Knee, resurfacing or replacement (prosthesis) — VA Rating Criteria (38 CFR DC 5055)
The VA rates Knee, resurfacing or replacement (prosthesis) under 38 CFR 38 CFR § 4.71a, Diagnostic Code 5055, from 30% to 100% based on the frequency and functional severity of symptoms. The maximum 100% rating requires For 4 months following implantation of prosthesis or resurfacing. Related conditions in the Musculoskeletal body system share this rating framework.
What are the VA rating criteria for Knee, resurfacing or replacement (prosthesis)?
Minimum evaluation, total replacement only
With chronic residuals consisting of severe painful motion or weakness in the affected extremity
For 4 months following implantation of prosthesis or resurfacing
“With chronic residuals consisting of severe painful motion or weakness in the affected extremity”
Which conditions are commonly secondary to Knee, resurfacing or replacement (prosthesis)?
How does the VA rate Musculoskeletal conditions?
Common Questions About Knee, resurfacing or replacement (prosthesis) VA Ratings
What is the VA disability rating for Knee, resurfacing or replacement (prosthesis)?
The VA rates Knee, resurfacing or replacement (prosthesis) under Diagnostic Code 5055 at the following tiers: 30%, 60%, 100%. The minimum 30% rating requires: Minimum evaluation, total replacement only. The maximum 100% rating requires: For 4 months following implantation of prosthesis or resurfacing.
What is Diagnostic Code 5055?
Diagnostic Code 5055 is the VA rating identifier for Knee, resurfacing or replacement (prosthesis) within 38 CFR 38 CFR § 4.71a. It defines the specific symptom criteria and percentage thresholds a VA adjudicator uses to assign a disability rating. The diagnostic code is listed on a veteran's rating decision letter.
What is the highest rating for Knee, resurfacing or replacement (prosthesis)?
The highest schedular rating for Knee, resurfacing or replacement (prosthesis) under DC 5055 is 100%. This tier requires: For 4 months following implantation of prosthesis or resurfacing. Veterans who cannot secure substantially gainful employment due to Knee, resurfacing or replacement (prosthesis) alone or in combination with other service-connected conditions may also qualify for TDIU at the 100% compensation rate under 38 CFR § 4.16.
What 38 CFR section governs Knee, resurfacing or replacement (prosthesis) ratings?
Knee, resurfacing or replacement (prosthesis) is rated under 38 CFR 38 CFR § 4.71a, Diagnostic Code 5055. This section is part of the Schedule for Rating Disabilities (38 CFR Part 4) and can be read in full at the eCFR website.
Which conditions are commonly secondary to Knee, resurfacing or replacement (prosthesis)?
Conditions commonly secondary to Knee, resurfacing or replacement (prosthesis) include: Contralateral Knee Degenerative Joint Disease. Secondary conditions caused or aggravated by a service-connected disability are ratable under 38 CFR § 3.310. Medical nexus evidence linking the primary and secondary condition is required.
What evidence do I need to establish service connection for Knee, resurfacing or replacement (prosthesis)?
Service connection for Knee, resurfacing or replacement (prosthesis) requires three elements: (1) a current diagnosis of the condition, (2) an in-service event, injury, or disease that may have caused or aggravated it, and (3) a medical nexus connecting the current diagnosis to that in-service event. A nexus letter from a treating physician or independent medical examiner is the most reliable nexus evidence. C&P exam findings can also establish nexus if adequately documented.
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