Ankle Conditions

Diagnostic Codes 5270–5271 • 38 CFR § 4.71a

DC 5270 rates ankylosis (fusion). DC 5271 rates limitation of dorsiflexion and plantar flexion—often the main fight is documented goniometer ROM plus painful motion under § 4.59.

Primary DCs

5270–71

Ankle Ratings at a Glance (2026 $, veteran alone)

Motion ratings under 5271 are based on dorsiflexion and plantar flexion measurements (and painful motion). 5270 applies when the tibiotalar joint is ankylosed—percentage depends on position and function.

20%+

5271 — marked limitation of motion (per schedule)

$356.66/mo+

10%

5271 — moderate limitation / painful motion

$180.42/mo

20–40%

5270 — ankylosis (tier by position/favorability)

$356.66–$795.84/mo

0%

Below compensable thresholds

$0

Bilateral factor: If both ankles are separately service-connected at qualifying percentages, VA combines them and applies the bilateral factor—materially increasing combined compensation.

📖
View Official DC 5271 Reference Page

Complete regulatory criteria, CFR citations, and official rating notes for ankle conditions

Three Compensation Scenarios

SCENARIO 1

Single ankle — motion vs stability

Example: 20% under 5271 for marked limitation, with documented brace use and repeated sprains supporting functional loss (illustrative).

Standalone 20% tier ≈ $356.66/mo—add knee or foot claims if gait drives additional diagnoses.

SCENARIO 2

Bilateral ankles

Example: 10% right + 10% left with bilateral factor.

Combined + bilateral

~21–24%

Approx. monthly

~$362–$400/mo

Use the Rating Calculator for your exact combined %.

SCENARIO 3

Ankle + knee + low back (kinetic chain)

Ankle 20%MSK
Knee 20%Compensatory loading
Lumbar strain 20%Altered gait

Combined often lands in the 40–60% range depending on math—verify with the Rating Calculator.

Complete Rating Criteria (summary — DC 5270–5271)

Paraphrased for readability. Match your decision letter and the exact degrees in 38 CFR § 4.71a for your effective date.

RatingCriteria (summary)Pay
40% / 30% / 20%5270 — ankylosis of the ankle in various positions (favorable vs unfavorable per schedule).$795.84 / $552.47 / $356.66
20%5271 — marked limitation of motion (dorsiflexion/plantar flexion thresholds in § 4.71a).$356.66
10%5271 — moderate limitation of motion; or qualifying painful motion (§ 4.59).$180.42
0%Motion not meeting compensable criteria and no qualifying painful motion.$0

Evidence Requirements

Goniometer ROM

Separate dorsiflexion and plantar flexion; stop at pain; request repetition after use if flare-ups are typical.

Imaging

X-ray/MRI for arthritis, loose bodies, prior fracture malunion—supports chronicity and severity.

Bracing & footwear

Prescriptions for ankle brace, CAM boot history, orthotic notes.

Instability history

Repeated inversion injuries, physical therapy notes, sports medicine follow-up.

Lay statements

Giving way on uneven ground, swelling after work shifts, need for railings on stairs.

Common Secondary Conditions

🦵 Knee strain

STRONG

5260Compensatory gait

🦴 Hip strain

STRONG

5252Pelvic tilt / limp

🫳 Lumbar strain

STRONG

5237Antalgic gait

🦶 Plantar fasciitis

MODERATE

5269Altered mechanics

🦶 Opposite ankle

STRONG

5271Overuse

🧠 Depression

MODERATE

9434Chronic pain / falls fear

Claim Timeline

1

Gather evidence

STR, imaging, PT notes, brace prescriptions, lay statements

2

File claim (526EZ)

Specify ankle side; claim secondaries if nexus is ready

3

C&P orthopedics

ROM with goniometer; ask examiner to note pain onset with motion

4

Decision review

Confirm correct DC (5270 vs 5271) and bilateral math

5

Increase / HLR

If ROM poorly measured, submit private PT goniometry

What Gets You Higher Ratings

10% → 20%

Objective marked limitation per schedule (not subjective “tight”)—often needs dorsiflexion/plantar flexion in the regulatory ranges plus consistent clinical findings.

Ankylosis (5270)

If surgically fused or non-motion joint, ensure position is documented—higher tiers track favorability of fusion angle.

Painful motion

Pain during active or passive motion can support minimum compensable evaluation when regulatory criteria are met—tie pain to measurable functional loss.

Common Mistakes

Eyeball ROM

Without goniometer numbers, appeals struggle—get PT or private ortho measurements.

Wrong joint coded

Foot vs ankle vs hindfoot—ensure exam addresses the tibiotalar joint.

Ignoring flare-ups

If repetitive use testing wasn’t discussed, argue DeLuca factors on review.

No bilateral factor

If both ankles qualify, combined rating should reflect bilateral rules.

FAQs

Can I get ankle and knee ratings together?

Yes—when each joint has distinct disability, VA combines percentages (subject to pyramiding rules). Document how each joint is limited.

Is ankle instability a separate rating?

Ankle ratings are often ROM-based; instability may be considered in functional loss or analogous evaluation depending on facts—confirm with current schedule and exam worksheet used.

Secondary to knee or back?

If gait from a service-connected knee/hip/back clearly aggravated the ankle, a secondary theory may work—medical nexus language helps.

Cross-Links

⚠️ Important Disclaimer

This page provides general educational information only based on public VA regulations (38 CFR) and va.gov resources. It is not legal, medical, or claims assistance. Ratings and service connections are decided case-by-case by the VA based on the individual veteran’s evidence. We do not prepare claims, generate documents, or provide personalized advice. Always consult a VA-accredited Veterans Service Organization (VSO), attorney, or your physician for help with your specific situation. Verify the latest rules on va.gov.

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