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VA Rating for Back and Knee Pain
38 CFR, Part 4, Subpart B
If you're a veteran living with chronic back or knee pain, you know how these conditions can affect your daily life—from basic mobility to your ability to perform well at work. What many veterans don't realize is that both of these issues are among the most commonly approved service-connected disabilities. However, you'll need to understand how the VA rating for back and knee pain is determined if you want to get fair compensation.
The VA's evaluation system isn't always straightforward. It's based on range of motion measurements, functional loss, and how your pain limits your ability to work and live. To maximize your claim, you need more than a diagnosis—you need documentation that paints a clear picture of how your condition limits you physically and functionally. If you want to know how to get VA disability for back and knee pain, this guide is for you. It walks you through the VA's approach to rating back and knee pain, what kind of evidence will support your claim the best, and how to position your claim for success.
How Does the VA Rate Back and Knee Pain?
Back and knee injuries are especially common among veterans due to the physically demanding nature of military service. Whether they're the result of combat, heavy lifting, parachuting, training exercises, or long marches, these conditions often worsen over time—especially if left untreated during or after active duty.
When assigning a rating for back and knee injuries, the VA considers factors like instability, pain during movement, functional loss, and crepitus (grinding or popping when you move a joint). The VA also relies heavily on range of motion (ROM) tests. The strong reliance on ROM tests can be frustrating to many veterans because it doesn't always capture the full extent of their limitations, especially if their pain flares intermittently or worsens with activity.
Knee pain is typically rated under diagnostic codes related to limitation of flexion, limitation of extension, or instability. Back pain is usually rated under the general spine conditions schedule, which includes the thoracolumbar spine and focuses heavily on ROM.
Many veterans are underrated because they don't understand how to communicate the full impact of their condition, or because their symptoms don't "show up" during brief exams. Learning how to tell your story the right way—and with the right evidence—can make a big difference in your disability rating.
Back Pain Rating Percentages
Back Pain Ratings
While back conditions are usually rated under 38 CFR, part 4, there are several diagnostic codes for different back conditions:
Lumbosacral and Cervical Strain (Code 5237)
This refers to an overuse or trauma injury of the tendons, ligaments, and/or muscles in the lower back or neck. It causes pain and limits range of motion.
Ratings range from 100% to 10%. With a 100% rating, the entire spine is affected by "unfavorable ankylosis," meaning all vertebrae have fused together.
Other ratings are assigned based on indicators like gait, spinal contour, degree of forward flexion, and severity of muscle spasms.
Degenerative Disc Disease (Code 5003 or 5242)
DDD occurs when the discs between the vertebrae lose their cushioning, tear, or leak. It can cause pain or numbness in the upper or lower limbs.
Ratings are determined by range of motion (and painful motion), functional loss, and X-ray evidence. Ratings range from 100% to 10%. A 100% rating is reserved for unfavorable ankylosis or fusion of the entire spine.
Intervertebral Disc Syndrome (Code 5243)
This condition occurs when spinal discs bulge or herniate and the nerve root becomes irritated. It results in sharp, chronic pain and, sometimes, numbness, tingling, and/or weakness in the legs.
Ratings usually range from 60% to 10% and are based on the length of "incapacitating episodes" that leave you unable to move or function. The 60% rating requires evidence that you were incapacitated by your IVDS for 6 weeks or more in the past 12 months.
Sciatic Nerve Issues
Paralysis of the Sciatic Nerve (Code 8520)
The sciatic nerve is the largest nerve in the body. It starts in the lower back and stretches down the buttocks and the back of each leg. Paralysis is rated between 80% and 10%, depending on the degree of paralysis.
Neuritis of the Sciatic Nerve (Code 8620)
This refers to the inflammation of the sciatic nerve. It is rated from 60% to 10%. A 60% rating is based on severe neuritis that causes you to lose reflexes and sensation, atrophies your muscles, and diminishes your function in the affected area. A 10% rating is for mild neuritis.
Neuralgia of the Sciatic Nerve (Code 8720)
Neuralgia refers to severe pain, though neuralgia can sometimes cause numbness. This condition is typically rated at 20% or 10% and takes into consideration the level of pain or numbness and the functionality of the affected limb.
Knee Pain Ratings
Knee pain ratings also fall under 38 CFR, Part 4 and can range from 0 to 100%. The rating depends on factors like the type and severity of the knee condition, the range of motion and stability of the knee, and how much pain the knee condition causes. The VA uses several diagnostic codes:
Limitation of Flexion (Code 5260)
This is the most commonly used diagnosis code for a VA rating for knee pain, and it is evaluated almost entirely based on range of motion. At the Compensation and Pension Exam (C&P), the physician will use a tool called a goniometer to measure how much the knee joint can move.
Ratings range as follows:
- 30% — flexion limited to 15°
- 20% — flexion limited to 30°
- 10% — flexion limited to 45°
- 0% — flexion limited to 60°
Limitation of Extension (Code 5261)
This refers to how much you can straighten out your knee. It is also assessed with a goniometer.
Ratings range as follows:
- 50% — extension limited to 45°
- 40% — extension limited to 30°
- 30% — extension limited to 20°
- 20% — extension limited to 15°
- 10% — extension limited to 10°
- 0% — extension limited to 5°
Ankylosis of the Knee (Code 5256)
This diagnosis refers to the knee stiffening so much that it is immobile. It is rated as follows:
- 60% — In flexion at an angle of 45° or more
- 50% — In flexion between 20 and 45°
- 40% — In flexion between 10 and 20°
- 30% — In slight flexion between 0 and 10°
Instability of the Knee (Code 5257)
This occurs when tendons or cartilage can't support the knee joint as much as it needs. As a result, the knee might move from side to side and be prone to dislocation.
Ratings range from 30% to 0%, with the highest ratings given when knees are so unstable that they give out or dislocate regularly.
Total Knee Replacement (Code 5055)
If your knee joint requires a total replacement by a prosthesis, you will be rated at 100% for four months after your surgery. After that, you must undergo a C&P exam. Based on the exam results, you will be assigned a new rating.
Once you have had a total knee replacement, you will not be assigned at less than 30%—no matter how much range of motion your knee has.
You could be rated at:
- 60% — Chronic residual issues post-replacement, such as severe weakness or severe pain with motion
- 30% — Intermediate degree of weakness or limited motion
Can I Get Multiple Ratings for a Knee Injury?
The VA may assign separate ratings as long as you can show that you are suffering from different symptoms or conditions (e.g., limited flexion and limited extension). This is important to know if you want to maximize your overall compensation. Note that this is different than "pyramiding," which the VA prohibits. Pyramiding is trying to get rated for the same disability or same symptom more than one time. Just make sure you clarify that your condition/symptoms are distinct.
Strengthen Your Claim for a VA Rating for Back and Knee Pain
Veterans often receive lower ratings than they deserve because they don't know how to properly document the full impact of their back and knee conditions. If you're trying to get or increase your VA rating for back and knee pain, here's how to strengthen your claim:
- Make Sure You Have a Current Diagnosis: This sounds basic, but some veterans file a claim without an updated diagnosis. If you haven't seen a doctor for your condition within the past year, schedule a visit promptly and get a formal, updated diagnosis.
- Show Use of Assistive Devices: If you rely on braces, a cane, or a back brace, make sure this is noted in your medical records or exam. These details signal to the VA that your condition is more serious.
- Write a Personal Statement: A good personal statement can show how your pain affects you personally and professionally on a daily basis. You don't want your statement to be overly long, but you do want to make sure it includes all relevant details about your symptoms and how they affect your function.
- Get Buddy Letters: Statements from family, friends, or former service members can add credibility. These should describe how your condition affects your daily function, including how it limits your mobility and forces you to avoid physical tasks.
- Get a Nexus Letter: In order to get a VA rating for back or knee pain, you must show a connection between your condition and your military service. If you were diagnosed while in service and have documentation to prove it, you should be fine. But if not, make sure you get a letter from a physician explaining that it is "at least as likely as not" that your condition is service-connected.
- Don't Overdo It at Your C&P Exam: After you file your claim, you will likely be called in for a C&P exam. When the physician tests your range of motion, don't push into the pain zone. This is not the time to be a hero! Also, don't whitewash your symptoms. Talk about all relevant symptoms and how they affect you on a daily basis. Consider reading your personal statement so that you make sure to include all the important details about your condition.
Secondary Conditions to Consider
Yes! This may be an effective way to increase your VA rating for back and knee pain. Secondary conditions are non-service-connected conditions that develop as a result of a primary service-connected injury. For example, let's say that your back pain keeps you from sleeping and getting out of the house easily. Your insomnia and isolation soon cause you to become depressed. You could file for depression secondary to back pain.
In another example, your knee pain may cause you to adjust your gait, leading to the development of foot and ankle problems secondary to your knee pain.
Why Choose VA Claims Academy?
Filing a claim for musculoskeletal pain requires more than just saying, "My back hurts." The VA needs precise measurements, evidence that your pain is service-connected, and a compelling case that explains how your pain impacts your daily life. VA Claims Academy specializes in helping veterans understand these details and present them effectively.
From unpacking diagnostic codes to learning how to advocate for yourself during exams, the Academy teaches you how to get a VA disability rating for back pain and knee pain—or how to increase your existing rating.
You'll gain insights into what examiners are looking for, how to prepare evidence, and what to do if your claim is underrated or denied. You'll also get ready-made resources, like plug-and-play templates for personal statements and nexus letters. These resources can save you a great deal of time and put you on a path for faster VA approval.
Chronic pain doesn't just limit your movement—it can limit your ability to earn a living, enjoy time with your family, and feel like yourself again. VA Claims Academy is here to help you translate that reality into a powerful claim that gets results.
FAQs: Back and Knee Pain Ratings
1. How does the VA measure range of motion for back and knee conditions?
The VA uses goniometers during C&P exams to measure how far you can bend or extend your joints. These measurements can directly impact your rating.
2. What is considered "functional loss" in VA claims?
Functional loss refers to limitations in daily activities like sitting, standing, walking, or lifting due to pain, fatigue, or weakness. It's a key factor in musculoskeletal ratings.
3. Do assistive devices affect my rating?
Yes. If you use a cane, knee brace, or back brace, this can support a higher rating. Be sure to document this in your claim and note it at your C&P exam. (Bring your assistive device with you to your exam.)
4. What is the average VA rating for back pain?
Most veterans receive between 10% and 20% for back conditions, but higher ratings are possible if mobility is severely restricted or if there are neurological complications.
5. Can back or knee pain be rated higher than 20%?
Absolutely. Severe limitations, chronic pain, or conditions like intervertebral disc syndrome with incapacitating episodes may justify ratings of 40% or more.
6. What if my pain isn't constant?
The VA considers how pain fluctuates. Describing flare-ups and how they impact your functioning helps ensure the rating reflects your worst days.
7. Can I get a rating for arthritis in my knee or spine?
Yes. Degenerative arthritis is often rated under its own diagnostic codes, especially if confirmed by X-ray and accompanied by painful motion.
8. What if I was denied a higher rating?
You have a few options. First, you can request a higher-level review. This doesn't allow you to submit new evidence, but it does send your claim up to a more senior reviewer to see if any mistakes were made in the original review of your claim. You can also submit new evidence through a supplemental claim. And finally, you can submit an appeal, but this can take much longer than a supplemental claim (often several years).
9. Does the VA consider pain during motion?
Yes. Pain during movement—even if your ROM isn't severely limited—can influence your rating when properly documented.