Rating Schedule for the Hip and Thigh
IMPORTANT NOTE:
For the purposes of Range of Motion (ROM), the examiner/rater are REQUIRED to consider flair ups in your conditions. Meaning, if you do not happen to have an Examination on your worst day, the examiner is required to reasonably estimate your impairment on your worst day! The rater is required to use this estimate, unless your ROM is somehow noted as being worse during ROM testing during the exam. In any event, the rater is to use the most impaired ROM measurements noted by the examiner!
Amputation Rule
Veterans CANNOT have a total Combined rating for places in the body higher than a Veteran who had those areas amputated. IE A veteran who has various disabilities in their knee, ankle, and foot; Those ratings cannot combine to be more than a Veteran who had their leg amputated just above the knee.
5160, 5161, 5162 Amputation
Veteran is entitled to Special Monthly Compensation.
5250 Joint Stiffness (Ankylosis)
When the Hip joint cannot move.
Abduction: Ability to move your leg sideways.
Adduction: Ability to cross your legs.
Flexion: Lifting the leg forward.
NOTE:
*Veteran is entitled to Special Monthly Compensation.
| Rating |
Description |
|---|---|
| 60% | Flexion at an angle between 20° and 40°, and slight adduction or abduction. |
| 70% | Intermediate. |
| 90% | When a foot cannot reach the ground, requiring the use of crutches*. |
5054 Hip Replacement (Prosthesis) or Resurfacing
IMPORTANT NOTES:
If the hip joint had ANY other musculoskeletal hip evaluations (ankylosis, range of motion, etc.) they WILL BE discontinued the date of the procedure!
If AFTER, your temp 100% ends you think your evaluation should be higher you CAN file an Increase claim.
As hip resurfacing/not total replacement, does not have a minimum evaluation an examination after the temp 100% ends is REQUIRED!
Since the total hip replacement has a minimum evaluation a reexamination is NOT required.
Medical evidence MUST show:
Date of admission;
Date of discharge;
Date of surgery; AND
Procedure performed.
If the procedure is noted for a non-service-connected condition then the VA will get a medical opinion to determine if the non-service-connected condition is a progression of the service-connected condition.
RATER NOTES:
Do NOT keep an open ended 100%! If you do not have an examination conducted AFTER the 100% ends for a resurfacing - you will return the hip to the evaluation(s) it had before the procedure and order an At once examination and END the temp 100%!
Temp 100% includes a bonus 1 month due to 38 CFR 4.30, so while it says 4 months it is actually 5 months total!
Example: Admitted for surgery June 12, 2025 and release June 12, 2025.
Effective date of 100% due to 38 CFR 4.30 is June 12, 2025 to August 1, 2025. Then 4 months due to the schedule ending on December 1, 2025. So in the end, temp 100% runs from June 12, 2025 to December 1, 2025.
Example rollover: Admitted for surgery February 28, 2025 and released March 2, 2025.
Effective date of 100% due to 38 CFR 4.30 is February 28, 2025 to May 1, 2025. Then 4 months due to the schedule ending on September 1, 2025. So in the end, temp 100% runs from February 28, 2025 to September 1, 2025.
Remember to check for temporary entitlement to SMC S and to discontinue it as appropriate!
Any residual Scars?
Temporary 100% CANNOT be the basis of the award of Permanent and Total… It is in the name…
Separate musculoskeletal hip evaluations are NOT allowed while the hip is rated under this Diagnostic code! In the rare event it would be better to continue to rate under a different diagnostic code(s) this is allowed so long as this diagnostic code is made secondary.
NOTES:
*Total replacement only; for VBA purposes a total replacement of the head of the femur or of the acetabulum counts.
**Veteran is entitled to Special Monthly Compensation.
| Rating |
Description |
|---|---|
| 30% | Minimum rating*. |
| 50% | Moderately severe residuals of weakness, pain or limitation of motion. |
| 70% | Markedly severe residual weakness, pain or limitation of motion following implantation of prosthesis. |
| 90% | Painful motion or weakness such as to require the use of crutches**. |
| 100% | For four months following the replacement/resurfacing. |
Ratings Based Off Limitations of Range of Motion (ROM)
PYRAMIDING NOTE:
Veterans CAN receive separate individual ratings for their limitations in:
Abduction/adduction/thigh rotation;
Extension; AND
Flexion.
5253 Abduction/Adduction/Thigh Rotation (Thigh Impairment)
Abduction: Ability to move your leg sideways.
Adduction: Ability to cross your legs.
Thigh rotation: Ability to rotate your leg so your toes point to the side.
| Rating |
Description |
|---|---|
| 10% | Limitation of adduction of, cannot cross legs. |
| 10% | Limitation of rotation of, cannot toe-out more than 15°, affected leg. |
| 20% | Limitation of abduction of, motion lost beyond 10°. |
5255 Thigh (Femur) Bone
Longest bone in the body.
NOTE:
For Veterans who's femur bone healed improperly. It will be rated in how it affects the hip or Knee; Whichever rating is higher
| Rating |
Description |
|---|---|
| 60% | Fracture of surgical neck of, with false joint |
| 60% | Bone will not heal, without loose motion, and leg can bear weight with aid of brace. |
| 80% | Bone will not heal, with loose motion (spiral or oblique fracture). |
5275 Shortening of the Leg
When the Veteran has their leg shortened as a result of trauma or a service-connected surgery.
PYRAMIDING NOTE:
CANNOT be given with other ratings for fracture or faulty union in the same leg; Veterans will be given the higher rating.
NOTES:
Measured from anterior superior spine of the ilium to the internal malleolus of the tibia.
*Entitles the Veteran to Special Monthly Compensation.
| Rating |
Shortening of |
|---|---|
| 10% | 1.25 to 1.99 inches. |
| 20% | 2 to 2.49 inches. |
| 30% | 2.5 to 2.99 inches. |
| 40% | 3 to 3.49 inches. |
| 50% | 3.5 to 4 inches*. |
| 60% | Over 4 inches*. |
Miscellaneous Ratings
The Veteran will NOT receive an additional rating if they fit the criteria of any of these miscellaneous cases. The Veteran will get a single rating for the ROM or Miscellaneous rating; Whichever rating is higher!
Pain with Motion
PYRAMIDING NOTE:
When there is an award based on pain with motion with movement of the hip. The VA will only award a SINGLE rating under range of motion! No matter how many ranges of motion are impacted!
| Rating |
Description |
|---|---|
| 10% |
Pain with motion. |
Arthritis
When a Veteran's arthritis does not warrant a rating based upon ROM or other miscellaneous situations. The Veteran's condition will be rated under degenerative arthritis.
For an explanation of arthritis ratings click HERE.
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