Ankle, limited motion of — VA Diagnostic Code 5271

DC 5270 is “Ankle, ankylosis of.” In plantar flexion at more than 40 degrees, or in dorsiflexion at more than 10 degrees, or with abduction, adduction, inversion, or eversion deformity, 40. In plantar flexion between 30 and 40 degrees, or in dorsiflexion between 0 and 10 degrees, 30. In plantar flexion less than 30 degrees, 20. The public page is the ankle guide.

DC 5056, “Ankle replacement (prosthesis),” says intermediate degrees of residual weakness, pain, or limitation of motion are rated by analogy to 5270 or 5271. The minimum rating is 20. For 1 year following implantation of prosthesis, 100. With chronic residuals consisting of severe painful motion or weakness, 40. Note (4) of the prosthesis block says the 100 percent rating for 1 year following implantation will commence after the initial grant of the 1-month total rating assigned under § 4.30 following hospital discharge. This catalog does not have a separate DC 5056 page.

DC 5272 is ankylosis of the subastragalar or tarsal joint: in poor weight-bearing position, 20; in good weight-bearing position, 10.

38 CFR § 4.71a Diagnostic Code 5003, “Degenerative arthritis, other than post-traumatic,” says degenerative arthritis established by X-ray findings is rated on limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved. When that limitation is noncompensable under those codes, “a rating of 10 pct is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5003.” Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. In the absence of limitation of motion, the code prints 20 for X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations, and 10 for that X-ray involvement without the exacerbations line. Note (1): those 20 pct and 10 pct ratings based on X-ray findings will not be combined with ratings based on limitation of motion. DC 5010, “Post-traumatic arthritis,” says: “Rate as limitation of motion, dislocation, or other specified instability under the affected joint. If there are 2 or more joints affected, each rating shall be combined in accordance with § 4.25.”

DC 5262 is “Tibia and fibula, impairment of.” For malunion, the schedule says: “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.”

DC 5273 is “Os calcis or astragalus, malunion of”: marked deformity, 20; moderate deformity, 10. DC 5274 is astragalectomy, 20.

DC 5284 is “Foot injuries, other”: severe, 30; moderately severe, 20; moderate, 10. The note says: “With actual loss of use of the foot, rate 40 percent.” 38 CFR § 4.14 says the evaluation of the same manifestation under different diagnoses are to be avoided. This page does not state that DC 5271 and DC 5284 are both applied to the same manifestation.

38 CFR § 4.26 (Bilateral factor). Paragraph (a) says the use of the terms “arms” and “legs” is not intended to distinguish between the arm, forearm and hand, or the thigh, leg, and foot, but relates to the upper extremities and lower extremities as a whole. Paragraph (c) says: “The bilateral factor is not applicable unless there is partial disability of compensable degree in each of 2 paired extremities, or paired skeletal muscles.” See bilateral factor.