- Diagnostic Code
- 5262
- CFR Section
- §4.71a — Musculoskeletal
Rating Tiers
Nonunion of, with loose motion, requiring brace
Requiring treatment for no less than 12 consecutive months, and unresponsive to surgery and either shoe orthotics or other conservative treatment, both lower extremities
Requiring treatment for no less than 12 consecutive months, and unresponsive to surgery and either shoe orthotics or other conservative treatment, one lower extremity
Requiring treatment for no less than 12 consecutive months, and unresponsive to either shoe orthotics or other conservative treatment, one or both lower extremities
Treatment less than 12 consecutive months, one or both lower extremities
Rated Under Formula
This condition is rated using the §4.71a general rating formula.
What Raters Look For
Based on M21-1 adjudication criteria for Musculoskeletal conditions. These are the factors a VA rater evaluates when assigning a rating percentage.
M21-1 III.iv.4.A- •Range of motion measurements in degrees for each affected joint, recorded on examination
- •Pain on motion — whether pain limits motion before the normal end point is reached
- •Functional loss — specific activities the Veteran cannot perform due to the condition
- •Flare-up history: how often they occur, how severe, and how long they last (Veteran's statement counts)
- •Effects of repetitive motion (whether additional loss of motion occurs after repeated use)
- •Muscle atrophy, guarding, or tenderness noted on physical exam
- •Whether ankylosis (complete fixation) is present and in a favorable or unfavorable position
- •Imaging findings: X-ray, MRI, or CT reports noting bone/joint changes