.
Note: Amounts are approximations rounded to nearest dollar. Actual comp varies with effective date, dependents (spouse, children, parents — each adds), Aid & Attendance, and additional disabilities. Combined ratings use VA Math (§ 4.25), not simple addition.
Key Definitions
📅What is the '4-Month 100% Post-Op Window'?
DC 5055 awards 100% automatically for 4 months following implantation of the prosthesis — that's the verbatim schedule language. Then a permanent minimum 30% rating begins (for total replacement). Some veterans hear '13 months' or 'one year' — that's older VA practice, not the current schedule.
🦵What's 'Severe Painful Motion or Weakness'?
The 60% gate. Substantial functional loss — measurable ROM deficit (typically < 90° flexion or > 10° extension lag), pain on motion noted in PT/ortho records, weakness preventing activities of daily living.
🔧Does partial knee replacement count?
Unicompartmental or partial knee resurfacing qualifies for the 4-month 100% window under DC 5055, but does NOT get the 30% permanent minimum — at the end of the 4 months, residuals rate under DC 5256-5262 (no floor). Total replacement is what triggers the 30% floor.
How to File Your Claim
Pull the operative report + post-op records
Establishes surgical date + prosthesis type. Critical for the 4-month 100% claim.
Verify you received the 4-month 100% window + retro pay
If you didn't, file supplemental immediately citing DC 5055.
Get a current ortho + PT evaluation for residuals
Goniometric ROM + strength testing + pain documentation. Drives 30 vs. 60%.
File 21-526EZ specifying 'knee replacement, residuals (DC 5055)'
Be explicit about which knee and prosthesis date.
File scar + altered-gait secondaries
DC 7804 for painful scar. Contralateral knee / hip / back claims if symptomatic.
Typical Claim Timeline
File initial claim
Day 0–7: Submit VA Form 21-526EZ with all medical evidence on file
VA acknowledges claim
Week 1–2: Receive confirmation letter and claim tracking number
C&P examination scheduled
Month 1–3: VA contracts an exam vendor and sends you appointment notice
Attend C&P exam
Bring your full evidence package; describe symptoms on your worst days, not your best
Decision & rating notice
Month 3–6: Decision letter with rating percentage and effective date
First payment & retro back pay
Within 15 days of decision; retroactive to claim date (or effective date if earlier)
Timeline varies by case complexity and VA regional office workload. Some claims resolve faster; others take longer.
Important Considerations
The 4-month 100% window is AUTOMATIC — claim it if you missed it
Per the current schedule, DC 5055 awards 100% for 4 months following implantation. Many veterans heard '1 year' and never realized the actual figure or that they're owed retro pay. File supplemental ASAP if your award letter skipped the 4-month window.
30% is the floor, not the standard
With pain on motion + weakness + ROM deficit documented, 60% is reachable. Don't accept 30% without current ortho/PT measurements.
Surgical scar = separate rating
TKA scars are 6+ inches; if painful, DC 7804 rates separately.
Altered gait drives multi-joint secondaries
Hip, back, contralateral knee, ankle — each can become a secondary claim.
Related Tools & Resources
Frequently Asked Questions
When does the 4-month 100% post-op window start and end?
Per the current schedule, the 100% rating runs for 4 months following implantation of the prosthesis. Example: surgery on April 15, 2026 → 100% through August 2026; 30%+ residuals rating begins September 2026. Per VA practice, the rating typically resolves on the first of the month after the 4-month period closes.
Why do I hear '13 months' or 'one year' for the 100% rating?
That's older VA practice or misinterpretation. The current 38 CFR § 4.71a schedule language for DC 5055 is '4 months following implantation' — same as DC 5054 (hip). If a VSO or attorney is still telling you '13 months,' they're working off outdated guidance.
Can I get above 30% residuals?
Yes — 60% is available for 'severe painful motion or weakness.' Get current ortho + PT evaluation documenting ROM deficit, pain scores, weakness, and functional limitations.
Does partial knee replacement also qualify for DC 5055?
Partial/unicompartmental resurfacing gets the 4-month 100% window under DC 5055, but does NOT get the 30% permanent floor that total replacement gets. After the 4 months, partial-resurfacing residuals rate under DC 5256-5262 with no minimum.
What if my knee replacement was years ago and the 4-month window was never granted?
File supplemental claim with the operative report. The 4-month 100% window + retro pay should be granted regardless of how long ago the surgery occurred, as long as service connection was established.
Can I claim both knees if both replaced?
Yes — each knee rates separately under DC 5055. With both ≥ 30% (or higher residuals), the § 4.25 bilateral factor adds 10% of the combined value.
Official Regulatory Source
Knee replacement (prosthetic) is rated under 38 CFR § 4.71a, DC 5055.
38 CFR § 4.71a — Musculoskeletal System (eCFR) →Scroll to DC 5055. Hip replacement (DC 5054) follows the same 4-month 100% + 30% minimum structure.
Next Steps
If your rating decision lists DC 5055, compare your current symptoms and documentation against the criteria above. Consider:
- Requesting a copy of your rating decision and C&P exam report from the VA
- Gathering all relevant medical records (VA and private providers)
- Documenting functional limitations and how they impact work and daily activities
- Obtaining a nexus letter if needed to establish or strengthen service connection
- Filing for secondary conditions that may be related to this primary condition
- Contacting a VA-accredited VSO, claims agent, or attorney to review your file
This is general educational information only — not legal or medical advice.
Also: DC code lookup (tools) lists the same index in a compact layout.
Source: 38 CFR Part 4, Diagnostic Code 5055 • va.gov
⚠️ Important Disclaimer
This page provides general educational information only based on public VA regulations (38 CFR) and va.gov resources. It is not legal, medical, or claims assistance. Ratings and service connections are decided case-by-case by the VA based on the individual veteran’s evidence. We do not prepare claims, generate documents, or provide personalized advice. Always consult a VA-accredited Veterans Service Organization (VSO), attorney, or your physician for help with your specific situation. Verify the latest rules on va.gov.