Leg, limitation of extension of — VA Diagnostic Code 5261

Extension limited to

Each line uses those words plus a degree: 45, 30, 20, 15, 10, or 5. The schedule does not define extension in a sentence under this code. A larger degree on this list is a higher percentage.

How extension is measured

38 CFR § 4.46 (Accurate measurement) says the use of a goniometer in the measurement of limitation of motion is indispensable in examinations conducted within the Department of Veterans Affairs. 38 CFR § 4.59 (Painful motion) says the joints involved should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint. The same section says the intent is to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint. 38 CFR § 4.40 (Functional loss) says functional loss may be due to pain, supported by adequate pathology and evidenced by the visible behavior of the claimant undertaking the motion, and that weakness is as important as limitation of motion. 38 CFR § 4.45 (The joints) directs inquiry to less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement, swelling, deformity, or atrophy of disuse. For arthritis, it names the shoulder, elbow, wrist, hip, knee, and ankle as major joints. 38 CFR § 4.71 says Plates I and II provide a standardized description of ankylosis and joint motion measurement. This page does not retype the plates.

Flexion of the same knee

VA General Counsel Precedent Opinion VAOPGCPREC 9-2004 (September 17, 2004), published on VA.gov, holds: “Separate ratings under DC 5260 (leg, limitation of flexion) and DC 5261 (leg, limitation of extension), both currently codified at 38 C.F.R. § 4.71a, may be assigned for disability of the same joint.” 38 CFR § 4.14 still says the evaluation of the same disability under various diagnoses is to be avoided. The opinion and the regulation are both in the record a rater uses. This page does not apply them to a particular knee.

Flexion, ankylosis, and replacement

What is the VA rating for limitation of extension of the leg?

Under 38 CFR § 4.71a, Diagnostic Code 5261, extension limited to 45 degrees is 50 percent, to 30 degrees is 40 percent, to 20 degrees is 30 percent, to 15 degrees is 20 percent, to 10 degrees is 10 percent, and to 5 degrees is 0 percent. Education only. VA decides on the evidence.

Which examination finding matches DC 5261?

A goniometer measurement of extension, under § 4.46, tested for pain on active and passive motion under § 4.59. Flexion measurements are the DC 5260 lines.

How does VA rate limitation of knee extension under DC 5261?

Under 38 CFR § 4.71a, extension limited to 45 degrees is 50 percent, to 30 degrees is 40 percent, to 20 degrees is 30 percent, to 15 degrees is 20 percent, to 10 degrees is 10 percent, and to 5 degrees is 0 percent. Education only.

Is a 10 degree extension limit the same as a 10 percent flexion rating?

No. Extension limited to 10 degrees is the DC 5261 10 percent line. Flexion limited to 45 degrees is the DC 5260 10 percent line. They are different motions and different codes.

Can the same knee be rated for both motions?

VAOPGCPREC 9-2004 holds that separate ratings under DC 5260 and DC 5261 may be assigned for disability of the same joint. Section 4.14 says the evaluation of the same disability under various diagnoses is to be avoided.