The Knee DBQ is unusual in the schedule: one knee can carry up to three separately compensable ratings at the same time. Limited flexion (DC 5260), limited extension (DC 5261), and recurrent subluxation or lateral instability (DC 5257) each get their own rating — they do not pyramid (overlap), they stack under 38 CFR § 4.25. Plus meniscal codes (5258 / 5259), genu recurvatum (5263), the § 4.59 painful motion floor, and the Correia/DeLuca measurement rules that apply to all musculoskeletal exams.
The form addresses several categories of knee findings. Review the completed record for accuracy and make sure symptoms are not counted twice under overlapping criteria.
What the examiner is filling out
The DBQ (Knee and Lower Leg Conditions Disability Benefits Questionnaire) covers:
- Diagnosis — specific knee condition(s). Each gets its own DC.
- Range-of-motion measurements — flexion (normal 0–140°), extension (normal 0°, hyperextension or loss of full extension noted). Goniometer measurements.
- Joint stability tests — anterior / posterior / medial-lateral. Examiner marks 1+ / 2+ / 3+ laxity.
- Meniscal symptoms — locking, frequent effusion, pain.
- Functional loss — § 4.59 painful motion, § 4.40 functional loss, § 4.45 additional factors (less movement, more movement, weakened movement, excess fatigability, incoordination, pain on use, swelling, deformity, atrophy, instability of station, disturbance of locomotion, interference with sitting/standing).
- Flare-up estimation (DeLuca / Mitchell) — ROM during flare-ups, after repetitive use, weight-bearing vs non-weight-bearing.
- Imaging / surgical history — X-ray, MRI, prior arthroscopy or replacement.
DC 5260 — Limitation of flexion
Painful motion gets §4.59 minimum compensable 10% even when flexion is full — see below.
Most common starting tier with meaningful limitation.
Maximum for limitation of flexion alone.
DC 5261 — Limitation of extension
DC 5257 — Knee, other impairment of
The current schedule does not use slight, moderate, or severe for DC 5257. The levels are 10, 20, and 30 percent. The higher levels turn on the ligament findings and on whether a medical provider prescribes a brace or assistive device for ambulation. Patellar instability is a separate track in the same code. Read the verbatim text, including both notes, on the DC 5257 page.
§ 4.59 painful motion — the 10% floor
38 CFR § 4.59 says “actually painful, unstable, or malaligned joints, due to healed injury, are entitled to at least the minimum compensable rating for the joint.” For the knee, that minimum is 10%. Even if your flexion is full and your extension is full, if motion is painful, you should get 10% — not 0%. The examiner is required to test for pain on motion and report it.
The Federal Circuit decisions Burton v. Shinseki (Vet. App. 2011) and Petitti v. McDonald (Vet. App. 2017) reinforced that § 4.59 applies broadly — painful motion warrants the minimum compensable rating regardless of whether the motion is measurably limited.
Meniscus codes — DC 5258 and 5259
One rating tier — flat 20%. Requires documentation of locking episodes, pain, and effusion (swelling). Often documented post-arthroscopy or on MRI.
Flat 10% after meniscus removal (meniscectomy). Records of the procedure plus ongoing symptoms suffice.
How to read the criteria
Use the criteria to understand the form
The rating schedule describes findings VA may consider. It is not a script. Describe only what is true in your own words, including frequency, duration, treatment, good and bad days, and effects on daily activities or work. Do not select or rehearse a rating tier.
The goniometer + Correia rule
Same as the spine: range-of-motion must be measured with a goniometer, and the exam must include active + passive ROM, weight-bearing + non-weight-bearing, and a comparison to the opposite (undamaged) joint. Without those measurements, the exam is inadequate under Correia v. McDonald (Vet. App. 2016). If your C&P examiner did not use a goniometer or did not test the opposite knee, you have grounds for a Supplemental Claim requesting a new exam.
Describe the full picture accurately
Accuracy reminder
Describe what is true in your own words, including frequency, duration, treatment, good and bad days, and effects on daily activities or work. Do not exaggerate, omit improvement, rehearse a rating tier, or guess. If something varies or you do not know, say that clearly.
Knee replacement and post-operative ratings
If you have had a total knee replacement (TKR / arthroplasty), DC 5055 applies:
- 100% for the 4-month post-operative period (per current § 4.71a)
- 60% with chronic residuals consisting of severe painful motion or weakness in the affected extremity
- 30% minimum after the 100% period ends, even with no other symptoms
See the knee replacement condition guide for the full schedule. The 4-month figure is correct — some online resources still cite the old 13-month period that was changed in the 2024 musculoskeletal restructure.
Use this with the rest of the site
- ▸ Knee condition guide — the rating schedule and evidence checklist for that condition.
- ▸ C&P Exam Prep — a checklist for organizing your history, treatment, and questions before the exam.
- ▸ Coach preview — free five-question preview; the dashboard organizes C&P prep and a VSO packet.
- ▸ Full C&P exam guide — how to describe your symptoms accurately.
Get the free Secondary Conditions Checklist by email
Educational content only. VA publishes Public Disability Benefits Questionnaires. Some DBQs are not available for public use. Rating criteria are in 38 CFR Part 4. Not legal or medical advice. Always consult a VA-accredited VSO or attorney for claim-specific guidance. CFR citations: 38 CFR § 4.71a (DC 5055, 5256–5263), § 4.59 (painful motion), § 4.40 (functional loss), § 4.45 (additional factors), § 4.25 (combined ratings). Court precedent: Correia v. McDonald (2016), DeLuca v. Brown (1995), Mitchell v. Shinseki (2011), Burton v. Shinseki (2011), Petitti v. McDonald (2017). VA OGC Prec. 9-2004 on pyramiding analysis..