Ankle VA Rating Criteria and Diagnostic Codes (DC 5270–5274)

Complete VA ankle rating table (DC 5270–5274, DC 5056, and 38 CFR 4.59)

The table below lists every rating percentage and regulatory criterion for ankle conditions under current 38 CFR 4.71a and 38 CFR 4.59.

Under the veteran-alone compensation schedule effective 2025-12-01, a 10% rating pays $180.42 per month, 20% pays $356.66, 30% pays $552.47, 40% pays $795.84, and 100% pays $3,938.58.

Diagnostic Code 5271: Moderate vs. marked limitation of ankle motion

Diagnostic Code 5271 (“Ankle, limited motion of”) is the primary code used in VA ankle claims whenever the joint retains active motion. Under 38 CFR 4.71 and Plate II, ankle movement is measured from a 0-degree neutral baseline where the sole of the foot forms a 90-degree angle with the lower leg:

• Dorsiflexion (0° to 20°): Pulling the top of the foot upward toward the shin.
• Plantar flexion (0° to 45°): Pointing the foot and toes downward away from the shin.

Prior to 2021, Diagnostic Code 5271 listed only “Marked” (20%) and “Moderate” (10%) without stating degree measurements in 38 CFR 4.71a. In the musculoskeletal final rule published on November 30, 2020 (85 FR 76453, effective February 7, 2021), the VA amended Diagnostic Code 5271 to codify objective goniometric degree thresholds:

• 10% rating (Moderate limitation of motion): Dorsiflexion is less than 15 degrees (0° to 14°), or plantar flexion is less than 30 degrees (0° to 29°).
• 20% rating (Marked limitation of motion): Dorsiflexion is less than 5 degrees (0° to 4°), or plantar flexion is less than 10 degrees (0° to 9°).

Because the regulation uses “or,” restriction in either dorsiflexion or plantar flexion qualifies. Note that the regulation specifies less than 15 degrees and less than 5 degrees: dorsiflexion of 15 degrees and plantar flexion of 30 degrees require documented painful motion under 38 CFR 4.59 or functional loss during flare-ups under 38 CFR 4.40 and 4.45 to warrant 10%.

How the VA rates ankle instability, sprains, and Achilles tendon conditions

Unlike the knee pain schedule—which provides a dedicated instability code (Diagnostic Code 5257)—there is no standalone diagnostic code for ankle instability in 38 CFR 4.71a.

When an in-service sprain tears or stretches the lateral collateral ligaments (anterior talofibular, calcaneofibular, and posterior talofibular) or the medial deltoid ligament, the joint can develop chronic laxity and give way on uneven ground. VA adjudicators rate chronic ankle sprains, ligament tears, and instability under Diagnostic Code 5271 (10% for moderate limitation, 20% for marked limitation) or 38 CFR 4.59 (10% for painful or unstable joints when range of motion is 15°–20° dorsiflexion and 30°–45° plantar flexion).

Under the anti-pyramiding rule in 38 CFR 4.14, you cannot receive separate ratings under DC 5271 for dorsiflexion and plantar flexion on the same ankle. Multiple diagnoses in the same ankle—such as chronic ligament instability, osteoarthritis, impingement, and Achilles, peroneal, or posterior tibial tendinitis (rated via DC 5024/5003)—that manifest as painful or restricted ankle motion receive a single rating (10% or 20%) under DC 5271. Separate ratings on the same leg require a distinct, non-overlapping disability, such as a painful surgical scar (DC 7804), peroneal nerve neuropathy (38 CFR 4.124a, DCs 8521–8523), or plantar fasciitis (DC 5269).

Ankylosis, subtalar fusion, bone malunion, and ankle replacement (DCs 5270, 5272–5274, 5056)

When an ankle injury involves joint fusion, hindfoot fractures, or prosthetic surgery, higher evaluations apply:

• Diagnostic Code 5270 (Ankylosis of the ankle): Complete immobilization or fusion of the tibiotalar joint is rated by angle of fixation: 20% in plantar flexion less than 30°; 30% in plantar flexion between 30° and 40°, or in dorsiflexion between 0° and 10°; and 40% in plantar flexion at more than 40°, in dorsiflexion at more than 10°, or with abduction, adduction, inversion, or eversion deformity.
• Diagnostic Code 5272 (Subastragalar or tarsal joint, ankylosis of): Fusion of the subtalar or tarsal joint is rated at 10% in a good weight-bearing position and 20% in a poor weight-bearing position.
• Diagnostic Code 5273 (Os calcis or astragalus, malunion of): Malunion of the calcaneus (heel) or talus (astragalus) is rated at 10% for moderate deformity and 20% for marked deformity.
• Diagnostic Code 5274 (Astragalectomy): Surgical removal of the talus bone (talectomy) warrants 20%.
• Diagnostic Code 5262 (Tibia and fibula, impairment of): Malunion affecting the ankle is rated under DC 5270 or DC 5271 (or knee codes 5256–5261), whichever yields the highest evaluation. Nonunion with loose motion requiring a brace warrants 40%.
• Diagnostic Code 5056 (Ankle replacement / prosthesis): Total ankle replacement receives 100% for 1 year after implantation (after the 1-month rating under 38 CFR 4.30 per Note 4), followed by 40% for chronic severe painful motion or weakness, 20% or 30% under DC 5270/5271 for intermediate residuals, and a 20% minimum rating.

The painful motion rule (38 CFR 4.59) and flare-ups (38 CFR 4.40 and 4.45)

If your ankle bends to 15° of dorsiflexion and 30° of plantar flexion during a clinic visit, three regulations protect your claim from a 0% rating:

1. Painful Motion (38 CFR 4.59): Because 38 CFR 4.45 classifies the ankle as a major joint, objective painful motion on active or passive testing—or X-ray arthritis under DC 5003/5010 with painful motion—warrants 10%.
2. Functional Loss (38 CFR 4.40): Disability includes inability to perform normal movements with normal excursion, strength, speed, coordination, and endurance due to pain or weakness on weight-bearing use.
3. Repetitive Use and Flare-Ups (38 CFR 4.45 and DeLuca v. Brown): Examiners must test repetitive motion and estimate range-of-motion loss during flare-ups. If flare-ups or repeated walking reduce dorsiflexion below 15° (for 10%) or below 5° (for 20%), the VA rates your ankle on that reduced range.

How the C&P exam and Ankle Conditions DBQ measure your claim

During a C&P exam, the clinician completes the Ankle Conditions Disability Benefits Questionnaire (DBQ):

• Sections 1 & 2 (Diagnosis and Flare-Ups): Records ankle diagnoses, affected side, functional limits, and flare-up or instability history.
• Section 3 (Range of Motion): Measures active and passive dorsiflexion (normal 20°) and plantar flexion (normal 45°); notes pain on motion and weight-bearing; performs three repetitions of repetitive-use testing; and estimates flare-up range of motion.
• Sections 4 & 5 (Muscle Atrophy and Ankylosis): Measures lower-leg circumference for atrophy and records fixed angles of ankylosis for the ankle (DC 5270) or subtalar/tarsal joint (DC 5272).
• Section 6 (Joint Stability Testing): Performs the Anterior Drawer Test (anterior talofibular ligament laxity) and the Talar Tilt Test (calcaneofibular and deltoid ligament stability).
• Sections 7–12 (Malunion, Surgeries, Bracing, and Imaging): Documents calcaneus or talus malunion (DC 5273), talectomy (DC 5274), shin splints/MTSS (DC 5262), ankle surgery or replacement (DC 5056), prescribed braces or canes, and X-ray/MRI arthritis findings.

Stop moving your foot as soon as pain begins during goniometer testing so the examiner records your accurate functional limit.

Secondary conditions, combined ratings, and accredited help

Under 38 CFR 3.310(a), a disability proximately caused or aggravated by a service-connected condition may qualify for secondary service connection with a current diagnosis and medical nexus opinion:

• Knee pain and contralateral overuse: Limping or restricted ankle dorsiflexion transmits abnormal stress to the knee and shifts load onto the opposite ankle and knee, which may cause or aggravate osteoarthritis or tendinopathy.
• Plantar fasciitis (DC 5269) and pes planus (DC 5276): Achilles tightness or restricted ankle motion may strain the plantar fascia and arch; conversely, service-connected flat feet or plantar fasciitis may alter hindfoot alignment and cause secondary ankle tendinitis or arthritis.
• Hip and lower back pain: Altered gait mechanics or walking in a rigid ankle brace may create pelvic tilt and uneven spinal loading, which may cause or aggravate lumbar spine or hip conditions.

Multiple ratings combine under 38 CFR 4.25, which you can calculate with our VA combined rating calculator. When compensable disabilities affect both lower extremities (such as both ankles, or a right ankle and a left knee), 38 CFR 4.26 adds a 10% bilateral factor to their combined value before combining with other ratings.

If your claim was denied or underrated, Veterans Service Organizations (VSOs) such as the DAV, VFW, and American Legion provide free representation, and VA-accredited claims agents or attorneys assist with appeals. No representative can promise an outcome; verify accreditation through the VA Office of General Counsel Accreditation Search.