38 CFR Part 4 — 38 CFR § 4.71a
Tibia and fibula, impairment of — VA Diagnostic Code 5262
Musculoskeletal
Diagnostic code
5262
38 CFR § 4.71a lists Diagnostic Code 5262 in The Knee and Leg table as “Tibia and fibula, impairment of:”. Nonunion of, with loose motion, requiring brace, is 40. Malunion has no percentage of its own. Medial tibial stress syndrome (MTSS), or shin splints, has lines at 30, 20, 10, and 0.
Reviewed 2026-10-05. Text checked against the eCFR versioner full-text XML for 2026-10-01 on 2026-10-05. Title 38 was up to date as of 2026-10-01 and last amended on 2026-08-27. The § 4.71a source note prints 29 FR 6718, May 22, 1964, as amended at 34 FR 5062, Mar. 11, 1969; 40 FR 42536, Sept. 15, 1975; 41 FR 11294, Mar. 18, 1976; 43 FR 45350, Oct. 2, 1978; 51 FR 6411, Feb. 24, 1986; 61 FR 20439, May 7, 1996; 67 FR 48785, July 26, 2002; 67 FR 54349, Aug. 22, 2002; 68 FR 51456, Aug. 27, 2003; 69 FR 32450, June 10, 2004; 80 FR 42041, July 16, 2015; 85 FR 76460, Nov. 30, 2020, 85 FR 85523, Dec. 29, 2020, 86 FR 8142, Feb. 4, 2021. The last two amendments are separated by commas in that note.
The rating criteria at each level
5262 Tibia and fibula, impairment of — The Knee and Leg
Rating %: 40
Criteria (verbatim). Nonunion of, with loose motion, requiring brace
Rating %: —
Criteria (verbatim). Malunion of:
Rating %: —
Criteria (verbatim). Evaluate under diagnostic codes 5256, 5257, 5260, or 5261 for the knee, or 5270 or 5271 for the ankle, whichever results in the highest evaluation.
Rating %: —
Criteria (verbatim). Medial tibial stress syndrome (MTSS), or shin splints:
Rating %: 30
Criteria (verbatim). Requiring treatment for no less than 12 consecutive months, and unresponsive to surgery and either shoe orthotics or other conservative treatment, both lower extremities
Rating %: 20
Criteria (verbatim). Requiring treatment for no less than 12 consecutive months, and unresponsive to surgery and either shoe orthotics or other conservative treatment, one lower extremity
Rating %: 10
Criteria (verbatim). Requiring treatment for no less than 12 consecutive months, and unresponsive to either shoe orthotics or other conservative treatment, one or both lower extremities
Rating %: 0
Criteria (verbatim). Treatment less than 12 consecutive months, one or both lower extremities
| Rating % | Criteria (verbatim) |
|---|---|
| 40 | Nonunion of, with loose motion, requiring brace |
| — | Malunion of: |
| — | Evaluate under diagnostic codes 5256, 5257, 5260, or 5261 for the knee, or 5270 or 5271 for the ankle, whichever results in the highest evaluation. |
| — | Medial tibial stress syndrome (MTSS), or shin splints: |
| 30 | Requiring treatment for no less than 12 consecutive months, and unresponsive to surgery and either shoe orthotics or other conservative treatment, both lower extremities |
| 20 | Requiring treatment for no less than 12 consecutive months, and unresponsive to surgery and either shoe orthotics or other conservative treatment, one lower extremity |
| 10 | Requiring treatment for no less than 12 consecutive months, and unresponsive to either shoe orthotics or other conservative treatment, one or both lower extremities |
| 0 | Treatment less than 12 consecutive months, one or both lower extremities |
The nonunion cell says “requiring brace.” It does not say “a brace.”
The 30 and 20 percent shin-splint lines say “unresponsive to surgery and either shoe orthotics or other conservative treatment.” The 10 percent line says “unresponsive to either shoe orthotics or other conservative treatment.” It does not say “surgery and.”
The 30 percent line says “both lower extremities.” The 20 percent line says “one lower extremity.” The 10 and 0 percent lines say “one or both lower extremities.”
The malunion sentence names DC 5256, knee ankylosis, whose public page is the knee guide; DC 5257, knee, other impairment; DC 5260, limitation of flexion of the leg; DC 5261, limitation of extension of the leg; DC 5270, ankle ankylosis, whose public page is the ankle guide; and DC 5271, ankle, limited motion. It says to use whichever results in the highest evaluation. 38 CFR § 4.7 assigns the higher rating when the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 CFR § 4.6 requires each element affecting the evidence to be studied so that decisions will be equitable and just.
The knee-replacement note under DC 5055 says that at the conclusion of the 100 percent evaluation period, evaluate resurfacing under diagnostic codes 5256 through 5262, and that there is no minimum evaluation for resurfacing. An earlier knee-replacement line says to rate intermediate degrees of residual weakness, pain or limitation of motion by analogy to diagnostic codes 5256, 5261, or 5262. The public page for DC 5055 is the knee replacement guide. Those sentences name DC 5262. They are not the DC 5262 criteria.
The next code in the table is DC 5263, genu recurvatum, at 10. That is a different title. 38 CFR § 4.31 says that in every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. DC 5262 does print a 0 percent line, on the shin-splint row for treatment less than 12 consecutive months.
Source: 38 CFR § 4.71a, Diagnostic Code 5262, eCFR full-text XML for 2026-10-01.
What the words mean in your records
Nonunion and malunion
Nonunion with loose motion, requiring brace, is 40. Malunion has an empty rating cell. The following cell tells the reader to evaluate under the named knee or ankle codes, whichever results in the highest evaluation.
Shin splints
The schedule’s words are “Medial tibial stress syndrome (MTSS), or shin splints.” The 30 and 20 percent lines require treatment for no less than 12 consecutive months and being unresponsive to surgery and either shoe orthotics or other conservative treatment. The 10 percent line uses the same 12-month clause and drops “surgery and.”
Evidence that speaks to each level
40
What the rater needs to see. Nonunion of the tibia and fibula, with loose motion, requiring brace.
Where that usually lives. The imaging and the examination that describe loose motion and a brace.
Malunion
What the rater needs to see. The knee or ankle findings the malunion sentence names, under DC 5256, 5257, 5260, 5261, 5270, or 5271.
Where that usually lives. The knee and ankle examinations those codes use.
30, 20, 10, or 0
What the rater needs to see. How long treatment has lasted, whether it was unresponsive to surgery and to shoe orthotics or other conservative treatment, and whether one or both lower extremities are named.
Where that usually lives. The treatment record for the 12 consecutive months, and the examination of each lower extremity.
VA’s public DBQ list, checked October 5, 2026, names “Knee and Lower Leg” and “Ankle” under Musculoskeletal. The files are Knee and Lower Leg and Ankle.
The exam form
DC 5262 prints 40 for nonunion, a malunion instruction with no percentage of its own, and shin-splint lines at 30, 20, 10, and 0. This page does not say either form replaces those lines.
Related codes and how they interact
The malunion sentence uses other codes.
Those codes have their own criteria. DC 5262 does not reprint the knee ankylosis, knee impairment, flexion, extension, ankle ankylosis, or ankle motion lines.
Secondary conditions and presumptions
The 2026-10-01 text of 38 CFR § 3.309 does not contain “tibia,” “fibula,” or “shin.” DC 5262 is a rating-schedule line, not a § 3.309 name.
Short answers
What is the VA rating for tibia and fibula impairment?
Under 38 CFR § 4.71a, Diagnostic Code 5262 is 40 percent for nonunion with loose motion, requiring brace. Malunion is evaluated under the knee or ankle codes that sentence names. Medial tibial stress syndrome, or shin splints, is 30, 20, 10, or 0 on the lines printed under that heading. Education only. VA decides on the evidence.
Does knee resurfacing use this code?
The DC 5055 note says to evaluate resurfacing under diagnostic codes 5256 through 5262 after the 100 percent evaluation period, and that there is no minimum evaluation for resurfacing. That note is on the knee-replacement code. It is not a percentage printed on DC 5262.
FAQ
What does nonunion of the tibia and fibula rate?
The DC 5262 line is “Nonunion of, with loose motion, requiring brace,” at 40. Education only.
Where does malunion get a percentage?
The malunion row has no percentage. The next cell says to evaluate under diagnostic codes 5256, 5257, 5260, or 5261 for the knee, or 5270 or 5271 for the ankle, whichever results in the highest evaluation.
How do the shin-splint lines differ?
The 30 percent line is both lower extremities and requires being unresponsive to surgery and either shoe orthotics or other conservative treatment, after no less than 12 consecutive months. The 20 percent line is one lower extremity with that same surgery clause. The 10 percent line is one or both lower extremities and does not say “surgery and.” The 0 percent line is treatment less than 12 consecutive months, one or both lower extremities.
Next steps
- Read the decision for DC 5262 and whether it used nonunion, the malunion codes, or a shin-splint line.
- The free worksheet is a place to write the code, the findings, and the records you already have. It does not file a claim or protect a filing date. An accredited representative is at find a VSO.
- Other musculoskeletal codes are on the musculoskeletal diagnostic-code index. The knee page is the knee guide. The ankle page is the ankle guide.
Education only. Not legal or medical advice. My Claim Packet is not a VA-accredited representative and does not file claims. VA decides every claim on its own evidence.
Other codes in this body system
Nearby catalog entries in Musculoskeletal, ordered by diagnostic code number. All Musculoskeletal codes
- DC 5254Hip, flail joint
- DC 5255Femur, impairment
- DC 5256Knee, ankylosis
- DC 5257Knee, other impairment
- DC 5258Cartilage, semilunar, dislocated
- DC 5259Cartilage, semilunar, removal
- DC 5260Leg, limitation of flexion
- DC 5261Leg, limitation of extension
- DC 5263Genu recurvatum
- DC 5269Plantar fasciitis
- DC 5270Ankle, ankylosis
- DC 5271Ankle, limited motion
- DC 5272Subastragalar or tarsal joint, ankylosis
- DC 5273Os calcis or astragalus, malunion
- DC 5274Astragalectomy
- DC 5275Lower extremity bones, shortening
Also: DC code lookup (tools) lists the same index in a compact layout.
Source: 38 CFR Part 4, Diagnostic Code 5262 • va.gov
⚠️ Important Disclaimer
This page provides general educational information based on public VA regulations and VA.gov resources. It is not legal or medical advice, and My Claim Packet is not a VA-accredited representative. Any worksheets or draft documents produced by the tools must be reviewed for accuracy and are not filed with VA for you. Ratings and service connection are decided case-by-case from the individual record. Consult a VA-accredited VSO, claims agent, attorney, or qualified clinician for help with your situation, and verify current rules using the linked official source.