38 CFR Part 4 — 38 CFR § 4.71a
Leg Limitation Of Flexion
dc-5260-leg-limitation-of-flexion
Musculoskeletal
Diagnostic code
5260
Why your DC matters: DC 5260 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 5260 — Leg Limitation Of Flexion — 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 (5260) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “5260”. 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 5260 (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 5260 in the subpart for your body system (use Find in Page if needed).
DC 5260 is one of the highest-volume MSK codes in the schedule. Ratings are mechanical — measured in degrees of knee flexion — but veterans regularly get under-rated because the C&P examiner only measures one pass, ignoring the DeLuca factors (pain, weakness, fatigability, repetition). Per Mitchell v. Shinseki and § 4.40/4.45, the rating must reflect the FUNCTIONAL limit after repetitive use.
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 30% | Flexion limited to 15° (knee will barely bend). | Goniometer measurement after repetitive use; functional inability to climb stairs or squat at all. |
| 20% | Flexion limited to 30°. | Goniometer reading; documented inability to flex more than 30° after pain onset or repetitive motion. |
| 10% | Flexion limited to 45°. | ROM measurement on DBQ; pain limiting flexion before reaching normal range. |
| 0% | Flexion limited to 60° (still 0%, but worth filing to document baseline). | Goniometer reading at the noncompensable threshold. |
What Qualifies as 'Limitation of Flexion of the Knee' Under DC 5260?
Documented limitation of knee flexion measured in degrees
Goniometric measurement showing reduced ability to bend the knee, BEFORE and AFTER three repetitions of motion per VA's exam protocol. Normal flexion is ~140°.
Rating tier ladders by degrees of flexion possible
Per § 4.71a, mechanical thresholds apply — but per § 4.40/4.45 and Mitchell v. Shinseki, the post-repetitive measurement (not the first pass) drives the rating:
- • 0% — flexion to 60°
- • 10% — flexion to 45°
- • 20% — flexion to 30°
- • 30% — flexion to 15° (knee barely bends)
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.
“Functional loss due to pain on repetitive use”
Per § 4.40, the rating must reflect the limit AFTER repetitive use — not the first pain-free measurement. If your DBQ only lists 'flexion to 110°' without a repetitive-use line, that's a defective exam. Push back.
“Where pain begins / onset of pain at [X] degrees”
Per Mitchell v. Shinseki and § 4.59, the point where pain BEGINS is what counts — not where motion physically stops. Make sure the examiner records the degree at which pain starts, not just where you give up.
“Painful motion (DC 5003) — 10% minimum”
Even if your flexion measurement only qualifies at 0%, painful motion + imaging-confirmed arthritis = 10% minimum under DC 5003. Many examiners miss this entirely.
Evidence Checklist — Specific to This Condition
Knee DBQ with goniometer ROM measurements
CRITICALActive AND passive ROM, both knees if relevant, before AND after three repetitions. Required by VA's own exam protocol — if missing, the exam is inadequate.
X-ray or MRI of the knee
CRITICALArthritis on imaging = DC 5003 10% floor regardless of ROM. Also supports severity for ROM ratings.
Functional impact statements
IMPORTANTSpecific tasks you can't do: stairs, squatting, kneeling, prolonged standing, getting up from a chair. Concrete examples beat 'pain.'
Flare-up frequency and severity log
IMPORTANTPer Sharp v. Shulkin, examiners must estimate ROM during flare-ups based on your history. Bring a 30-day flare log so they have something to estimate from.
Treatment trail (injections, PT, bracing)
SUPPORTINGDocuments severity and supports separate ratings for instability (5257) and/or meniscal damage (5258/5259).
C&P Exam Tips
Ask the examiner to repeat ROM measurement
VA's protocol requires three repetitions. If they only measure once, point that out — politely. The post-repetition measurement is what the rater uses.
Tell them WHERE the pain starts, not just that it hurts
'It starts hurting at about here' (gesture to ~70°) lets the examiner record a specific degree. 'It hurts the whole time' makes it impossible to apply Mitchell.
Don't push past pain to 'show how good your range is'
Some veterans try to demonstrate they're tough. Bad strategy — the painless range is the rating range. Stop at pain onset; let the examiner document it.
Describe flare-ups even if you're having a good day
Per Sharp, the examiner must estimate flare-up ROM. Say: 'Right now I can bend to about 100°, but during a flare-up — about twice a week — I can barely bend it past 30°.'
Common Mistakes That Cost Veterans Points
Accepting a one-pass ROM measurement
If the DBQ doesn't show pre- and post-repetitive measurements, the exam is inadequate. File for HLR or supplemental claim with new DBQ.
Not separately rating flexion + extension
Per VAOPGCPREC 9-2004, DC 5260 (flexion) and DC 5261 (extension) can be rated separately for the same knee if both are limited. Many raters apply only one.
Not adding 10% under DC 5003 when arthritis is present
If imaging shows degenerative arthritis but ROM is noncompensable, you still get 10% per affected major joint group under DC 5003. Often missed.
Ignoring instability (DC 5257) as a separate rating
Per VAOPGCPREC 23-97, instability is rated separately from ROM. If your knee buckles or gives way, file under 5257 in addition to 5260/5261.
Tactical Plays
⚡ Stack 5260 + 5261 + 5257 + 5003 on a single knee
One bad knee can carry FOUR ratings: flexion (5260), extension (5261), instability (5257), and arthritis (5003 — when ROM is noncompensable). Few veterans realize this. Audit your last decision; file for the missing pieces.
⚡ Demand a Sharp-compliant flare-up estimate
If your DBQ doesn't include a flare-up ROM estimate, the exam violates Sharp v. Shulkin. That's grounds for HLR or supplemental claim. Bring a written flare log so the examiner has data to extrapolate from.
⚡ Pre-existing condition aggravated by service = service-connected
If you entered service with a pre-existing knee issue but it WORSENED during service, you're entitled to a rating for the aggravation portion (§ 3.306). STRs showing complaints during service are the key.
Secondary Conditions to File With This One
Knee, limitation of extension
STRONGDC 5261
Rated separately from flexion for the same knee per VAOPGCPREC 9-2004 when both motions are limited.
Knee instability
STRONGDC 5257
Separate from ROM rating per VAOPGCPREC 23-97. If your knee gives way, this is a separate compensable rating.
Degenerative arthritis (when imaging supports)
STRONGDC 5003
If ROM is noncompensable but X-ray shows arthritis with painful motion, 10% under 5003 applies. Cannot be combined with 5260 if 5260 already yields a compensable rating.
Contralateral knee (compensatory load)
MODERATEDC 5260
Bad knee shifts weight to the good knee, which eventually breaks down. File the second knee when imaging shows degeneration.
Hip / back / ankle (gait alteration)
MODERATEDC 5252
Antalgic gait stresses other joints. Well-accepted secondary pathway.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
0% — single, no dependents
TOTAL
$0.00/mo
Flexion to 60° — noncompensable. File for DC 5003 10% floor if imaging shows arthritis.
10% — single, no dependents
Base rating
$180.42
TOTAL
$180.42/mo
Flexion to 45° (or DC 5003 floor with painful arthritis).
20% — single, no dependents
Base rating
$356.66
TOTAL
$356.66/mo
Flexion to 30°.
30% — single, no dependents
Base rating
$552.47
TOTAL
$552.47/mo
Flexion to 15°.
One knee at 30% flexion + 10% extension + 10% instability + DC 5003
TOTAL
$1,132.90/mo
Combined ~46–49% under § 4.25, rounds to 50% = $1,132.90/mo alone. One bad knee can carry multiple stacking ratings.
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 are 'DeLuca Factors'?
Per DeLuca v. Brown and § 4.40/4.45, ratings must account for functional loss from pain, weakness, excess fatigability, incoordination, AND repetitive motion. The single first-pass ROM number is insufficient if pain/weakness limit function further.
⚖️What is 'Mitchell v. Shinseki'?
Federal Circuit case requiring examiners to record the degree at which PAIN BEGINS, not just where motion physically stops. The pain-onset point is what the rating reflects.
📊What is 'Sharp v. Shulkin'?
CAVC case requiring examiners to estimate ROM during flare-ups based on the veteran's history, even when the exam happens on a good day. Bring a flare-up log to the C&P.
🛡️What is the 'DC 5003 10% Floor'?
Per DC 5003 (degenerative arthritis), painful motion + imaging-confirmed arthritis = minimum 10% rating per major joint group, even if ROM is technically noncompensable. Many raters miss this.
How to File Your Claim
Get goniometric DBQ measurements — BOTH knees if both are symptomatic
Active AND passive ROM, before AND after three repetitions, with pain-onset degrees recorded per Mitchell. Required by VA's own exam protocol; if missing, exam is inadequate.
Get X-ray or MRI before filing for increase
Imaging confirming arthritis triggers the DC 5003 10% floor regardless of ROM. Imaging is also evidence for instability claims (DC 5257) and meniscal damage (5258/5259).
File flexion (DC 5260), extension (DC 5261), and instability (DC 5257) separately if applicable
Per VAOPGCPREC 9-2004 and 23-97, all three are separately compensable on the SAME knee. Many veterans file 'knee pain' and only get one rating.
Bring a 30-day flare-up log to C&P
Per Sharp v. Shulkin, the examiner must estimate flare-up ROM. Without your data, they have nothing to estimate from — and you get rated on your best day.
File secondary musculoskeletal claims for compensatory issues
Bad knee → altered gait → contralateral knee, hip, back, ankle problems. Each is a separate claim if onset post-dates the original knee injury.
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
One knee can legitimately carry FOUR ratings
5260 (flexion) + 5261 (extension) + 5257 (instability) + 5003 (arthritis floor when ROM is noncompensable). Audit your last decision — most veterans only have one of these.
Demand post-repetitive and flare-up ROM measurements
If the DBQ shows only a first-pass measurement, the exam violates Sharp and Mitchell. That's grounds for HLR (higher-level review) or supplemental claim with a new DBQ.
Don't push past pain at the C&P
The pain-onset ROM is your rating ROM. 'Trying harder' to demonstrate flexibility erases your rating. Stop where pain starts.
Total knee replacement = automatic 100% for 4 months, 30% floor after
Per DC 5055, post-TKR you get 100% for 4 months following implantation, then rated on residuals but never below 30%. Verify your surgery date is on file.
Related Tools & Resources
Frequently Asked Questions
Can I rate flexion and extension separately on the same knee?
Yes — per VAOPGCPREC 9-2004, DC 5260 (flexion) and DC 5261 (extension) are separately compensable when both motions are limited. Many raters apply only one.
What happens if my ROM is normal but my knee still hurts?
DC 5003 provides a 10% floor for painful motion with imaging-confirmed arthritis. Even with full ROM, you get 10% per affected major joint group with arthritis.
Does instability rate separately from ROM limitations?
Yes — per VAOPGCPREC 23-97, recurrent subluxation or lateral instability (DC 5257) is rated SEPARATELY from limitation of motion. If your knee buckles, file under 5257 in addition to 5260.
What if my flexion is 'limited by pain at 45°'?
Per Mitchell, the pain-onset degree is the rating ROM. Flexion to 45° = 10% under DC 5260. Make sure the DBQ explicitly states the degree at which pain began, not just where motion physically stopped.
Can I get 5260 AND 5003 on the same knee?
Generally no — 5003 only applies when ROM is noncompensable (0%). If 5260 already gives you a compensable rating, 5003 doesn't add on. But 5260 + 5261 + 5257 can all combine.
Official Regulatory Source
Knee limitation of flexion is rated under 38 CFR § 4.71a, Diagnostic Code 5260.
38 CFR § 4.71a — Musculoskeletal System (eCFR) →Scroll to DC 5260. Sibling codes 5261 (extension) and 5257 (instability) follow.
⚠️ Verify with a VSO
Knee ratings interact in complex ways — pyramiding rules under § 4.14 prevent rating the same disability twice. Separate ratings for flexion, extension, and instability are PERMITTED (per VA General Counsel precedent), but 5260 + 5003 cannot both be compensably assigned. Verify combinations with a VSO before filing.
Next Steps
If your rating decision lists DC 5260, 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 5260 • 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.