ACL Tear Residuals

DC 5257Musculoskeletal38 CFR 4.71a, DC 5257

Residual knee instability following an anterior cruciate ligament (ACL) tear or reconstruction. The VA rates ACL tear residuals based on the degree of recurrent subluxation or lateral instability of the knee, measured during clinical examination.

How the VA rates this condition

The VA rates this condition based on objective clinical measurements and test results. The examiner will use standardized tests or lab values to determine the severity of your condition rather than relying primarily on subjective symptom reports.

Diagnostic code

DC 5257

Rating range

10% – 30%

Rating levels

Rating criteria are defined in 38 CFR 4.71a, DC 5257. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

You have severe recurrent subluxation or lateral instability of the knee. Your knee is unreliable and gives way regularly, making weight-bearing activities dangerous and requiring constant use of a brace or assistive device.

What the VA looks for

Severe recurrent subluxation or lateral instability documented
Marked instability on clinical testing
Constant use of knee brace or assistive device required
Significant functional impairment in weight-bearing activities

Common Pitfalls

⚠Not requesting instability testing during the C&P exam — the examiner must perform anterior drawer, Lachman, and valgus/varus stress tests to document instability.
⚠Not understanding that instability (DC 5257) can be rated separately from limitation of motion (DC 5260/5261) — VAOPGCPREC 23-97 allows separate ratings for both.
⚠Not documenting the use of a knee brace or assistive device — this supports the severity of instability.
⚠Failing to report how often the knee gives way and in what activities — frequency and functional impact determine the rating level.

Related DBQ Forms

DBQ Knee and Lower Leg Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

How the VA rates this condition

Diagnostic code

DC 5257

Rating range

10% – 30%

Rating levels

Rating Levels

What the VA looks for

Severe recurrent subluxation or lateral instability documented
Marked instability on clinical testing
Constant use of knee brace or assistive device required
Significant functional impairment in weight-bearing activities

Common Pitfalls

⚠Not requesting instability testing during the C&P exam — the examiner must perform anterior drawer, Lachman, and valgus/varus stress tests to document instability.

⚠Not understanding that instability (DC 5257) can be rated separately from limitation of motion (DC 5260/5261) — VAOPGCPREC 23-97 allows separate ratings for both.

⚠Not documenting the use of a knee brace or assistive device — this supports the severity of instability.

⚠Failing to report how often the knee gives way and in what activities — frequency and functional impact determine the rating level.