KNEE IMPAIRMENT OF

Summary

The veteran, who served in the United States Navy from January 1963 to March 1967 and June 1969 to June 1983, appeals the denial of an increased disability rating for his left knee total arthroplasty. The veteran contends he is entitled to a 60 percent rating, citing chronic residuals of severe painful motion or weakness. The Board reviewed the evidence of record at the time of the September 2025 agency of original jurisdiction decision, as the veteran waived the remainder of the period to switch dockets. The veteran underwent a total knee replacement in February 2017. A VA examination in August 2025 noted flexion to 115 degrees and extension to 0 degrees, with pain on flexion and weight-bearing. The examiner estimated range of motion during flare-ups as flexion to 110 degrees and extension to 0 degrees. The Board found the evidence weighed against a finding of severe painful motion or weakness, ankylosis, or significant limitation of motion or impairment sufficient to warrant a rating higher than the current 30 percent. The Board concluded that the criteria for a rating in excess of 30 percent were not met, and the benefit-of-the-doubt rule did not apply as the evidence was not in approximate balance. Service connection for the left knee disability is currently rated at 30 percent, and the appeal for a higher rating is denied.

Rationale

VA examination showed intermediate degrees of pain and limitation of motion.; Evidence weighs against severe painful motion or weakness.; Evidence weighs against ankylosis, limitation of flexion/extension, or tibia/fibula impairment.

Full Decision Text

Citation Nr: A26039319
Decision Date: 04/28/26	Archive Date: 04/28/26

DOCKET NO. 251127-615197
DATE: April 28, 2026

ORDER

Entitlement to a rating in excess of 30 percent for left knee total arthroplasty is denied.

FINDING OF FACT

The Veteran's left knee total arthroplasty manifested in intermediate degrees of residual weakness, pain, or limitation of motion but not severe painful motion or weakness, extension limited to 30 degrees or more, ankylosis, or tibial or fibular impairment.

CONCLUSION OF LAW

The criteria for a disability rating in excess of 30 percent for left knee total arthroplasty have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5055.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served in the United States Navy from January 1963 to March 1967 and from June 1969 to June 1983.

As an initial matter, in Williams v. McDonough, 37 Vet. App. 305 (2024), the United States Court of Appeals for Veterans Claims held the Board should not adjudicate an appeal until the time for the appellant to switch Board dockets has ended. This period ends either one year from the date the agency of original jurisdiction (AOJ) mailed notice of the decision on appeal, or 60 days from the date the Board received the VA Form 10182, whichever date is later. 38 C.F.R. § 20.202(c)(2). Here, the Board may proceed with adjudication because on February 17, 2026, the Board received the Veteran's waiver of the remainder of the period to switch dockets. 

In the November 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket.

Therefore, the Board may only consider the evidence of record at the time of the September 2025 AOJ decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. 

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

Entitlement to a rating in excess of 30 percent for left total knee arthroplasty is denied.

The Veteran is seeking a higher rating for his left knee condition. Specifically, the Veteran contends he is entitled to a 60 percent rating for chronic residuals consisting of severe painful motion or weakness. See July 2025 Application for Disability Compensation; November 2025 Notice of Disagreement.

The Board notes that the Veteran referred to a May 2017 rating decision in his November 2025 notice of disagreement. As the November 2025 notice of disagreement was received more than one year after the May 2017 rating decision and the Veteran did not otherwise appeal the May 2017 rating decision, the May 2017 rating decision is final. 38 C.F.R. §3.2500

The Veteran's left knee disability is rated at 30 percent under Diagnostic Code 5055. Diagnostic Code 5055 provides a total rating (100 percent) for four months following prosthetic replacement of a knee joint. Once the four month period has elapsed, under Diagnostic Code 5055 a 30 percent rating is the minimum evaluation following total replacement. Prosthetic replacement of the knee joint with intermediate degrees of residual weakness, pain, or limitation of motion are to be rated by analogy to Diagnostic Code 5256, 5261, or 5262. A 60 percent rating is to be assigned if there are chronic residuals consisting of severe painful motion or weakness in the affected extremity. Following the assignment of a total disability rating, the maximum schedular rating that can be assigned under Diagnostic Code 5055 is 60 percent. See 38 C.F.R. § 4.71a.

Diagnostic Code 5256 provides for a 30 percent rating for ankylosis of favorable angle in full
5055 a 30 percent rating is the minimum evaluation following total replacement. Prosthetic replacement of the knee joint with intermediate degrees of residual weakness, pain, or limitation of motion are to be rated by analogy to Diagnostic Code 5256, 5261, or 5262. A 60 percent rating is to be assigned if there are chronic residuals consisting of severe painful motion or weakness in the affected extremity. Following the assignment of a total disability rating, the maximum schedular rating that can be assigned under Diagnostic Code 5055 is 60 percent. See 38 C.F.R. § 4.71a.

Diagnostic Code 5256 provides for a 30 percent rating for ankylosis of favorable angle in full extension or in slight flexion between 0 and 10 degrees. A 40 percent rating is provided for knee flexion between 10 degrees and 20 degrees. A 50 percent rating is provided for knee in flexion between 20 degrees and 45 degrees. A 60 percent rating is provided for extremely unfavorable ankylosis with the knee in flexion at an angle of 45 degrees or more.

Diagnostic Code 5260 provides ratings based on limitation of flexion of the leg. A 10 percent rating is warranted for flexion limited to 45 degrees. A 20 percent rating is warranted for flexion limited to 30 degrees. The maximum 30 percent rating is warranted for flexion limited to 15 degrees.

Diagnostic Code 5261 provides ratings based on limitation of extension of the leg.  A 10 percent rating is warranted for extension limited to 10 degrees. A 20 percent rating is warranted for extension limited to 15 degrees. A 30 percent rating is warranted for extension limited to 20 degrees. A 40 percent rating is warranted for extension limited to 30 degrees. The maximum 50 percent rating is warranted for extension limited to 45 degrees.

Diagnostic Code 5262 provides ratings based on impairment of the tibia and fibula. A 0 percent rating is warranted for medial tibial stress syndrome (shin splints) with treatment for less than 12 consecutive months for one or both lower extremities. A 10 percent rating is warranted for medial tibial stress syndrome requiring treatment for no less than 12 consecutive months, and unresponsive to either shoe orthotics or other conservative treatment for one or both lower extremities. A 20 percent rating is warranted for medial tibial stress syndrome requiring treatment for no less than 12 consecutive months, and unresponsive to surgery and either shoe orthotics or other conservative treatment for one lower extremity. A 30 percent rating is warranted for medial tibial stress syndrome requiring treatment for no less than 12 consecutive months, and unresponsive to surgery and either shoe orthotics or other conservative treatment for both lower extremities. A 40 percent rating is warranted for nonunion of the tibia and fibula with loose motion, requiring a brace. Malunion of the tibia and fibula is to be evaluated under diagnostic codes 5256, 5257, 5260, or 5261 for the knee, or 5270 or 5271 for the ankle, whichever results in the highest evaluation.

The Veteran presented for VA examination in August 2025. On examination, the left knee manifested with flexion to 115 degrees and extension to 0 degrees. There was pain on flexion and pain with weightbearing, active motion, and passive motion which causes functional loss. There was no evidence of crepitus or localized tenderness or pain on palpation of the joint or associated soft tissue. The Veteran was able to perform repetitive-use testing with no additional loss of function or range of motion after three repetitions. The examiner noted that pain significantly limits functional ability with repeated use over time. The examiner estimated the Veteran's range of motion after repeated use over time was flexion to 110 degrees and extension to 0 degrees. The examiner noted that pain significantly limits functional ability with flare-ups. The examiner estimated the Veteran's range of motion during flare-ups was flexion to 110 degrees and extension to 0 degrees. The Veteran did not report any additional factors contributing to his left knee disability. The examiner noted the Veteran does not have muscle atrophy, ankylosis, recurrent subluxation or persistent instability, ligament tear, or patellar instability. The examiner also noted that the Veteran does not currently have and has not been diagnosed with a recurrent patellar dislocation, shin splints, stress fractures, or any other tibial or fibular impairment. The examiner noted the Veteran does not currently have and has not been diagnosed with a meniscus condition. 

The August 2025 VA examiner noted that the Veteran underwent a total knee joint replacement in February 2017 and has residuals of intermediate degrees of residual weakness, pain, or limitation.
 The Veteran did not report any additional factors contributing to his left knee disability. The examiner noted the Veteran does not have muscle atrophy, ankylosis, recurrent subluxation or persistent instability, ligament tear, or patellar instability. The examiner also noted that the Veteran does not currently have and has not been diagnosed with a recurrent patellar dislocation, shin splints, stress fractures, or any other tibial or fibular impairment. The examiner noted the Veteran does not currently have and has not been diagnosed with a meniscus condition. 

The August 2025 VA examiner noted that the Veteran underwent a total knee joint replacement in February 2017 and has residuals of intermediate degrees of residual weakness, pain, or limitation. The examiner also noted that the Veteran underwent a meniscectomy in 1981. The examiner noted the Veteran's left knee disability impacts his ability to perform occupational tasks, as the Veteran has difficulty with prolonged walking and standing due to pain. 

Based on the foregoing, the Board finds that a rating in excess of 30 percent for the Veteran's left knee disability is not warranted. As shown above, the Veteran's left knee manifested with intermediate pain and limitation of motion. A higher evaluation is not warranted unless there is evidence of chronic residuals consisting of severe painful motion or weakness. Moreover, a higher evaluation under a potentially applicable Diagnostic Code such as, 5256 (ankylosis), 5260 (limitation of flexion), 5261 (limitation of extension), or 5262 (impairment of the tibia and fibula) is not warranted as the evidence weighs against a finding of ankylosis, limitation of flexion or extension, or impairment of the tibia and fibula sufficient to warrant a rating in excess of 30 percent.

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Accordingly, the most probative evidence of record persuasively weighs against the claim of entitlement to a higher rating for left knee total arthroplasty. As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt rule does not apply and a higher rating for left knee total arthroplasty is not warranted. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

 

 

David Gratz

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Henderson, Catherine

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.