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Free Viability Check →Total knee replacement (TKR) is a major surgical intervention, and the VA has specific rating rules that apply before, during, and after the procedure. Veterans who don't understand these rules often miss significant compensation they're owed, particularly the mandatory rating period immediately following surgery.
Diagnostic Code 5055 governs total knee replacement ratings. Unlike most musculoskeletal ratings that depend entirely on range of motion measurements, DC 5055 has a built-in rating structure tied to the phases of recovery and long-term function.
Immediately following a total knee replacement, the VA is required to assign a 100% rating for one year from the date of surgery. This is a blanket, non-negotiable provision. It doesn't depend on how well the surgery went or how quickly you're recovering.
If you underwent knee replacement for a service-connected knee condition and did not receive a 100% rating for the post-surgical year, you may be owed back pay. This applies even if the VA reduced your rating before the year elapsed.
After the one-year mandatory period, the rating is reassessed based on residual functional limitation. DC 5055 sets the following criteria:
In practice, most post-TKR ratings settle in the 30% to 60% range based on how much function is recovered. Range of motion, pain with activity, and the need for assistive devices are the primary factors. Veterans who are underrated after the one-year reassessment should compare the C&P exam findings against the DC 5055 criteria for 60%.
If you undergo a knee replacement and the underlying condition (osteoarthritis, post-traumatic arthritis, ligament damage) was caused or aggravated by military service, the surgery itself doesn't change the service-connection status. In fact, the surgery is evidence of severity.
Veterans who had not yet established service connection for a knee condition and then undergo TKR should file or reopen their claim. The severity of a condition requiring joint replacement is powerful evidence that the disability is real, severe, and worthy of rating.
If you have a service-connected condition (back condition, flat feet, other lower extremity disability) that altered your gait and placed abnormal loads on the knee, the resulting knee degeneration requiring replacement may be ratable as a secondary condition. These secondary pathways are worth exploring before surgery if possible, and certainly worth pursuing after.
DC 5055 covers total knee replacement specifically. Partial (unicompartmental) knee replacements are more common now for isolated compartmental disease. The VA's rating for partial replacement follows the residual limitation codes (DC 5260, 5261) rather than DC 5055. The one-year 100% period does not automatically apply to partial replacement in the same way.
This distinction matters because veterans with partial replacement may be underrated if the rater applies DC 5055 criteria to a procedure that doesn't qualify. The correct approach is to document the specific type of surgery and ensure the correct diagnostic code is applied.
Veterans with bilateral knee replacement (both knees) are entitled to ratings for each knee separately, plus the VA bilateral factor under 38 CFR 4.68, which adds additional compensation when both lower extremities are rated. See our article on bilateral joint conditions and the VA bilateral factor for how this calculation works.
Post-replacement C&P exams focus on:
As with any knee C&P exam, the most common mistake is minimizing symptoms. Report your limitations accurately, describe what you can and cannot do, and make sure the examiner documents pain throughout the range of motion.
Flat Rate Nexus provides physician-signed independent medical opinions and free educational tools at flatratenexus.com, including a nexus letter grader and a C&P exam prep resource. These tools are particularly useful when appealing post-replacement rating decisions.
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