38 CFR Part 4 — 38 CFR § 4.71a
Knee Other Impairment
dc-5257-knee-other-impairment
Musculoskeletal
Diagnostic code
5257
Why your DC matters: DC 5257 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 5257 — Knee Other Impairment — 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): Knee disability; rated on instability, limitation of motion, or ankylosis as described in the schedule.
Exact rating criteria: Open Part 4 in the eCFR (link under “Official source” below). Locate your diagnostic code number (5257) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “5257”. 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 5257 (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 5257 in the subpart for your body system (use Find in Page if needed).
DC 5257 is the third leg of the knee-rating stool — rated SEPARATELY from limitation of motion per VAOPGCPREC 23-97. If your knee buckles, gives way, or shifts under load, that's instability. Veterans frequently leave this rating on the table because they (and the examiner) only think about ROM.
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 30% | Severe recurrent subluxation or lateral instability. | Multiple documented falls or buckling episodes; ortho exam showing gross laxity; use of knee brace or crutch; MRI showing complete ligamentous tear or post-reconstruction laxity. |
| 20% | Moderate recurrent subluxation or lateral instability. | Routine use of a knee brace; positive Lachman, anterior/posterior drawer, or varus/valgus stress test; intermittent buckling. |
| 10% | Slight recurrent subluxation or lateral instability. | Occasional give-way; mild laxity on stress testing; PRN brace use; subjective sense of instability. |
What Qualifies as 'Recurrent Subluxation or Lateral Instability' Under DC 5257?
Documented knee instability — separate from ROM
The knee buckles, gives way, or shifts laterally under load. Confirmed by positive stress testing (Lachman, anterior/posterior drawer, varus/valgus stress, McMurray) and supported by MRI evidence of ligamentous damage.
Severity (slight/moderate/severe) drives the tier
Per § 4.71a, three subjective tiers with examiner discretion:
- • 10% — slight recurrent subluxation or lateral instability
- • 20% — moderate (routine brace use + positive stress testing)
- • 30% — severe (multiple falls, gross laxity, advanced brace use)
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.
“Recurrent subluxation / lateral instability”
These are the exact CFR terms. 'Knee gives out' is colloquial — the DBQ should use 'subluxation' or 'instability' to match the schedule. If your DBQ only says 'pain and weakness,' there's no instability rating.
“Positive Lachman / anterior drawer / varus stress test”
Objective stress testing positivity supports moderate or severe tiers. A purely subjective 'feels unstable' report tends to land at 10%.
Evidence Checklist — Specific to This Condition
Knee DBQ — stability section completed
CRITICALMake sure the examiner performs and documents Lachman, anterior/posterior drawer, varus/valgus stress, and McMurray tests. Each positive = supports a higher tier.
MRI showing ligament damage
IMPORTANTACL/PCL/MCL/LCL tears or post-reconstruction laxity is objective anatomical evidence supporting moderate-to-severe instability.
Brace prescription and usage records
IMPORTANTVA-issued or civilian brace with documented daily use = supports moderate. Hinged or unloader brace = supports severe.
Fall / buckling incident log
SUPPORTINGDates and circumstances of give-way episodes, particularly any requiring ER visits or causing further injury (e.g., fall-induced fracture).
C&P Exam Tips
Ask for stress testing explicitly
If the examiner doesn't perform Lachman, drawer, and varus/valgus testing, the stability portion of the exam is incomplete. Request it on record.
Wear your brace to the exam
Visible use of an unloader or hinged brace tells the examiner this isn't theoretical instability. Don't take it off to 'look better.'
Describe specific falls or near-falls
'It buckled three times last week — once I dropped my coffee, once I fell at the grocery store, once my wife caught me.' Specific > general.
Common Mistakes That Cost Veterans Points
Not filing 5257 alongside 5260/5261
Per VAOPGCPREC 23-97, instability is a SEPARATE rating from ROM limitations. Audit your decision — if you have a 5260 rating but no 5257, file an increase if you have buckling.
Examiner conflating pain with instability
'My knee hurts when I twist' is not instability. 'My knee actually shifts/buckles/gives way' is. Be precise so the rater can apply 5257.
Post-TKR — using 5257 when 5055 applies
After total knee replacement, residuals are rated under DC 5055 (with 30% minimum), not 5257. Verify which code applies to your situation.
Tactical Plays
⚡ The 5260 + 5261 + 5257 trifecta
One bad knee can legitimately carry three separate ratings: flexion loss, extension loss, and instability. Combined under § 4.25 + bilateral factor under § 4.26, a single severely damaged knee can push past 50% on its own.
⚡ Brace = evidence
If you don't have a brace prescription on file, ask your provider for one before your next C&P. The brace itself is documentary evidence of instability — and using it in the exam is visible proof.
Secondary Conditions to File With This One
Knee, limitation of flexion
STRONGDC 5260
Separately compensable per VAOPGCPREC 23-97.
Knee, limitation of extension
STRONGDC 5261
Separately compensable per VAOPGCPREC 23-97.
Meniscal injury
MODERATEDC 5258
Dislocated semilunar cartilage with frequent locking/effusion = 20% under DC 5258. Often co-occurs with ligamentous instability.
Contralateral knee strain
MODERATEDC 5260
Compensatory load on the stable knee causes degeneration. File the second knee when imaging supports.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
10% — single, no dependents
Base rating
$180.42
TOTAL
$180.42/mo
Slight instability — PRN brace, occasional give-way.
20% — single, no dependents
Base rating
$356.66
TOTAL
$356.66/mo
Moderate — routine brace use, positive stress testing.
30% — single, no dependents
Base rating
$552.47
TOTAL
$552.47/mo
Severe — falls, gross laxity, advanced bracing.
30% instability + 30% flexion + 30% extension (one knee)
TOTAL
$1,808.45/mo
Combined ~66% + bilateral factor → 70% = $1,808.45/mo alone. One catastrophically damaged knee.
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 Subluxation?
Partial dislocation — the knee shifts out of alignment momentarily, often with audible/palpable 'pop' or 'shift.' Common with ACL/PCL deficiency or meniscal damage.
↩️What is Lateral Instability?
The knee gives way to the side under load, typically from MCL/LCL damage. Distinct from subluxation but rated together under DC 5257.
⚖️Why is DC 5257 separate from ROM?
Per VAOPGCPREC 23-97, recurrent subluxation or lateral instability addresses a DIFFERENT functional impairment than range of motion. Rated separately without pyramiding.
📅What is the 2024–2025 DC 5257 rewrite?
VA updated DC 5257 effective 2025 to refine 'slight/moderate/severe' criteria. Verify which version of the schedule applies to your effective date.
How to File Your Claim
Get a brace prescription from your provider
VA-issued or civilian brace = documentary evidence of instability. The brace itself is proof. Hinged or unloader braces support 20%/30%.
File VA Form 21-526EZ specifying 'recurrent subluxation' or 'lateral instability'
Use the CFR terminology, not 'knee gives out.' This signals DC 5257 to the rater.
Submit knee DBQ with stability section completed
Make sure examiner performs and documents Lachman, anterior/posterior drawer, varus/valgus stress, and McMurray tests. Each positive supports a higher tier.
Attach MRI showing ligamentous damage + fall/buckling log
MRI documents anatomical instability. Personal log of buckling events with dates and circumstances supports the 'recurrent' element.
File 5257 alongside 5260/5261 if ROM is also limited
Per VAOPGCPREC 23-97, separately compensable on the same knee. Don't leave instability off the table.
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
Wear your brace to the C&P
Visible brace use tells the examiner this isn't theoretical instability. Don't take it off to 'look better' — that erases evidence.
Document specific buckling events
'It buckled three times last week — once I dropped my coffee, once I fell at the grocery store, once my wife caught me.' Specific > general for the 'recurrent' element.
Pain ≠ instability
'My knee hurts when I twist' is pain, not instability. 'My knee actually shifts/buckles/gives way' is instability. Be precise so the rater can apply DC 5257.
Post-TKR uses DC 5055, not 5257
After total knee replacement, residuals (including instability) are rated under DC 5055 with a 30% minimum. Verify which code applies if you've had TKR.
Related Tools & Resources
Frequently Asked Questions
Can I claim DC 5257 without a positive Lachman test?
Subjective instability with a brace prescription can support 10%, but objective findings (positive stress tests, MRI) support higher tiers. The stronger the objective evidence, the higher the rating.
Does meniscus damage count as instability?
Meniscal injuries are rated under DC 5258 (dislocated semilunar cartilage, 20%) or DC 5259 (symptomatic removal, 10%) — separate from DC 5257. Both can co-occur with instability.
Can I get DC 5257 if I had ACL reconstruction?
Yes — residual instability after ACL repair is a recognized rating basis. Post-reconstruction laxity on stress testing or imaging supports the rating.
What if my instability only happens on stairs?
Situational instability still qualifies. Describe the trigger (stairs, uneven ground, twisting) and frequency. 'Recurrent' doesn't require constant — just regular.
How is the 2025 DC 5257 update different?
VA refined the slight/moderate/severe definitions effective in 2025 — among other changes, clearer thresholds based on brace use and falls. If your effective date crosses the rule change, verify which schedule applies with a VSO.
Official Regulatory Source
Recurrent subluxation or lateral instability of the knee is rated under 38 CFR § 4.71a, Diagnostic Code 5257.
38 CFR § 4.71a — Musculoskeletal System (eCFR) →Scroll to DC 5257. Per VAOPGCPREC 23-97, separately compensable from DC 5260/5261.
⚠️ Verify with a VSO
VA updated DC 5257 effective 2025 to refine 'slight/moderate/severe' criteria; verify the version that applies to your effective date with a VSO if your claim crosses the rule-change boundary.
Next Steps
If your rating decision lists DC 5257, 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 5257 • 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.