This guide covers how the VA actually rates knee / hip / shoulder under diagnostic code 5257 / 5260 / 5261 — the criteria the rater applies, the evidence that carries weight, and the related conditions veterans most often leave unclaimed. It's the same playbook our own case managers work from.
How the VA rates it
Knee: instability (5257) and limitation of motion (5260/5261) can STACK — a rare double-dip the VA allows.
Honest ceiling: 30% at flexion limited to 15°.
The evidence that wins
Service connection: In-service injury, or overcompensation from another service-connected joint.
Medical opinion (nexus): Needed for the overcompensation theory.
Secondary conditions veterans miss
Conditions that commonly develop because of this one can be service-connected on top of it:
- Opposite knee / hip / back overcompensation
- Depression secondary to chronic pain
Filing it right the first time
Most denials on knee / hip / shoulder claims trace to the same failures: the evidence never addressed the actual rating criteria, the connection to service was asserted instead of supported, or the C&P exam went sideways because nobody prepared for it. A complete file — records, statements written to the criteria above, and honest exam preparation — is the difference.
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