Diagnostic Code 5257: Knee. Instability (Recurrent Subluxation or Patellar Instability) Rating Criteria
- CFR section
- 38 CFR § 4.71a
- Rating range
- 10% to 30%
- Rating levels
- 3
- Body system
- Musculoskeletal system
The VA rates Knee. Instability (Recurrent Subluxation or Patellar Instability) under diagnostic code 5257 in 38 CFR § 4.71a. The table below is the full set of rating criteria, from the schedule itself, with the evidence factors raters look for at each level.
DC 5257 rating criteria
| Rating | Criteria |
|---|---|
| 10% | Recurrent subluxation or instability: sprain, incomplete ligament tear, or complete ligament tear (repaired, unrepaired, or failed repair) causing persistent instability, without a prescription from a medical provider for an assistive device (e.g., cane(s), crutch(es), walker) or bracing for ambulation; patellar instability: a diagnosed condition involving the patellofemoral complex with recurrent instability (with or without history of surgical repair) that does not require a prescription from a medical provider for a brace, cane, or walker What raters look forpersistent instability without a prescribed assistive device or bracing; patellar instability without a prescribed brace, cane, or walker |
| 20% | Recurrent subluxation or instability, one of the following: (a) sprain, incomplete ligament tear, or repaired complete ligament tear causing persistent instability, and a medical provider prescribes a brace and/or assistive device (e.g., cane(s), crutch(es), walker) for ambulation, or (b) unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribes either an assistive device (e.g., cane(s), crutch(es), walker) or bracing for ambulation; patellar instability: a diagnosed condition involving the patellofemoral complex with recurrent instability after surgical repair that requires a prescription by a medical provider for one of the following: a brace, cane, or walker What raters look forsprain, incomplete tear, or repaired complete tear with a prescribed brace and/or assistive device; unrepaired or failed repair of a complete tear with a prescribed assistive device or bracing; patellar instability after surgical repair with a prescribed brace, cane, or walker |
| 30% | Recurrent subluxation or instability: unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribes both an assistive device (e.g., cane(s), crutch(es), walker) and bracing for ambulation; patellar instability: a diagnosed condition involving the patellofemoral complex with recurrent instability after surgical repair that requires a prescription by a medical provider for a brace and either a cane or a walker What raters look forunrepaired or failed repair of a complete ligament tear with both a prescribed assistive device and bracing; patellar instability after surgical repair with a prescribed brace and either a cane or a walker |
DC 5257 rating appeals at the Board
The Board of Veterans' Appeals issued 8,113 rulings on higher ratings, reductions and severance under diagnostic code 5257 from 2021 to 2026. It granted 49.4%, denied 31.2% and sent 19.4% back for more work. One appeal can contain more than one ruling.
| What the appeal asked for | Decided rulings | Granted |
|---|---|---|
| A higher rating | 7,896 | 48.3% |
| A rating VA reduced | 209 | 90.9% |
By the rating the Board's order named
Only orders that state a rating percentage with a date are counted. An order denying a rating "in excess of 50 percent" names the existing rating; a grant may name the rating awarded. These are not all ratings veterans requested.
| Rating the order named | Decided rulings | Granted |
|---|---|---|
| 10 percent | 1,374 | 55.7% |
| 20 percent | 892 | 59.9% |
| 30 percent | 311 | 75.9% |
| Two or more ratings for different periods (staged) | 111 | 21.6% |
Recorded exam issues in remanded DC 5257 rulings
Percentages use all 1,577 rating rulings under this code the Board remanded, 2021 to 2026. Some rulings have no recorded exam classification, and small categories are not shown, so these rows need not total 100 percent.
- The VA exam or opinion was not adequate71.8%
- The exam was out of date or the condition had worsened17.5%
- No exam problem recorded9.3%
- Another problem with the exam1.2%
Method: Claim Raven read each ruling in every Board decision stored for 2021 to 2026 and counted it under this code when the decision named DC 5257 for a rating question. These results cover only rulings with an identified diagnostic code and may not represent rulings where no code was stated. Granted includes partial grants; dismissed and withdrawn rulings are left out. These are outcomes within appeals, not first decisions, and not your personal odds.
Condition guide
The rating criteria are only part of the picture for Knee. The Knee condition page covers service connection, common evidence problems, secondary conditions, and Board outcome patterns in depth.
What happens to Knee appeals at the Board
Claim Raven's analysis of 107,856 decided Board of Veterans' Appeals rulings on Knee, 2021 to 2026. The Knee condition page has the full breakdown, including which evidence types are associated with better outcomes.
Method: each ruling's outcome is read from the order in the Board's published decision and rolled up as granted (including partial grants), denied, or remanded, leaving out dismissals and withdrawals. The data codes the condition the Board ruled on, not the diagnostic code, so these numbers describe Knee appeals generally rather than DC 5257 specifically. The DC 5257 section above counts this code's own rating appeals. Board outcomes describe appealed claims, not initial decisions.
Frequently asked questions
What is VA diagnostic code 5257?
Diagnostic code 5257 is the VA rating schedule entry for Knee. Instability (Recurrent Subluxation or Patellar Instability), found in 38 CFR § 4.71a. The VA assigns this code when it rates the condition and applies the criteria listed on this page.
What ratings are possible under DC 5257?
DC 5257 provides ratings of 10%, 20%, 30%. The percentage depends on which criteria your medical evidence documents, not on the diagnosis alone.
What does the highest rating under DC 5257 require?
The 30% rating for Knee. Instability requires: Recurrent subluxation or instability: unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribes both an assistive device (e.g., cane(s), crutch(es), walker) and bracing for ambulation; patellar instability: a diagnosed condition involving the patellofemoral complex with recurrent instability after surgical repair that requires a prescription by a medical provider for a brace and either a cane or a walker.
How often does the Board grant a higher rating under DC 5257?
In 7,896 decided Board of Veterans' Appeals rulings on a higher rating under DC 5257 from 2021 to 2026, 48.3% were granted, 31.8% denied and 19.8% sent back for more work. These are appeal outcomes, not your personal odds.
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