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🦴 MusculoskeletalLower Extremity JointsDC 5257

Knee Instability / Ligament Injury

Instability of the knee joint due to ligamentous laxity, rupture, or injury — including ACL, MCL, PCL, and LCL tears. The knee may give out, buckle, or feel loose during activity. Common in veterans from physical training, sports, ruck marching, combat, and jumping. Rated specifically under DC 5257 (knee, recurrent subluxation or lateral instability) based on the degree of instability — separate from and in addition to any limited motion rating.

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VA Rating Tiers

30%
severe instability
20%
moderate instability
10%
slight instability
0%
Meets minimum criteria

Rating Notes

  • ›30%: Severe recurrent subluxation or lateral instability — frequent giving out that significantly limits daily activity. DC 5257.
  • ›20%: Moderate recurrent subluxation or lateral instability — fairly regular giving out affecting walking and stairs. DC 5257.
  • ›10%: Slight recurrent subluxation or lateral instability — occasional giving out, mainly during vigorous activity. DC 5257.
  • ›0%: Instability documented but below rating threshold — service connected but non-compensable. DC 5257.
  • ›Rated under DC 5257 (knee, recurrent subluxation or lateral instability).
  • ›If you ALSO have limited range of motion, you may qualify for an additional rating under DC 5260 or 5261 — the VA can rate both instability and motion limitation separately.
  • ›ACL reconstruction does not disqualify you — many veterans retain residual instability post-surgery.
  • ›An MRI confirming the ligament tear is the strongest evidence for this claim.
  • ›Actual rating depends on findings at the C&P exam, including stability testing.

Eligibility Basics

✅
Current symptoms
✅
In-service event
✅
Diagnosis or lay evidence
  • •Knee instability is rated under DC 5257 (recurrent subluxation or lateral instability) — separate from knee limited motion codes.
  • •Rating tiers: slight (10%), moderate (20%), severe (30%).
  • •If you also have limited range of motion, the VA may rate both the motion limitation AND the instability — you could receive ratings under both DC 5257 and DC 5260/5261.
  • •ACL, MCL, PCL, and LCL tears all qualify — the ligament involved determines severity, not necessarily which one it is.
  • •ACL reconstruction surgery does not mean you lose eligibility — many veterans still have residual instability post-surgery.

Evidence to Gather

Service Records

  • •sick call or treatment records for knee injury, ligament sprain, or instability
  • •injury report from a training, combat, or sports incident
  • •records of physical therapy for knee injury during service
  • •profile or limited duty documents due to knee condition
  • •separation physical noting knee instability or ligament injury

Medical Evidence

  • •MRI of the knee confirming ligament tear or laxity (ACL, MCL, PCL, LCL)
  • •orthopedic evaluation with stability tests (Lachman, valgus/varus stress test)
  • •surgical operative report and post-op notes (if reconstruction was performed)
  • •physical therapy records documenting functional instability
  • •X-ray of the knee (to assess joint space, rule out fracture)

Lay Evidence (Buddy Statements)

  • •statement describing the in-service incident that caused the knee injury
  • •statement describing how often the knee gives out and what activities trigger it
  • •buddy statement noting observed knee injury or instability during or after service

Diagnostic Tests

  • •MRI of the knee (most important for ligament tears — confirms ACL/MCL/PCL/LCL status)
  • •Lachman test and anterior drawer test (ACL integrity)
  • •valgus and varus stress tests (MCL / LCL integrity)
  • •posterior drawer test (PCL integrity)
  • •X-ray of the knee (weight-bearing — joint space assessment)
  • •arthrometer (KT-1000) measurement of anterior knee laxity

C&P Exam Preparation

Exam type: Orthopedic / Lower Extremity (Knee)

Be ready to describe

  • •how often the knee gives out and what triggers it (pivoting, stairs, walking)
  • •whether the instability has gotten better or worse since service
  • •any falls caused by the knee giving out
  • •whether you wear a brace — and whether it controls the instability
  • •how the instability limits specific job duties and daily activities

Prep notes

  • •Move through all testing honestly — let the examiner see what happens when the knee is stressed.
  • •Bring your MRI report and any surgical records if available.
  • •Mention whether you wear a brace regularly — and demonstrate what happens without it if asked.
  • •Describe your worst-case scenarios — times when the knee has fully given out and caused a fall.
  • •If you also have limited range of motion, describe that clearly — it may qualify for a separate rating.

Quick Facts

Diagnostic Code
DC 5257
Category
Musculoskeletal
Subcategory
Lower Extremity Joints
Typical Claim Type
direct
Rating Range
0% – 30%

Also Known As

knee instabilityACL tearACL injuryACL reconstructionMCL tearPCL tearLCL tearknee ligament tearknee ligament injuryknee gives outknee subluxationrecurrent knee instabilityknee bucklingknee dislocationACL surgeryligament reconstructionchronic knee instability

Related Conditions

Secondary to

lower back pain

Commonly leads to

sciaticaankle condition
📋

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