Ankle VA Rating

Most ankle claims come down to two measurements. DC 5271 rates limited motion of the ankle as "moderate" at 10 percent or "marked" at 20 percent, and since February 7, 2021 the code defines both terms in degrees. Older Board decisions treat the two words as undefined. They no longer are, which puts the goniometer reading, and whether it reflects pain, repetition and flare-ups, at the center of most ankle decisions.

The ankle is also a low-ceiling joint. The limited-motion code tops out at 20 percent, and the only way past that on a single ankle is ankylosis, a joint that no longer moves, under DC 5270. VA's fiscal year 2025 Annual Benefits Report counts 1,273,110 service-connected disabilities for limitation of motion of the ankle, which puts it among the ten most common disabilities in the report. In my read, the rating fight on most of them is about a few degrees and whether the exam counted what happens on a bad day.

TL;DR

• Ankle conditions are rated under 38 CFR § 4.71a across five codes: 5270 (ankylosis of the ankle), 5271 (limited motion), 5272 (ankylosis of the subastragalar or tarsal joint), 5273 (malunion of the heel bone or talus) and 5274 (astragalectomy).
• DC 5271 has two levels. Marked (20 percent) is less than 5 degrees of dorsiflexion or less than 10 degrees of plantar flexion. Moderate (10 percent) is less than 15 degrees of dorsiflexion or less than 30 degrees of plantar flexion.
• Normal ankle motion is 0 to 20 degrees of dorsiflexion and 0 to 45 degrees of plantar flexion (Plate II, 38 CFR § 4.71).
• Painful motion supports at least the minimum compensable rating for the joint (§ 4.59), and the exam has to account for pain, repetition and flare-ups.
• A surgically fused ankle is rated as ankylosis, up to 40 percent. An ankle replacement rates 100 percent for one year, then at least 20 percent.
• Secondary claims run both ways: an ankle can be secondary to a service-connected knee, hip, back or flat feet, and a bad ankle can drive knee, hip and back problems.
• Across 27,035 decided Board rulings on ankle conditions from 2021 to 2026, 19.8% were granted, 28.3% denied and 52.0% remanded. A ruling is one issue the Board decided in one decision; one decision often rules on several issues. Remand is the most common outcome on the ankle. The data records outcome by issue type rather than by diagnostic code, so I can't read the DC 5270 vs DC 5271 split directly from it.

Ankle VA rating criteria (DC 5270 to 5274)

The ankle section of 38 CFR § 4.71a reads as follows.

DC 5270, Ankle, ankylosis of.

In plantar flexion at more than 40°, or in dorsiflexion at more than 10° or with abduction, adduction, inversion or eversion deformity: 40%

In plantar flexion, between 30° and 40°, or in dorsiflexion, between 0° and 10°: 30%

In plantar flexion, less than 30°: 20%

DC 5271, Ankle, limited motion of.

Marked (less than 5 degrees dorsiflexion or less than 10 degrees plantar flexion): 20%

Moderate (less than 15 degrees dorsiflexion or less than 30 degrees plantar flexion): 10%

DC 5272, Subastragalar or tarsal joint, ankylosis of.

In poor weight-bearing position: 20%

In good weight-bearing position: 10%

DC 5273, Os calcis or astragalus, malunion of.

Marked deformity: 20%

Moderate deformity: 10%

DC 5274, Astragalectomy: 20%.

The os calcis is the heel bone and the astragalus is the talus, the bone that sits in the ankle joint. DC 5272 covers the joints just below the true ankle, and an astragalectomy is surgical removal of the talus. Only DC 5270 rates above 20 percent, so a single ankle that is not fused is capped at 20 percent no matter how painful or limited it is.

Arthritis is not rated under its own ankle code. DC 5003 rates X-ray arthritis on limitation of motion of the joint, and when that limitation is noncompensable but objectively confirmed by swelling, muscle spasm or painful motion, it assigns 10 percent for each major joint. The ankle is a major joint (§ 4.45(f)).

Ankle range of motion VA rating: moderate or marked

The examiner measures your ankle against Plate II of 38 CFR § 4.71: dorsiflexion (toes toward the shin) from 0 to 20 degrees and plantar flexion (toes pointed down) from 0 to 45 degrees. The ankle DBQ uses the same endpoints. Either measurement is enough on its own, so an ankle with normal plantar flexion but dorsiflexion under 5 degrees meets the marked level.

The last row is where § 4.59 matters. It says the schedule intends "to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint." An ankle with painful motion that measures above the moderate lines still supports 10 percent.

The fight between moderate and marked usually turns on whether the number reflects how the ankle works. Section 4.40 says "a part which becomes painful on use must be regarded as seriously disabled," and § 4.45 adds weakened movement, excess fatigability, incoordination and pain on movement, with "instability of station, disturbance of locomotion, interference with sitting, standing and weight-bearing" as related considerations. Under Sharp v. Shulkin, 29 Vet. App. 26 (2017), when you are not examined during a flare-up, the examiner still has to estimate the flare-up limits from what you report. A flare-up estimate that shows dorsiflexion near zero can support the marked level even when the clinic reading stopped at moderate.

Achilles tendonitis VA rating

Achilles tendonitis, also called Achilles tendinitis or tendinopathy, falls under DC 5024 (tenosynovitis, tendinitis, tendinosis or tendinopathy). The note to DCs 5013 through 5024 says to evaluate these conditions "as degenerative arthritis, based on limitation of motion of affected parts." For the Achilles tendon, the affected motion is usually the ankle, so the DC 5271 levels and the painful-motion rule above apply.

One detail cuts against some claims. Note (2) to DC 5003 says the 10 and 20 percent ratings based on X-ray findings alone "will not be utilized in rating conditions listed under diagnostic codes 5013 to 5024." An Achilles rating has to rest on motion and function, so document measured motion, pain on use, weakness, and loss after repeated use and during flares. Plantar fasciitis is a different condition with its own code, and an Achilles diagnosis does not justify a second rating for the same lost motion.

Source: 38 CFR § 4.71a, DCs 5003, 5024 and 5271 (opens in a new tab).

Ankle instability and old sprains

No ankle code rates instability by name. An unstable ankle is rated through its motion and its function: § 4.45(b) lists "more movement than normal (from ... relaxation of ligaments)" as a factor of joint disability, and § 4.59 names "actually painful, unstable, or malaligned joints, due to healed injury" as entitled to at least the minimum compensable rating. The ankle DBQ tests stability directly with the anterior drawer and talar tilt tests, and asks you to describe instability in your own words.

Old sprains matter for service connection too. In a case series of 30 patients with end-stage ankle arthritis after ligament injuries, the average time from injury to arthritis was 34.3 years, and 52% still had instability at follow-up (Valderrabano and colleagues, 2006). At one university orthopedic center, 445 of 639 ankles with advanced arthritis (70%) were post-traumatic, most often after rotational ankle fractures (Saltzman and colleagues, 2005). Neither study proves your case, but both answer the argument that arthritis decades after an in-service injury must have another cause.

Ankle fusion and ankle replacement

A surgical fusion is rated as ankylosis. The ankle DBQ defines ankylosis as "the immobilization of a joint due to disease, injury, or surgical procedure," and DC 5270 rates it at 20, 30 or 40 percent by the angle the ankle is fixed at. The examiner records that angle in degrees, so the operative report and later imaging should show it.

An ankle replacement is rated under DC 5056.

Prosthetic replacement of ankle joint: For 1 year following implantation of prosthesis: 100%

With chronic residuals consisting of severe painful motion or weakness: 40%

With intermediate degrees of residual weakness, pain or limitation of motion rate by analogy to 5270 or 5271.

Minimum rating: 20%

Note (4) to the prosthetic implant codes says the year at 100 percent begins after the one-month total rating under § 4.30 following hospital discharge. Note (1) says no additional § 4.71a rating is assigned for a replaced joint unless the schedule directs it.

How to prove an ankle condition is service connected

Direct service connection needs a current ankle diagnosis, an injury or event in service, and a medical link between them. An ankle injury in service may leave only a thin record: a rolled ankle on a ruck march, a parachute landing, a sprain treated with a wrap and a profile. Sick call notes, profiles and physical therapy records are the first place to look. A buddy letter from someone who saw the injury or the limp afterward can fill in what the records left out.

Arthritis is on the chronic disease list in 38 CFR § 3.309(a), and under § 3.307(a)(3) it can be presumed service connected if it became manifest to a degree of 10 percent or more within one year of separation. When arthritis shows up much later, the opinion has to explain the time line, and the research on post-traumatic ankle arthritis above helps it do that.

Timing also affects back pay. Under 38 CFR § 3.400(b)(2)(i), the effective date can reach back to the day after separation only if the claim is received within one year of separation; otherwise it is generally the date the claim is received or the date entitlement arose, whichever is later.

The ankle C&P exam and DBQ

The exam follows the ankle conditions DBQ. On the ankle, a few degrees decide the level, so each part of it matters.

• Active and passive motion, weight-bearing and nonweight-bearing, and the other ankle. Section 4.59 says joints "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 Court of Appeals for Veterans Claims held in Correia v. McDonald, 28 Vet. App. 158 (2016), that VA exams should include that testing, and the DBQ tells examiners to test the opposite joint unless it is medically contraindicated.
• Repetitive use. The DBQ asks for motion after at least three repetitions.
• Flare-ups. The DBQ asks the examiner to estimate dorsiflexion and plantar flexion during a flare, based on relevant sources including your lay statements.
• Stability. The anterior drawer and talar tilt tests, or an explanation of why they could not be done.
• Ankylosis and other conditions. The fusion angle, and any Achilles tendonitis or rupture, malunion or talectomy.
• Assistive devices. Any brace, cane or crutches you use as a normal way of getting around.

Before the exam, track how far the ankle moves on bad days, how often it swells or gives way, and what a flare stops you from doing. A symptom tracker gives you dates, and C&P exam prep walks through the questions. Describe the flares in a personal statement so the examiner has something to base the estimate on.

Why VA denies ankle claims

No record of the injury in service. The fix is the sick call or profile record if it exists, and lay statements from people who saw it if it does not.

A long gap before arthritis. VA reads the gap as another cause. The fix is a nexus opinion that explains post-traumatic arthritis and its time course, which the research above supports, and that addresses later injuries by name. A nexus letter should cite the in-service record it relies on.

Moderate assigned on a good-day reading. The fix is a flare-up description in your own words and a request for the estimate Sharp requires, plus § 4.40 and § 4.45 on functional loss.

An incomplete exam. No passive motion, no weight-bearing testing, no comparison with the other ankle. Those gaps are grounds for a new exam under § 4.59 and Correia.

Instability left out. The record says "reports rolling the ankle" with no stability testing. Ask for the anterior drawer and talar tilt results and bring any brace prescription.

The Board section below shows how ankle appeals were decided from 2021 to 2026, how often they were sent back for more work, and how the Board ruled when a private medical opinion was in the record.

The ankle and secondary claims

The ankle sits in more secondary chains than most joints because it can be the new claim or the cause of one. Under 38 CFR § 3.310, a condition is service connected when a service-connected condition caused it (at least as likely as not), or when it is aggravated by that condition, meaning it would be less severe but for the service-connected condition (M21-1 V.ii.2.D). VA rates only the part above the baseline, which has to come from medical evidence, so the opinion should describe the baseline. An opinion that addresses only causation and not aggravation is inadequate (El-Amin v. Shinseki, 26 Vet. App. 136 (2013)).

The ankle as the new claim. A service-connected knee, hip or back can change how you walk and load the ankle. Secondary conditions to a knee lists the ankle among the conditions claimed secondary to the knee and shows the Board's numbers for that pair. Flat feet are the other common cause: § 4.57 describes acquired flatfoot as an "unfavorable mechanical relationship" that includes inward rotation of the top of the heel bone, inward deviation of the Achilles tendon insertion and inward tilting of the top of the talus, which is why examiners look at the ankle when flat feet are service connected.

The ankle as the cause. Limited or painful ankle motion can change your gait and load the knee, hip and low back on one or both sides. The opinion has to describe the gait change, the time line and the other causes it ruled out.

Because a single unfused ankle tops out at 20 percent, the secondary chain is often where the combined rating moves. A 20 percent ankle and a 10 percent knee on the same leg, plus a 20 percent back, combine to 42, which rounds to 40 percent under § 4.25. One limit applies: under the amputation rule in § 4.68, combined ratings for disabilities below the knee cannot exceed the 40 percent rating for amputation below the knee (DC 5165).

The bilateral factor when both ankles are rated

When both legs carry compensable disabilities, 38 CFR § 4.26 says the ratings for the right and left sides "will be combined as usual, and 10 percent of this value will be added (i.e., not combined) before proceeding with further combinations." The regulation's own example uses two 10 percent ratings: they combine to 19, and adding 1.9 gives 21, which is then treated as one disability.

The conditions do not have to match. Section 4.26(a) treats each leg as a whole, so a rated ankle on one side and a rated knee, hip or foot on the other count. Each side has to be compensable (§ 4.26(c)), and if including a bilateral disability would lower the result, VA leaves it out (§ 4.26(d)).

Questions veterans ask about ankle conditions

What is the highest VA rating for ankle pain?

For an ankle that still moves, 20 percent under DC 5271 for marked limited motion. A fused ankle can reach 40 percent under DC 5270, and an ankle replacement rates 100 percent for a year before dropping to its residuals.

What is the VA rating for ankle range of motion?

Dorsiflexion under 15 degrees or plantar flexion under 30 degrees is moderate, 10 percent. Dorsiflexion under 5 degrees or plantar flexion under 10 degrees is marked, 20 percent, and painful motion above those lines still supports 10 percent under § 4.59.

Does VA rate ankle instability?

There is no separate ankle instability code. VA rates an unstable ankle through its motion and functional loss, and § 4.59 treats an unstable joint from a healed injury as entitled to at least the minimum compensable rating.

What is the VA rating for Achilles tendonitis?

DC 5024 rates it as degenerative arthritis based on limited motion of the affected part, usually the ankle under DC 5271. The X-ray-only ratings under DC 5003 do not apply to it.

What is the VA rating for an ankle fusion?

A fusion is rated as ankylosis under DC 5270: 20, 30 or 40 percent depending on the angle the ankle is fixed at.

Can an ankle condition be secondary to a knee or flat feet?

Yes, when a medical opinion explains how the service-connected knee or flat feet caused the ankle condition or made it worse. The opinion has to address both causation and aggravation and describe the ankle's baseline.

Bottom Line

Ankle ratings are simpler than the knee in structure and harder in the place that matters. One motion code, DC 5271, caps an unfused ankle at 20 percent and splits on a few degrees, so the exam's handling of pain, repetition and flare-ups decides most claims. A strong record has the passive and weight-bearing testing § 4.59 describes, a flare-up estimate built on your own account, stability findings, and an opinion that explains post-traumatic arthritis when it shows up years later. The higher ratings live in fusion and replacement, and the real combined-rating movement usually comes through the secondary chains the ankle opens into the knee, hip and back.

Methodology and Limitations

• Data source: Rating criteria quoted from 38 CFR § 4.71a (DCs 5003, 5024, 5056 and 5270 through 5274) as published in eCFR for October 1, 2026, with normal motion from Plate II of § 4.71. Disability counts from VA's fiscal year 2025 Annual Benefits Report. Exam items from the Ankle Conditions DBQ (updated July 29, 2026). Every rule, case and study is listed under Sources.
• Sample size: Board figures in this post come from Claim Raven's read of every Board decision from 2021 to 2026 that it holds, 511,036 decisions containing 1,378,030 rulings. That includes 27,035 decided Board rulings on ankle conditions (29,290 rulings in all, counting dismissed and withdrawn issues): 19.8% were granted, 28.3% denied and 52.0% remanded. The grant rate was 15.7 percent on service connection rulings and 20.0 percent on increased-rating rulings. The data captures outcome by issue type rather than by diagnostic code (DC 5270-5274).
• Classification approach: Diagnostic code definitions drawn from the regulatory text. The moderate-versus-marked analysis reflects the degree thresholds DC 5271 has carried since February 7, 2021. Combined-rating math follows §§ 4.25, 4.26 and 4.68.
• Limitations:
• Board decisions covering periods before February 7, 2021 applied the older DC 5271, which left "moderate" and "marked" undefined, so older decisions are not a reliable guide to the current thresholds.
• The research on post-traumatic ankle arthritis comes from specialty clinic case series, not from veterans. It supports a time line; it does not decide an individual claim.
• Board-level patterns reflect cases that were appealed. Most ankle claims resolve at the regional office.
• These observations reflect the regulatory text, case law and Board decisions. They are not predictions of individual outcomes.

Sources

• 38 CFR § 4.71a: DCs 5003, 5024, 5056, 5270 to 5274 and the notes to the prosthetic implant codes. eCFR (opens in a new tab)
• 38 CFR § 4.71 and Plate II; §§ 4.25, 4.26, 4.30, 4.40, 4.45, 4.57, 4.59 and 4.68.
• 38 CFR §§ 3.307(a)(3), 3.309(a), 3.310 and 3.400(b)(2).
• "Schedule for Rating Disabilities: Musculoskeletal System and Muscle Injuries," 85 FR 76453 (November 30, 2020), effective February 7, 2021.
• M21-1, V.ii.2.D.
• Correia v. McDonald, 28 Vet. App. 158 (2016); Sharp v. Shulkin, 29 Vet. App. 26 (2017); El-Amin v. Shinseki, 26 Vet. App. 136 (2013).
• VA, Ankle Conditions Disability Benefits Questionnaire; VA Annual Benefits Report, fiscal year 2025, Compensation.
• Valderrabano V, Hintermann B, Horisberger M, Fung TS. Ligamentous posttraumatic ankle osteoarthritis. Am J Sports Med. 2006. PMID 16303875.
• Saltzman CL, Salamon ML, Blanchard GM, et al. Epidemiology of ankle arthritis: report of a consecutive series of 639 patients from a tertiary orthopaedic center. Iowa Orthop J. 2005. PMID 16089071.
• Board figures on this page: Claim Raven's read of every Board decision from 2021 to 2026 that it holds, and of every decision since 1992 for the longer view.