Hip & Thigh: VA Rating Criteria

Plain-language guide

What this rating actually turns on

Because a normal hip flexes all the way to 125 degrees, the joint has to lose most of its motion before any rating attaches, which is why so many hip claims turn on bone damage and ankylosis rather than range of motion alone. Under 38 CFR 4.71a, “The Hip and Thigh” table runs six codes: limitation of flexion (DC 5252) and extension (DC 5251) in degrees; impairment of the thigh’s abduction, adduction, or rotation (DC 5253); ankylosis, a hip fused in place (DC 5250); flail joint (DC 5254); and impairment of the femur (DC 5255).

Normal hip flexion is 0 to 125 degrees and abduction 0 to 45 degrees (Plate II), so motion has to be badly cut to pay. Flexion limited to 45° rates 10 percent; to 30° is 20; to 20° is 30; to 10° is 40. Extension limited to 5° (DC 5251) is 10 percent, the only level in that code. Thigh impairment (DC 5253): loss of abduction with motion lost beyond 10° is 20 percent; inability to cross the legs (adduction) is 10; inability to toe-out more than 15° (rotation) is 10. Those live in three separate codes, so more than one can apply to the same hip at once.

The high numbers come from ankylosis and bone damage. DC 5250: favorable ankylosis, fused in flexion at an angle between 20° and 40° with slight adduction or abduction, is 60 percent; intermediate is 70; unfavorable or extremely unfavorable, the foot not reaching the ground and crutches necessitated, is 90. Flail joint (DC 5254) is 80 percent. Femur (DC 5255): nonunion of the shaft or anatomical neck with loose motion is 80 percent; nonunion without loose motion, weight bearing preserved with a brace, is 60; fracture of the surgical neck with a false joint is 60.

Two rules cut in your favor. Painful motion: 38 CFR 4.59 entitles an actually painful, unstable, or malaligned joint to at least the minimum compensable rating even when the measured motion falls short. Bilateral factor: because the hips are a paired joint, 38 CFR 4.26 adds 10 percent of their combined value when both hips are compensable, the calculator on this site handles that.

A worked example

Take a veteran who fractured the right hip in a vehicle rollover and later developed post-traumatic arthritis. Normal hip flexion runs to 125 degrees, but at the C&P exam the joint stops at 20 degrees of flexion, holding at that endpoint through three repetitions and on the examiner’s estimate for flare-ups. On the DC 5252 scale, flexion limited to 20 degrees is the 30 percent level, the amount shown in the pay table below. Because abduction, adduction, and rotation each sit in their own code (DC 5253), the veteran makes sure the examiner measures every plane: if abduction is also lost beyond 10 degrees, that is a separate 20 percent under DC 5253 that combines on top of the flexion rating rather than replacing it.

What the C&P exam measures

The examiner completes the Hip and Thigh DBQ. It requires range of motion in degrees, active and passive, weight-bearing and nonweight-bearing, with the opposite hip tested for comparison and at least three repetitions to check for added loss after use. Flexion, extension, abduction, adduction, and internal and external rotation are each recorded, because each maps to a different code. The exam captures your description of flare-ups (frequency, duration, severity), and the examiner must estimate the degrees lost during a flare from your statements even if you are not flaring at the appointment. It also documents any ankylosis, leg-length difference, and femur nonunion or malunion shown on imaging.

What to have in your file

Per VA’s evidence requirements: service treatment records, operative reports for any fracture fixation or hip surgery (they establish nonunion, malunion, or false-joint status under DC 5255), and imaging showing the bone. If a provider prescribed a cane, crutches, or a brace, get that in the record, it corroborates the functional picture the DBQ asks about. Lay statements (VA Form 21-10210) describing flare-ups, giving-way, and what you can no longer do feed the DBQ questions the examiner has to answer.

Common mistakes

• Reporting only flexion. Abduction, adduction, and rotation are rated under a separate code (DC 5253); if the examiner does not measure every plane, a compensable loss can go unrated. Ask that all of them be tested.
• Underreporting flare-ups. The DBQ tells the examiner to estimate degrees lost during flares from your account; saying nothing gets recorded as no additional loss.
• Reading the femur apart from the joint. Under the current schedule, malunion of the femur is evaluated under the knee or hip limitation codes, whichever pays highest (DC 5255), so the fracture and the joint limitation are read together, not in isolation.

Worth knowing

VA rewrote the musculoskeletal schedule effective February 7, 2021 (85 FR 76453). Under the current regulation, DC 5255 no longer uses a slight/moderate/marked malunion scale; it directs the rater to evaluate malunion of the femur under the knee (DC 5256, 5257, 5260, 5261) or hip (DC 5250 to 5254) codes, whichever yields the highest rating. A hip replacement or resurfacing is rated separately under DC 5054: 100 percent for 4 months after implantation (the 2021 rewrite cut this from one year), intermediate levels of 90, 70, or 50 percent for residual weakness or pain, then a 30 percent minimum. Unfavorable ankylosis or loss of use of the leg can also open special monthly compensation.

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.