Diagnostic Code 5260 · 38 CFR §4.71a
Limitation of knee flexion refers to a reduced ability to bend the knee. Normal knee flexion is 140 degrees (fully bent). The VA rates limitation of flexion under DC 5260 based on the degree to which flexion is restricted. This condition commonly results from knee injuries during military service — ligament tears, meniscus injuries, or repetitive stress from running, rucking, jumping, and other physical training. The VA can rate limitation of flexion separately from limitation of extension (DC 5261) on the same knee under VAOPGCPREC 9-2004, which means a veteran with both limited bending and limited straightening can receive two separate ratings for the same knee.
| Rating | Criteria |
|---|---|
| 0% | Flexion limited to 60 degrees. The veteran can bend the knee to 60 degrees but no further. Normal flexion is 140 degrees. |
| 10% | Flexion limited to 45 degrees. The veteran cannot bend the knee past 45 degrees. |
| 20% | Flexion limited to 30 degrees. Significant restriction in bending the knee. |
| 30% | Flexion limited to 15 degrees. Severe restriction — the knee barely bends beyond a near-straight position. This is the maximum rating under DC 5260. |
Range of motion (ROM) measurements using a goniometer are the primary evidence. The C&P examiner will measure your knee flexion in degrees. Medical records documenting knee injuries during service, imaging (X-rays, MRIs) showing joint damage, and treatment records showing ongoing knee problems are all relevant. Under the DeLuca factors (38 CFR 4.40 and 4.45), the VA must also consider pain on movement, weakness, fatigability, and loss of ROM during flare-ups or after repetitive use. If your ROM is worse during flare-ups than during a single exam measurement, document that pattern.
Yes. Under VAOPGCPREC 9-2004, the VA can assign separate ratings for limitation of flexion (DC 5260) and limitation of extension (DC 5261) for the same knee when both are compensable. This means one knee can produce two separate ratings.
Normal knee flexion is 140 degrees (fully bent) and normal extension is 0 degrees (fully straight). The VA rates based on how far from normal your measured range falls.
The DeLuca factors refer to the principles from DeLuca v. Brown requiring the VA to consider pain on movement, weakness, excess fatigability, incoordination, and additional loss of function during flare-ups when rating musculoskeletal conditions. These factors can result in a higher effective rating even if your measured ROM at the exam meets a lower criteria.