Ankle Conditions: VA Rating Criteria

Plain-language guide

What this rating actually turns on

The whole ankle rating hinges on one line: if the joint still moves, it caps at 20 percent no matter how painful, and only a fused ankle rates higher. Under 38 CFR 4.71a, an ankle that still moves is rated only under DC 5271, limitation of motion, and that code stops at 20 percent: 10 percent for moderate (less than 15° dorsiflexion or less than 30° plantar flexion) and 20 percent for marked (less than 5° dorsiflexion or less than 10° plantar flexion). Normal is 0–20° dorsiflexion and 0–45° plantar flexion under 4.71, Plate II. Those degree definitions are new: they were added when VA rewrote the musculoskeletal schedule effective February 7, 2021 (85 FR 76453), replacing the old bare “moderate/marked” wording.

To get above 20 percent you need ankylosis, a fused ankle, under DC 5270. Its levels run counterintuitively: a fusion locked near neutral pays less than one locked far from neutral. Plantar flexion less than 30° is 20 percent; plantar flexion 30–40° or dorsiflexion 0–10° is 30 percent; plantar flexion more than 40°, or dorsiflexion more than 10°, or a fusion with abduction, adduction, inversion, or eversion deformity is 40 percent. The other ankle-region codes are narrower: DC 5272, ankylosis of the subastragalar or tarsal joint (10 percent in a good weight-bearing position, 20 percent in a poor one); DC 5273, malunion of the os calcis or astragalus (10 percent moderate, 20 percent marked deformity); and DC 5274, astragalectomy, removal of the talus, a flat 20 percent.

One rule works in your favor: painful motion. 38 CFR 4.59 entitles an actually painful joint to at least the minimum compensable rating (10 percent here) even if your measured motion would not otherwise qualify.

A worked example

Consider a veteran with chronic right-ankle arthritis after repeated sprains on jump status. The ankle still moves, so it is rated under DC 5271. At the C&P exam dorsiflexion reaches only 3 degrees, where normal is 20, and plantar flexion is close to full. Because dorsiflexion is less than 5 degrees, the loss counts as “marked,” which is the 20 percent level of DC 5271, the amount shown in the pay table below. That is the ceiling for an ankle that still bends: even though the joint is painful and swollen most weeks, limitation of motion alone cannot rate above 20 percent. Reaching 30 or 40 percent would take a fused ankle (ankylosis under DC 5270), and this one is not fused.

What the C&P exam measures

The examiner completes the Ankle Conditions DBQ. It requires range of motion in degrees, active and passive, weight-bearing and nonweight-bearing, with the other ankle tested for comparison, plus at least three repetitions to check for additional loss after repeated use. It records your description of flare-ups (frequency, duration, severity), and the examiner must estimate your range of motion in degrees during a flare based on your statements even if no flare is observed at the exam. It also documents functional loss, any history of instability or recurrent subluxation, and objective signs of ankylosis or malunion.

What to have in your file

Per VA’s evidence requirements: service treatment records, imaging that shows arthritis, malunion of the calcaneus or talus, or a fusion, operative reports for any fusion or astragalectomy (they establish which code applies), and clinical range-of-motion measurements in degrees. Lay statements (VA Form 21-10210) describing flare-ups, giving-way, and what you can no longer do feed the flare and functional-loss questions the examiner has to answer.

Common mistakes

• Expecting more than 20 percent for an ankle that still moves. Only ankylosis (DC 5270) exceeds 20 percent; limitation of motion (DC 5271) caps there no matter how painful.
• Assuming a worse-positioned fusion always looks worse to VA. A fusion near neutral rates lower than one locked in extreme plantar or dorsiflexion, so the exact fused position needs to be measured and stated.
• Underreporting flare-ups. The DBQ instructs the examiner to estimate degrees lost during flares from your account; saying nothing gets recorded as no functional loss.
• Letting one ankle be rated twice under overlapping codes. Pyramiding is barred by 38 CFR 4.14; ankylosis subsumes limitation of motion of the same joint.

Worth knowing

Because every ankle-region code tops out at 40 percent and most at 20, the amputation rule (38 CFR 4.68) rarely changes a single ankle rating, but it does cap what stacking several foot-and-ankle codes on one leg can reach: the combined rating for an extremity cannot exceed the rating for amputation at the elective level. If both ankles are compensable, the bilateral factor (38 CFR 4.26) adds 10 percent of their combined value before further combination, and the calculator on this site handles that.

If your rating came back lower than this

A decision that ignores the criteria above is a frequent reason veterans are underpaid. Line your decision up against the levels on this page. If the evidence supports a higher level than VA assigned, you have three ways to challenge it, and the right one depends on why it went wrong:

• Something was missing from the record (an exam finding, a prescription, a flare-up statement, a nexus letter): add it with a Supplemental Claim.
• The evidence was already there and VA misread it: ask for a Higher-Level Review by a more senior rater, with no new evidence needed.
• A legal or judgment error: take it to the Board of Veterans' Appeals.

Before you file, recombine this rating with your others (VA math does not add ratings), check how long each lane is taking right now, and remember a VA-accredited representative or VSO will help you for free. You can also browse every other condition's criteria to make sure you are claiming everything you are owed.