Knee Instability (Recurrent Subluxation or Instability)
A knee that gives way due to ligament damage or kneecap instability. Under criteria revised in 2021, the rating depends on the type of ligament injury and whether a medical provider has prescribed a brace or assistive device.
How the VA rates it
DC 5257 was overhauled effective February 2021: the old slight/moderate/severe scale is gone. For ligament-based instability, the rating now turns on (1) whether the ligament tear is complete and unrepaired (or failed repair) versus a sprain, incomplete tear, or repaired tear, and (2) whether a medical provider has prescribed bracing and/or an assistive device (cane, crutches, walker) for walking. A parallel track rates patellar (kneecap) instability at the same 10/20/30 levels based on surgical-repair history and prescribed devices. Persistent instability without any prescribed brace or device rates 10 percent.
Rating criteria by percentage
Rated up to 30%Unrepaired or failed repair of a complete ligament tear causing persistent instability, with a medical provider prescribing BOTH an assistive device (cane, crutches, walker) AND bracing for walking. (Patellar track: recurrent instability after surgical repair requiring a prescribed brace plus a cane or walker.)
Sprain, incomplete tear, or repaired complete tear with a prescribed brace and/or assistive device; or an unrepaired/failed-repair complete tear with EITHER a prescribed assistive device OR bracing. (Patellar track: post-repair instability requiring one of brace, cane, or walker.)
Persistent instability from a sprain or ligament tear (any repair status) without a prescription for a brace or assistive device. (Patellar track: recurrent patellar instability not requiring prescribed devices.)
Secondary condition strategy
Commonly claimed secondary to this
Conditions veterans often develop from this one — each can be its own rating under 38 CFR 3.310.
- Degenerative Arthritis — Chronic instability accelerates cartilage wear; arthritis in the same knee can be separately rated on limitation of motion since the criteria do not overlap.
- Limitation of Knee Flexion (opposite knee) — Years of favoring an unstable knee can overload the opposite knee (contralateral compensation).
- Lumbosacral Strain — A compensating, guarded gait from an unstable knee can cause or aggravate low back problems.
Evidence that strengthens this claim
- Under the 2021 criteria, the prescription is the evidence: get your provider to formally prescribe (not just recommend) a brace, cane, crutches, or walker, and make sure the prescription is in your records.
- Get imaging or surgical records that characterize the tear: complete versus incomplete, repaired versus unrepaired, is now the difference between rating tiers.
- Document instability events: falls, buckling episodes, ER visits. Lachman and drawer test results at the C&P exam should match your reported history.
- Instability is rated separately from arthritis and motion loss in the same knee, so claim and document each problem distinctly.
Rating rules to know
Knee instability (5257) may be combined with separate ratings for limitation of flexion (5260), limitation of extension (5261), or arthritis in the same knee because the criteria measure different things (VA General Counsel precedent opinions 23-97 and 9-98). The bilateral factor (38 CFR 4.26) applies when both knees carry compensable ratings.
Related diagnostic codes
More musculoskeletal conditions
Lumbosacral Strain (Low Back Strain)
Chronic strain of the low back muscles and ligaments, one of the most commonly claimed VA disabilities. VA rates it on how far you can bend and move your low back, not on how much it hurts.
Rated up to 100%
Limitation of Knee Flexion
The most commonly rated knee disability: how far you can bend the knee. Ratings run 0 to 30 percent based on measured flexion, with a 10 percent floor for a painful knee under the painful-motion rule.
Rated up to 30%
Degenerative Arthritis (Osteoarthritis)
Wear-and-tear arthritis confirmed by X-ray. VA rates it through the motion limits of each affected joint, with a 10 percent floor for a painful arthritic joint even when motion is nearly normal.
Rated up to 20%
Cervical Strain (Neck Strain)
Chronic strain of the neck muscles and ligaments. VA rates it on how far you can move your neck under the same spine formula used for the low back, with neck-specific degree thresholds.
Rated up to 100%
Degenerative Disc Disease (DDD)
Wear-and-tear breakdown of the spinal discs and joints, in the low back or neck. VA rates it on measured spinal motion under the same formula used for back and neck strain.
Rated up to 100%
Plantar Fasciitis
Inflammation of the tissue band supporting the arch, causing heel and arch pain. VA gave it its own diagnostic code in 2021, rated 10 to 30 percent based mainly on whether treatment provides relief.
Rated up to 40%
Disclaimer: Valor Rating is not affiliated with the U.S. Department of Veterans Affairs. This content is for educational purposes only and does not constitute legal or medical advice. Always review your documents carefully before submitting to the VA. For official guidance, consult an accredited VSO, claims agent, or attorney.