VA Disability Rating for Hip Pain Secondary to Knee Injury
January 4, 2023 in
For many Veterans, knee injuries don’t just cause discomfort around the knee joints or legs. Knee injuries or chronic conditions can also lead to hip pain or limited mobility, especially if the knee injuries persist for months or years.
Under such circumstances, Veterans may receive higher VA disability ratings for hip pain secondary to knee injuries. However, it’s important to know what to expect from your VA disability rating if you apply for secondary benefits.
Let’s break down this topic in detail:
VA Disability Ratings for Knee Injuries
The VA uses a disability rating system to determine how injured a Veteran is and the level of benefits they should receive.
Knee injuries can be debilitating and very painful and vary widely. As such, the VA assigns disability ratings ranging between 0% and 100% for this injury category.
The disability rating for any given knee injury can vary dramatically based on factors like:
- How much pain the injury causes every day
- How severe the injury is
- The range of motion that remains after the injury
- The kind of injury it is
- And more
Examples of Knee Injuries and Typical Diagnostic Rating
Here are some examples of knee conditions or injuries, plus their typical rating ranges from the VA:
- Limitation of flexion of the knee, diagnostic code 5260. This is the most common service-connected knee condition among US military Veterans. It prevents Veterans from flexing their knees to their maximum extent because of frozen knee muscles. This injury is typically rated based on the Veteran’s range of motion after injury. It may receive a disability rating between 10% and 30%
- Limitation of extension of the knee, diagnostic code 5261. This refers to difficulty in terms of the knee’s range of motion. Specifically, Veterans with this condition can’t straighten their knees fully. Disability ratings could range from 0% to 50%.
- Total knee replacement, diagnostic code 5055. If a Veteran’s complete knee joint is replaced by a prosthetic, the knee replacement has a disability rating of 100% for the first year post-surgery. The condition may decrease over time but will never go below 30%.
- Partial knee replacements don’t have dedicated diagnostic codes. Instead, they may be rated according to the symptoms a Veteran experiences.
- Ankylosis of the knee, diagnostic code 5256. This refers to immobility or stiffening of the knee. It may receive a diagnostic code between 30% and 60%.
- Instability of the knee, diagnostic code 5257. This refers to an injury that frequently causes knee tendons or joints to dislocate. Veterans with his injury may receive disability ratings of between 0% and 30%.
VA Disability Ratings for Hip Pain/Injuries
The VA also has a disability rating range for Veterans’ hip pain and hip injuries. Individual hip injuries are rated on the underlying cause of the hip injury or pain, the severity of the pain, and how it affects a Veteran’s day-to-day range of motion and physical abilities.
Here are some examples of hip injuries or pain and the ratings the VA may assign them:
- Ankylosis, diagnostic code 5250. This refers to immobility or stiffening of one or both hip joints. Ratings can range from 60% to 90%.
- Osteoarthritis, diagnostic code 5003. Some osteoarthritis can cause hip pain and immobility. This condition will result in a disability rating of between 10% and 20%.
- Limitation of hip motion. This does not have a diagnostic code and broadly refers to any pain or limited motion a Veteran may experience due to a hip injury.
- Hip replacements, diagnostic code 5054. All Veterans who receive a prosthetic hip replacement receive a disability rating of 100% for one-year post-surgery. The disability rating can drop to as low as 30% after healing, depending on the Veteran’s range of motion and daily comfort.
Veterans’ disability ratings for hip pain or knee injuries depend heavily on the symptoms they experience and the range of motion they maintain.
Secondary Disabilities and Benefits
Some Veterans suffer from more than one related injury or chronic condition. In these cases, Veterans may file for secondary disabilities. The VA adds secondary disabilities to a Veteran’s total disability rating. In some cases, this is enough to necessitate further monthly benefits.
Can Hip Pain Be Connected to Knee Injury Disability?
Yes. Your knee joints are some of the most important in your body. Your knees affect how much stress is placed on your legs and hips when walking. For example, favoring one leg over the other could cause one knee or leg to become injured or inflamed over time.
Therefore, hip pain often relates to or contributes to knee injuries, especially those that cause disability in Veterans.
Knee injuries may also lead to other types of pain and injuries, like foot pain or ankle injuries. That’s because knee injuries affect your posture and how you walk and carry your weight.
How Are Disability Ratings Calculated?
Unfortunately, the VA does not make calculating combined disability ratings easy.
Here’s how the disability ratings and math system works in a nutshell:
- The VA begins with the assumption that a Veteran is 100% not disabled (or “efficient”).
- Next, the VA considers the most important or impactful disability a Veteran has. For example, if a Veteran has a disability rating of 20%, to begin with, the VA considers that Veteran to be 80% non-disabled and 20% disabled.
- The VA then adds a secondary disability percentage to that Veteran’s disability rating. However, the disability rating is not a percent out of 100 because the Veteran, in this case, is not 100% non-disabled.
- Instead, the secondary disability rating is a percent of the current remaining non-disabled percentage. In this example case, that’s 80%.
- So, say that a Veteran receives another disability rating of 20%. 20 percent of 80% is 16%.
- Therefore, the VA adds 16% to the existing 20% disability rating. The total amount of the Veteran’s disability rating is 36%.
- However, the VA math system always rounds up to the nearest increment of 10. So the Veteran in this example receives a final combined disability rating of 40%.
That’s a lot to take in. That’s why it’s important to have knowledgeable Veterans law attorneys on your side when getting a VA disability rating for hip pain secondary to knee injuries.
How To File a Claim for Hip Pain Secondary to a Knee Injury
Filing a claim for a secondary condition, like hip pain caused by a pre-existing knee injury, follows largely the same process as filing a primary disability claim. However, Veterans must prove a secondary service connection.
There are two types of secondary service connections:
- Standard secondary service connections. These are any illnesses or injuries caused by another service-connected injury, condition, and so on. For example, if you develop diabetes in the military, then develop a complication from diabetes like kidney failure, the kidney failure could be classified as a standard secondary service connection.
- Secondary service connections by aggravation. Your service-connected injury or illness may not directly cause these conditions, but it exacerbates them. The initial injury of illness aggravates the secondary condition, which then causes its own unique issues.
- For instance, if you receive a knee injury during your military service, which leads to hip pain, the hip pain could be classified as a secondary service connection by aggravation.
Understanding which type of claim to file is vital, as is gathering the right evidence to prove your claim. Experienced Veterans law attorneys can help you gather the important evidence you need, like medical notes or personal journal notes, to ensure that your claim is successful.
This is especially important because the VA always looks for several key pieces of information before increasing your disability rating, such as:
- Medical records that serve as backing for your primary diagnosis
- Records of treatments for the primary diagnosis
- Medical proof that your existing condition causes your new hip pain or other condition
- A medical diagnosis of your aggravated or new injury or illness
Contact Berry Law Today
You don’t have to file for primary or secondary VA benefits alone. Instead, contact Berry Law right away. When you contact us, we’ll offer a free consultation and help you understand the details of your upcoming VA claim. We can even help you appeal a VA decision if your claim was initially denied.
We believe you deserve the full range of compensation available to you for your primary condition and any secondary conditions. Contact us today.
eCFR :: 38 CFR Part 4 – Schedule for Rating Disabilities | ECFR.gov
38 CFR § 4.71a – Schedule of Ratings – Musculoskeletal System | Cornell Law School
Department of Veterans Affairs § 4.71a | Govinfo.gov