United States · VA disability · 38 CFR 4.71a
VA diagnostic code 5257: knee instability.
Rating criteria for diagnostic code 5257, quoted from the regulation.
DC 5257 has three levels, 10, 20 and 30 percent, in two tracks: ligament-based instability and patellar instability. The text ties the higher levels to what a medical provider prescribes for walking: a brace, an assistive device, or both.
The short version
DC 5257 has three levels, 10, 20 and 30 percent, in two tracks: ligament-based instability and patellar instability. The text ties the higher levels to what a medical provider prescribes for walking: a brace, an assistive device, or both. The levels in the code are 10, 20 and 30 percent.
DC 5257 rating criteria
Recurrent subluxation or instability (ligament-based)
| Criteria (quoted from the regulation) | Rating |
|---|---|
| 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 | 30% |
| 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. (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 | 20% |
| 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 | 10% |
Patellar instability
| Criteria (quoted from the regulation) | Rating |
|---|---|
| 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 | 30% |
| 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 | 20% |
| 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 | 10% |
Notes in the regulation
- Note (1): For patellar instability, the patellofemoral complex consists of the quadriceps tendon, the patella, and the patellar tendon.
- Note (2): A surgical procedure that does not involve repair of one or more patellofemoral components that contribute to the underlying instability shall not qualify as surgical repair for patellar instability (including, but not limited to, arthroscopy to remove loose bodies and joint aspiration).
How to read DC 5257
DC 5257 sits in the knee and leg group of the musculoskeletal schedule (38 CFR 4.71a). The current text of the code is written around two things: what is wrong structurally (a ligament tear, a sprain, or a patellofemoral problem) and whether a medical provider has prescribed a brace, a cane, crutch or walker for ambulation. The ratings step up with those two facts, from 10 to 30 percent.
The table is long because every level repeats the same qualifiers. Read each row as a complete condition: the structural finding, the instability, and the prescription all have to match the wording of that row. The rule text itself, not a summary, is what a rating decision applies.
Other text in 4.71a says to evaluate under diagnostic codes 5256, 5257, 5260 or 5261 for the knee, whichever results in the highest evaluation, so 5257 is one of several knee codes. Which codes apply to a given knee is a rating-decision matter; this page covers only the 5257 criteria.
What this page does not do
It does not diagnose, pick a diagnostic code, estimate your rating or advise on a claim. Every rating decision depends on the medical evidence and on VA’s application of the full schedule, including provisions this page does not reproduce.
Frequently asked questions
What are the rating levels for DC 5257?
Three: 10, 20 and 30 percent, under 38 CFR 4.71a. They apply to ligament-based recurrent subluxation or instability and, separately, to patellar instability.
What is the highest rating under DC 5257?
30 percent, either for an unrepaired or failed repair of a complete ligament tear with persistent instability where a medical provider prescribes both an assistive device and bracing, or for post-surgical patellar instability requiring a prescribed brace and either a cane or a walker.
Does a prescribed brace or cane matter?
Yes. The text of the diagnostic code makes the prescription from a medical provider part of the criteria: the 10 percent level covers instability without a prescription, and the 20 and 30 percent levels require one.
What is the patellofemoral complex?
Per Note (1) of the code, it consists of the quadriceps tendon, the patella, and the patellar tendon.
Does arthroscopy count as surgical repair for patellar instability?
Note (2) says a surgical procedure that does not involve repair of one or more patellofemoral components contributing to the instability does not qualify, and names arthroscopy to remove loose bodies and joint aspiration as examples.
Does this page say what rating I should get?
No. It reproduces the published criteria. VA decides the diagnosis, the code and the rating, and this page is not medical or claim advice.
Sources
Read directly from the primary sources below on November 2, 2026 (eCFR text current through October 29, 2026). Quotations are the regulation text; anything labelled as a reading or calculation is TNAADO's. The schedule is amended from time to time, so check the linked section for the latest text.
Reference, not a VA determination, medical advice or claim advice
Rating criteria summarized from 38 CFR 4.71a as of October 29, 2026 (eCFR). This page reproduces published criteria so you can read them; it does not tell you whether you qualify, what your rating should be, or how to file. VA decides the diagnosis, the code and the rating. It is not legal, financial or medical advice; an accredited representative (VSO, attorney or claims agent) can review your case.