Proving Service Connection for Knee Ankylosis
A significant number of military veterans experience knee and lower leg pain as a result of their active service. The U.S. Department of Veteran Affairs assesses compensation and assigns military disability ratings for knee pain.
If you have developed knee issues due to military service, you may qualify for financial compensation through the VA. Every veteran needs to know which knee disabilities are recognized by VA to become eligible for VA disability benefits.
Knee Conditions And Diagnostic Codes Recognized By VA
Diagnostic criteria for knee impairment or pain are under 38 CFR § 4.71a, Schedular Ratings, Musculoskeletal System. These criteria outline various knee conditions that are assigned specific diagnostic codes, including but not limited to:
Diagnostic Code 5256
Diagnostic Code 5256 pertains to knee ankylosis, characterized by abnormal stiffening. It can receive a disability rating ranging from 30 to 60 percent, with higher ratings corresponding to greater limitations in knee mobility.
Diagnostic Code 5257
Diagnostic Code 5257 addresses knee instability characterized by excessive side-to-side motion or frequent dislocation. Inadequate support from tendons and cartilage leads to this condition. VA assigns a rating of 0 to 30 percent based on the level of instability observed.
Diagnostic Code 5260
Diagnostic Code 5260 refers to the limitation of flexion of the knee. It is the most common knee condition for veterans receiving VA disability benefits.
It refers to a restricted range of motion when the knee is bent or moved towards the body. The highest disability rating for this condition is 30 percent, but the most common rating is 10 percent.
The VA has specific rating criteria for knee conditions that involve measuring the range of motion. Disability ratings are determined based on defined measurement parameters.
Diagnostic Code 5261
Diagnostic Code 5261 pertains to limited knee extension - the knee cannot fully straighten but is not frozen. The disability rating ranges from 0 to 50 percent based on the extension limitation. VA uses a specific range of motion measurements for each disability percentage.
Proving Service Connection For Knee Pain
The most common approach is establishing a direct service connection to obtain a VA rating for knee pain. There are three main factors in proving service connection for knee pain:
Current Diagnosis
The first crucial factor is obtaining a current diagnosis for the claimed disability. A qualified medical professional must provide this diagnosis and address the condition for which compensation is sought.
It is essential that the diagnosis directly links your knee pain to a specific illness or knee condition. VA will not accept a diagnosis that only partially explains the cause of your knee pain.
In-Service Medical Documents
The second factor to consider is to provide proper documentation of an in-service event that caused or aggravated the knee condition. For chronic diseases that develop gradually, collecting sufficient documentation can be challenging.
Many veterans proactively maintain records of their pain before leaving the military. In the case of knee pain resulting from a specific incident, it is important to provide comprehensive information, including the timing, impact on pain, post-incident changes, and any medical treatment received.
Make sure to include these crucial details in your supporting documents.
Nexus Letter
Lastly, it is essential to provide a medical nexus letter for knee pain as required by the VA.
A medical nexus refers to a document or statement from a medical provider that establishes the relationship between your knee condition and military service. This letter can be obtained from the same doctor who diagnosed your condition or from a separate medical professional approved by the VA.
The presence of a well-documented medical nexus can greatly influence the outcome of your VA disability claim for knee pain.
