VA disability ratings for hip and thigh conditions range from 10% to 90% under 38 CFR 4.71a (Diagnostic Codes 5250 to 5255). Ratings evaluate limited range of motion in thigh flexion, extension, abduction, and rotation, total hip replacement (DC 5054), hip joint ankylosis, and femur fracture residuals or flail joint.
Condition Overview & Clinical Scope
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The published hip and thigh schedule uses several separate pathways. Some focus on residuals after hip replacement or resurfacing. Others focus on hip ankylosis, a fixed joint position described as favorable, intermediate, or unfavorable. Others focus on limited thigh flexion, extension, abduction, adduction, or rotation, a flail hip joint, femur fracture nonunion or false joint, or thigh and hip-level amputation. Unlike several upper-extremity guides, the hip and thigh schedule does not distinguish a dominant or nondominant side, and this hub does not calculate the VA bilateral factor.
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The published hip and thigh schedule uses several separate pathways. Some focus on residuals after hip replacement or resurfacing. Others focus on hip ankylosis, a fixed joint position described as favorable, intermediate, or unfavorable. Others focus on limited thigh flexion, extension, abduction, adduction, or rotation, a flail hip joint, femur fracture nonunion or false joint, or thigh and hip-level amputation. Unlike several upper-extremity guides, the hip and thigh schedule does not distinguish a dominant or nondominant side, and this hub does not calculate the VA bilateral factor.
Regulatory authority: 38 CFR 4.71a, DC 5054, DC 5160-5162, and DC 5250-5255
This guide is educational only. RatingScope does not diagnose a hip or thigh condition, does not infer missing measurements, does not determine service connection, and does not predict a VA decision. IMPORTANT DISCLOSURE: 38 CFR 4.71a's Prosthetic Implants and Resurfacing heading states that when an evaluation is assigned for joint resurfacing or the prosthetic replacement of a joint under diagnostic codes 5051-5056 (DC 5054 for the hip), an additional rating under 4.71a may not also be assigned for that same joint, unless otherwise directed -- disclosed here, not silently applied or combined with a DC 5250-5254 finding. Femur malunion under DC 5255 must be evaluated under whichever of the hip or knee criteria yields the highest evaluation, and that review route is not yet enumerated in this hub as its own percentage and is flagged below rather than estimated. A hip/knee malunion comparison tool below lets you enter documented findings for each route and see them side by side, with the highest result identified; it is informational only and does not submit or save anything.
Percentage Guides
Understanding Your Percentage
Select a pathway to see what the published criteria ask about, what records may clarify it, and what should not be assumed.
10%
Next: 20%
The 10% level can describe thigh extension limited to 5 degrees, thigh flexion limited to 45 degrees, thigh impairment that prevents crossing the legs, or thigh impairment that prevents toeing out more than 15 degrees.
What separates the next level: Higher levels move into more limited thigh flexion or abduction motion lost beyond 10 degrees, rather than a further degree of extension, adduction, or rotation limitation described at this level.
Review CFR criteria, examples, and evidence
Official CFR language
DC 5251 lists thigh extension limited to 5 degrees at 10 percent. DC 5252 lists thigh flexion limited to 45 degrees at 10 percent. DC 5253 lists thigh impairment where limitation of adduction prevents crossing the legs at 10 percent, and thigh impairment where limitation of rotation prevents toeing out more than 15 degrees at 10 percent.
Qualification explanation
These are four separate routes across three diagnostic codes. RatingScope should not blend an extension finding with a flexion finding, or an adduction finding with a rotation finding, unless the record documents that specific route.
Examples
Thigh extension is measured at 5 degrees.; Thigh flexion is measured at 45 degrees.; The record documents that the veteran cannot cross the affected leg over the other leg.; The record documents that the veteran cannot toe out the affected leg more than 15 degrees.
Medical evidence
Hip and Thigh DBQ range-of-motion section; Goniometer measurements for thigh extension and flexion; Examiner notes describing leg-crossing or toe-out limitation
Functional impact examples
Difficulty with tasks that require bending or straightening the hip.; Difficulty crossing the legs while sitting or dressing.; Difficulty rotating the leg outward during walking or standing.; Pain or activity limits may still be real even when the record only supports a 10% pathway.
Common misconceptions
A painful hip does not by itself identify which 10% route applies.; Extension, flexion, adduction, and rotation are different movements and are not interchangeable measurements.; A missing measurement is not the same as a noncompensable measurement.
38 CFR 4.71a; 5251, 5252, 5253; Current educational Hip guide; deterministic assessment support is not active.
20%
Next: 30%
This level can describe thigh flexion limited to 30 degrees, or thigh impairment with abduction motion lost beyond 10 degrees.
What separates the next level: Higher levels move into more limited thigh flexion or the minimum route after total hip replacement, rather than a further degree of abduction loss.
Review CFR criteria, examples, and evidence
Official CFR language
DC 5252 lists thigh flexion limited to 30 degrees at 20 percent. DC 5253 lists thigh impairment with abduction motion lost beyond 10 degrees at 20 percent.
Qualification explanation
These are two separate routes under different diagnostic codes. A flexion measurement should not be blended with an abduction finding unless the record documents that specific route.
Examples
Thigh flexion is measured at 30 degrees.; The record documents abduction motion lost beyond 10 degrees.
Medical evidence
Hip and Thigh DBQ range-of-motion section; Goniometer measurements for thigh flexion and abduction; Physical therapy range-of-motion notes
Functional impact examples
Increasing difficulty with bending the hip for sitting, stairs, or standing from a seated position.; Increasing difficulty moving the leg away from the body, such as for balance or lateral movement.
Common misconceptions
Flexion and abduction are different movements measured separately.; A general hip diagnosis is not the same as a documented flexion or abduction measurement.
Related topics
thigh flexion; abduction
Source context
38 CFR 4.71a; 5252, 5253; Current educational Hip guide; deterministic assessment support is not active.
30%
Next: 40%
This level can describe the minimum evaluation after total hip replacement when higher residual criteria are not documented, or thigh flexion limited to 20 degrees.
What separates the next level: Higher levels require thigh flexion limited to 10 degrees, or moderately severe residuals following hip replacement, rather than this level's findings.
Review CFR criteria, examples, and evidence
Official CFR language
DC 5054 lists a minimum 30 percent evaluation after total hip replacement when higher residual criteria are not documented. DC 5252 lists thigh flexion limited to 20 degrees at 30 percent.
Qualification explanation
This minimum replacement route depends on a documented total hip replacement procedure, separate from a thigh flexion measurement under DC 5252.
Examples
A total hip replacement was performed and no higher residual criteria are documented.; Thigh flexion is measured at 20 degrees.
Medical evidence
Operative report for total hip replacement; Hip and Thigh DBQ replacement and range-of-motion sections; Postoperative follow-up records
Functional impact examples
Recovery-stage limits after hip replacement even when severe residual criteria are not yet documented.; Meaningful difficulty bending the hip for daily tasks when flexion is limited to this degree.
Common misconceptions
A general hip surgery is not automatically a qualifying total hip replacement.; This minimum route does not require a specific degree measurement, but it does require a documented replacement procedure.
Related topics
hip replacement minimum evaluation; thigh flexion
Source context
38 CFR 4.71a; 5054, 5252; Current educational Hip guide; deterministic assessment support is not active.
40%
Next: 50%
This level describes thigh flexion limited to 10 degrees.
What separates the next level: Higher levels move into moderately severe hip replacement residuals or favorable hip ankylosis, rather than a further degree of limited flexion under DC 5252.
Review CFR criteria, examples, and evidence
Official CFR language
DC 5252 lists thigh flexion limited to 10 degrees at 40 percent.
Qualification explanation
The record needs to document the specific flexion measurement rather than a general description of stiffness.
Examples
Thigh flexion is measured at 10 degrees on examination.
Medical evidence
Hip and Thigh DBQ range-of-motion section; Goniometer measurements for thigh flexion; Orthopedic specialist notes
Functional impact examples
Substantial difficulty bending the hip for sitting, standing, walking, or stairs.; Assistive devices or significant gait changes may be documented at this level.
Common misconceptions
Severe pain alone is not the same as a documented flexion measurement at this degree.; This is the highest flexion-only level under DC 5252; further severity moves into other diagnostic codes.
Related topics
thigh flexion; limited motion
Source context
38 CFR 4.71a; 5252; Current educational Hip guide; deterministic assessment support is not active.
50%
Next: 60%
This level describes moderately severe residual weakness, pain, or limitation of motion following hip replacement.
What separates the next level: The next higher hip replacement level requires markedly severe residuals, while the minimum route and the lower flexion levels use different, less severe findings.
Review CFR criteria, examples, and evidence
Official CFR language
DC 5054 lists moderately severe residual weakness, pain, or limitation of motion following hip replacement at 50 percent.
Qualification explanation
This route depends on a documented hip replacement procedure and residual findings afterward. It should not be assumed from ordinary hip pain without a replacement history.
Examples
A hip replacement was performed and follow-up records describe moderately severe residual pain or weakness.; Residual limitation of motion after hip replacement is documented as moderately severe.
Medical evidence
Operative report for hip replacement; Postoperative follow-up records; Hip and Thigh DBQ replacement section; Range-of-motion measurements after the procedure
Functional impact examples
Substantial ongoing difficulty walking, standing, or bearing weight after hip replacement.; Residual pain or weakness affecting daily tasks well beyond the recovery period.
Common misconceptions
A general hip surgery is not automatically a qualifying hip replacement.; Ordinary post-surgical soreness alone does not establish this pathway; the record needs a moderately severe residual finding.
Related topics
hip replacement; moderately severe residuals
Source context
38 CFR 4.71a; 5054; Current educational Hip guide; deterministic assessment support is not active.
60%
Next: 70%
This level can describe amputation of the middle or lower third of the thigh, favorable hip ankylosis, femur nonunion without loose motion where weight bearing is preserved by a brace, or fracture of the surgical neck of the femur with a false joint.
What separates the next level: Higher levels require upper-third thigh amputation, intermediate hip ankylosis, or femur nonunion with loose motion, rather than this level's findings.
Review CFR criteria, examples, and evidence
Official CFR language
DC 5162 lists amputation of the middle or lower third of the thigh at 60 percent. DC 5250 lists favorable hip ankylosis, in flexion at an angle between 20 and 40 degrees with slight adduction or abduction, at 60 percent. DC 5255 lists femur fracture nonunion without loose motion, where weight bearing is preserved with the aid of a brace, at 60 percent. DC 5255 also lists fracture of the surgical neck of the femur with a false joint at 60 percent.
Qualification explanation
These are four separate routes across three diagnostic codes. An amputation level should not be blended with an ankylosis position or a femur fracture finding unless the record documents that specific route.
Examples
Amputation is documented at the middle or lower third of the thigh.; The hip is ankylosed in flexion between 20 and 40 degrees with slight adduction or abduction.; Femur nonunion is documented without loose motion, and weight bearing is preserved with a brace.; A fracture of the surgical neck of the femur with a false joint is documented in the operative record.
Medical evidence
Operative report for amputation, hip replacement, or femur fracture; Hip and Thigh DBQ ankylosis and amputation sections; Imaging confirming the fixed joint position, nonunion, or false joint; Brace or assistive-device prescription records
Functional impact examples
Substantial difficulty walking, standing, or bearing weight when a mid-thigh or lower-thigh amputation, ankylosis, or femur fracture finding is documented.; Reliance on a prosthesis or brace for weight bearing and mobility.
Common misconceptions
Ankylosis means a fixed joint, not just pain or stiffness, and the specific position distinguishes favorable, intermediate, and unfavorable ankylosis.; A general fracture history is not the same as a documented nonunion or false joint finding.; Amputation level is measured from the perineum, not simply described as an above-the-knee amputation.
38 CFR 4.71a; 5162, 5250, 5255; Current educational Hip guide; deterministic assessment support is not active.
70%
Next: 80%
This level can describe markedly severe residual weakness, pain, or limitation of motion following hip replacement, or intermediate hip ankylosis between the favorable and unfavorable positions.
What separates the next level: The next higher levels require residuals requiring crutches, unfavorable ankylosis, or hip disarticulation, rather than this level's findings.
Review CFR criteria, examples, and evidence
Official CFR language
DC 5054 lists markedly severe residual weakness, pain, or limitation of motion following hip replacement at 70 percent. DC 5250 lists intermediate hip ankylosis at 70 percent.
Qualification explanation
These are two separate routes with different underlying findings. A hip replacement residual finding should not be blended with an ankylosis position finding, and the record needs to identify which route actually applies.
Examples
Markedly severe residual pain or weakness is documented after hip replacement.; The hip is ankylosed in an intermediate position between the favorable and unfavorable ranges.
Medical evidence
Operative report and follow-up records for hip replacement; Hip and Thigh DBQ ankylosis section; Imaging confirming the fixed joint position; Orthopedic specialist notes describing severity
Functional impact examples
Severe difficulty walking, standing, or bearing weight when markedly severe replacement residuals are documented.; Marked limitation when the hip is fixed in an intermediate ankylosis position.
Common misconceptions
Severe pain alone is not automatically markedly severe residuals or ankylosis.; Intermediate ankylosis is a distinct fixed position, not simply a description of moderate pain.
Related topics
markedly severe residuals; intermediate ankylosis
Source context
38 CFR 4.71a; 5054, 5250; Current educational Hip guide; deterministic assessment support is not active.
80%
Next: 90%
This level can describe amputation of the upper third of the thigh, a flail hip joint, or femur fracture of the shaft or anatomical neck with nonunion and loose motion.
What separates the next level: Higher levels require residuals requiring crutches, unfavorable ankylosis, or hip disarticulation under DC 5054, 5250, or 5160, rather than this level's findings.
Review CFR criteria, examples, and evidence
Official CFR language
DC 5161 lists amputation of the upper third of the thigh, one-third of the distance from the perineum to the knee joint measured from the perineum, at 80 percent. DC 5254 lists a flail hip joint at 80 percent. DC 5255 lists femur fracture of the shaft or anatomical neck with nonunion and loose motion (spiral or oblique fracture) at 80 percent.
Qualification explanation
These are three separate routes across different diagnostic codes. An amputation level should not be blended with a flail-joint finding or a femur nonunion finding unless the record documents that specific route.
Examples
Amputation is documented at the upper third of the thigh.; A flail hip joint is documented on examination.; Femur nonunion with loose motion, described as a shortened limb, is documented in the operative or imaging record.
Medical evidence
Operative report for amputation or femur fracture; Hip and Thigh DBQ flail-joint and femur sections; Imaging confirming nonunion, loose motion, or shortening; Orthopedic specialist notes describing severity
Functional impact examples
Severe loss of function and mobility when an upper-third thigh amputation, flail joint, or unstable femur fracture is documented.; Reliance on a prosthesis, brace, or assistive device for weight bearing.
Common misconceptions
Amputation level is measured from the perineum, so upper-third and middle-or-lower-third amputations are not interchangeable.; A flail joint means the joint has lost normal stability, distinct from ordinary ankylosis or limited motion.; Loose motion with shortening is a distinct femur finding from nonunion without loose motion.
Related topics
upper-third thigh amputation; flail joint; femur nonunion with loose motion
Source context
38 CFR 4.71a; 5161, 5254, 5255; Current educational Hip guide; deterministic assessment support is not active.
90%
Next: 100%
This level can describe residual painful motion or weakness following hip replacement that requires the use of crutches, disarticulation at the hip, or extremely unfavorable hip ankylosis where the foot does not reach the ground and crutches are necessitated.
What separates the next level: The next higher level requires the temporary post-procedure period following hip replacement or resurfacing, or trans-pelvic amputation with loss of intrinsic pelvic girdle muscles, rather than this level's findings.
Review CFR criteria, examples, and evidence
Official CFR language
DC 5054 lists residual painful motion or weakness following hip replacement that requires the use of crutches at 90 percent. DC 5160 lists disarticulation at the hip at 90 percent. DC 5250 lists extremely unfavorable ankylosis, with the foot not reaching the ground and crutches necessitated, at 90 percent.
Qualification explanation
These are three separate routes across different diagnostic codes. A crutches-dependent replacement residual finding should not be blended with a disarticulation finding or an ankylosis position finding unless the record documents that specific route.
Examples
Crutches are documented as required due to residual painful motion or weakness after hip replacement.; Disarticulation at the hip is documented in the operative record.; The hip is ankylosed with the foot not reaching the ground, and crutches are necessitated.
Medical evidence
Operative report and follow-up records for hip replacement or disarticulation; Assistive-device or crutches prescription records; Hip and Thigh DBQ ankylosis section; Imaging confirming the fixed joint position
Functional impact examples
Severe reliance on crutches for ambulation.; Substantial loss of independent mobility when disarticulation or extremely unfavorable ankylosis is documented.
Common misconceptions
Using a cane or occasional support is not the same as a documented crutches-dependent finding.; Disarticulation at the hip is distinct from thigh-level amputation under DC 5161 or 5162.; Extremely unfavorable ankylosis requires both the foot-position and crutches findings, not just severe pain.
Related topics
hip replacement residuals requiring crutches; hip disarticulation; extremely unfavorable ankylosis
Source context
38 CFR 4.71a; 5054, 5160, 5250; Current educational Hip guide; deterministic assessment support is not active.
100%
Highest listed pathway
DC 5054 provides a temporary 100% level following hip resurfacing or replacement when timing requirements are met, and DC 5160 lists trans-pelvic amputation with loss of intrinsic pelvic girdle muscles at 100 percent.
What separates the next level: After the temporary post-replacement period, chronic residual severity is evaluated using the crutches-dependent, markedly severe, moderately severe, or minimum-evaluation levels rather than a further step of this temporary or trans-pelvic level.
Review CFR criteria, examples, and evidence
Official CFR language
DC 5054 lists a temporary 100 percent evaluation for 4 months following hip resurfacing or replacement (Note (5); the hip and knee codes, DC 5054 and DC 5055, use this shorter 4-month period, distinct from the 1-year period used by the shoulder, elbow, wrist, and ankle replacement codes, DC 5051-5053 and 5056, under Note (4)). DC 5160 lists trans-pelvic amputation (involving complete removal of the femur and intrinsic pelvic musculature along with any portion of the pelvic bones) under the lower-extremity amputation schedule at 100 percent -- distinct from disarticulation (complete removal of the femur and intrinsic pelvic musculature only), which is rated 90 percent.
Qualification explanation
The procedure type and timing must be explicit for the replacement route, and the amputation level and muscle-loss finding must be explicit for the trans-pelvic route. These are two separate routes with different underlying findings.
Examples
A hip prosthesis or resurfacing procedure was implanted within the 4-month period.; The operative report identifies trans-pelvic amputation with loss of intrinsic pelvic girdle muscles.
Medical evidence
Operative report; Procedure date; Postoperative follow-up records; Hip replacement or amputation residual findings
Functional impact examples
Postoperative recovery occurs during the schedule-defined temporary period after hip replacement or resurfacing.; Complete loss of the limb and pelvic girdle muscle function when trans-pelvic amputation is documented.; Later residual function after hip replacement is evaluated once the temporary period ends.
Common misconceptions
The temporary 100% route is not permanent by default.; A general hip surgery is not automatically prosthetic replacement or resurfacing.; Trans-pelvic amputation is a distinct, more extensive finding than hip disarticulation -- the two are separately rated (100 percent vs. 90 percent), not the same finding under different names.
Related topics
DC 5054; hip prosthesis; resurfacing; temporary post-procedure period; trans-pelvic amputation
Source context
38 CFR 4.71a; 5054, 5160; Current educational Hip guide; deterministic assessment support is not active.
Diagnostic Code 5255 comparison tool
Compare femur malunion evaluation routes
Malunion of the femur (DC 5255) does not have its own percentage table. The schedule instead directs evaluation under whichever hip route (DC 5250-5254) or knee route (DC 5256, 5257, 5260, or 5261) results in the highest evaluation. Enter documented findings for each route below to see them side by side. This is an informational comparison, not a submission. Nothing entered here is saved or sent anywhere.
No documented thigh abduction, adduction, or rotation impairment entered.
Flail hip joint (DC 5254)
–
No documented flail hip joint entered.
Knee ankylosis (DC 5256)
–
No documented knee ankylosis entered.
Knee flexion (DC 5260)
–
No measured knee flexion entered.
Knee extension (DC 5261)
–
No measured knee extension entered.
Knee instability (DC 5257)
–
No documented knee instability route entered.
Enter at least one documented route above to see a comparison. This comparison covers only the DC 5250, 5251, 5252, 5253, 5254, 5256, 5257, 5260, and 5261 routes listed in the DC 5255 malunion instruction; it does not include DC 5255's own nonunion, false joint, or replacement tiers, DC 5160-5162 amputation levels (see the Amputations hub), combined ratings math, or any other disability.
Use these short guides to connect published terms with the records and observations that may clarify them.
Favorable, intermediate, and unfavorable hip ankylosis
DC 5250 separates hip ankylosis into three fixed-position levels rather than a single ankylosis finding.
Favorable ankylosis is fixed in flexion at an angle between 20 and 40 degrees, with slight adduction or abduction.
Intermediate ankylosis falls between the favorable and unfavorable positions.
Extremely unfavorable ankylosis is fixed so that the foot does not reach the ground and crutches are necessitated.
Ankylosis describes a fixed joint position and is distinct from ordinary limited motion, which still moves but not through the full range.
Records to review: Hip and Thigh DBQ ankylosis section; imaging confirming fixed position; orthopedic specialist notes.
Thigh flexion and extension measurements
DC 5251 evaluates limited thigh extension, and DC 5252 evaluates limited thigh flexion, using separate degree thresholds.
Thigh extension limited to 5 degrees is the single level rated under DC 5251.
Thigh flexion limited to 45, 30, 20, or 10 degrees describes four separate severity levels rated under DC 5252.
Flexion and extension are different movements and are not interchangeable measurements.
These limitation-of-motion routes are distinct from the fixed-position ankylosis findings evaluated under DC 5250.
Records to review: Hip and Thigh DBQ range-of-motion section; goniometer measurements; physical therapy range-of-motion notes.
Thigh abduction, adduction, and rotation impairment
DC 5253 evaluates thigh impairment using abduction, adduction, and rotation findings rather than a single flexion or extension measurement.
Abduction motion lost beyond 10 degrees is rated at 20 percent.
Adduction limitation that prevents crossing the legs is rated at 10 percent.
Rotation limitation that prevents toeing out more than 15 degrees is rated at 10 percent.
These are separate functional findings under the same diagnostic code and should not be assumed from a general description of hip stiffness.
Records to review: Hip and Thigh DBQ range-of-motion section; examiner notes describing functional movement tests.
Thigh and hip-level amputation levels
DC 5160-5162 rate hip and thigh amputation by level, measured from the perineum, rather than a single amputation finding.
Trans-pelvic amputation with loss of intrinsic pelvic girdle muscles is rated at 100 percent.
Disarticulation at the hip (complete removal of the femur and intrinsic pelvic musculature only, without the pelvic-bone loss that defines trans-pelvic amputation) is rated at 90 percent.
Amputation of the upper third of the thigh, one-third of the distance from the perineum to the knee joint measured from the perineum, is rated at 80 percent.
Amputation of the middle or lower third of the thigh is rated at 60 percent.
Amputation level and any muscle-loss finding should be documented specifically rather than described only as an above-the-knee amputation.
Records to review: operative report; surgical history; prosthetic fitting records.
Hip replacement or resurfacing (prosthesis) residuals
DC 5054 addresses the temporary period after hip resurfacing or replacement and the residual findings evaluated afterward.
A temporary 100 percent level applies for 4 months following hip resurfacing or replacement when timing requirements are met (Note (5)) -- this is shorter than the 1-year period used by the shoulder, elbow, wrist, and ankle replacement codes (DC 5051-5053, 5056) under Note (4); do not carry the 1-year figure over from those codes.
After that period, residual painful motion or weakness requiring crutches is rated at 90 percent.
Markedly severe residual weakness, pain, or limitation of motion is rated at 70 percent.
Moderately severe residual weakness, pain, or limitation of motion is rated at 50 percent.
A minimum 30 percent evaluation applies after total hip replacement when higher residual criteria are not documented.
A general hip surgery history is not the same as a documented prosthetic replacement or resurfacing procedure.
The Prosthetic Implants and Resurfacing heading's own introductory Note is the textual basis for why a DC 5054 hip replacement rating stands alone rather than combining with a DC 5250-5254 ankylosis or limitation-of-motion finding for the same hip: when an evaluation is assigned under DC 5051-5056 for joint resurfacing or prosthetic replacement, an additional rating under 38 CFR 4.71a may not also be assigned for that same joint, unless otherwise directed.
The 'unless otherwise directed' clause is confirmed, via fresh verbatim fetch, to have no elaboration anywhere in 38 CFR 4.71a -- the word 'directed' appears nowhere else in the section. Who may direct an exception, or where such a direction would appear, is not stated. RatingScope discloses that this escape clause exists rather than guessing at what would satisfy it.
Records to review: operative report; procedure date; postoperative follow-up records.
Flail hip joint and femur fracture nonunion, false joint, or malunion
DC 5254 rates a flail hip joint, and DC 5255 rates several distinct femur fracture findings rather than a single fracture severity level.
A flail hip joint is rated at 80 percent under DC 5254.
Femur fracture of the shaft or anatomical neck with nonunion and loose motion, described as shortening, is rated at 80 percent under DC 5255.
Femur nonunion without loose motion, where weight bearing is preserved with the aid of a brace, is rated at 60 percent under DC 5255.
Fracture of the surgical neck of the femur with a false joint is rated at 60 percent under DC 5255.
Femur malunion does not have its own fixed percentage; it must be evaluated under whichever of the hip or knee criteria yields the highest evaluation, and this hub does not estimate that comparison.
The word 'shortening' in DC 5255's 80 percent tier is a plain-English descriptor of that specific fracture finding, not a separate measured rating. 38 CFR 4.71a DC 5275 (Shortening of the Lower Extremity) is a distinct diagnostic code that independently rates actual measured leg-length discrepancy (measured from the anterior superior iliac spine to the internal malleolus of the tibia) on its own six-tier scale, and its own Note bars combining a DC 5275 rating with other ratings for fracture or faulty union in the same extremity. This hub does not compute a DC 5275 rating; do not conflate DC 5255's descriptive 'shortening' with a separate DC 5275 measurement.
Records to review: imaging confirming nonunion, loose motion, or false joint; operative reports; brace or assistive-device prescription records.
Flare-ups, repeated use, and functional loss
Hip and thigh function can change with repeated use, flare-ups, pain, weakness, fatigability, incoordination, or lack of endurance.
The DBQ may ask how flare-ups affect movement and ordinary tasks.
Repeated-use findings may identify whether motion changes after repetitive testing or over time.
Functional impact can include walking, standing, sitting, dressing, stairs, uneven terrain, and prolonged weight-bearing tasks.
RatingScope uses functional-loss language as educational context and does not infer absent medical findings.
Records to review: DBQ flare-up section; repeated-use testing; treatment notes; lay descriptions of functional impact.
Measurement Guide
How hip and thigh movement is measured
Measurements should come from medical records, examinations, DBQs, or other documented clinical findings. RatingScope does not estimate motion from symptoms.
Thigh flexion
Flexion bends the hip, bringing the thigh up toward the torso.
Normal reference: The DBQ commonly references thigh flexion to 125 degrees.
Why it matters: DC 5252 uses thigh flexion degree thresholds to identify four separate limitation-of-motion levels.
Thigh extension
Extension straightens the hip, moving the thigh backward relative to the torso.
Normal reference: The DBQ commonly references thigh extension to 5 degrees.
Why it matters: DC 5251 uses a limited-extension finding to identify its own diagnostic code and percentage.
Thigh abduction and adduction
Abduction moves the leg away from the midline of the body, and adduction moves the leg toward and across the midline.
Normal reference: The DBQ records abduction and adduction findings, including whether the veteran can cross the legs.
Why it matters: DC 5253 uses abduction motion lost beyond 10 degrees, and adduction limitation that prevents crossing the legs, as separate rated findings.
Thigh rotation (toe-out)
Rotation turns the leg outward or inward at the hip, commonly measured by how far the toes point outward.
Normal reference: The DBQ records whether the veteran can toe out the affected leg more than 15 degrees.
Why it matters: DC 5253 uses rotation limitation that prevents toeing out more than 15 degrees as a separate rated finding.
How an examination adds context
Active and passive motion
Records may distinguish motion the veteran performs from motion the examiner moves through passively.
Repeated-use testing
The DBQ may ask whether repeated use causes additional loss of function or range of motion.
Flare-ups
Flare-up descriptions help explain whether function changes during worse episodes, but they should not be converted into measurements unless documented.
Painful motion
Pain can matter when it affects documented function or motion. RatingScope does not treat pain as a stand-alone rating calculation.
Assistive devices
Crutches, braces, canes, or prosthetic devices may be documented and can help distinguish some hip replacement or ankylosis findings from lower-severity levels.
A DBQ is useful context, but RatingScope does not require uploads and this hub does not accept records.
Diagnosis and treatment records
Treatment notes can show the current condition, course over time, therapy, medication, brace use, surgery, and clinician observations.
A diagnosis alone does not identify which percentage pathway applies.
X-rays, MRI, CT, or operative imaging
Imaging may help document a fixed ankylosis position, femur nonunion or false joint, replacement or resurfacing hardware, or other structural findings.
Imaging severity should not be substituted for a route-specific CFR finding.
Range-of-motion measurements
Thigh flexion, extension, abduction, adduction, and rotation measurements help clarify which limitation-of-motion pathway is being discussed.
RatingScope does not estimate degrees from words such as stiff, sore, or limited.
Surgery, replacement, or amputation records
Operative and orthopedic records can clarify hip replacement or resurfacing procedure timing, amputation level, and residual findings afterward.
A general surgery history is not the same as a qualifying prosthetic replacement, resurfacing, or specific amputation level.
Personal and firsthand lay evidence
Plain descriptions can explain walking, standing, sitting, dressing, stairs, uneven terrain, and flare-up impact.
Lay evidence can describe observed impact, but it should not invent medical measurements or diagnoses.
Functional-loss descriptions
Records describing pain, weakness, fatigability, incoordination, lack of endurance, flare-ups, or repeated-use limits help connect symptoms to function.
Functional loss is context; it does not let RatingScope infer absent CFR findings.
Official VA Forms & DBQs
Downloadable DBQs & Supporting Claim Forms
Take the public DBQ to your private physician or review it prior to your C&P examination.
Terminology
Plain-English terms
Thigh flexion
How far the thigh bends up toward the body at the hip.
DC 5252 uses thigh flexion degree thresholds to identify four separate limitation-of-motion levels.
The hip is fixed in a position, not just painful or stiff.
DC 5250 uses favorable, intermediate, and extremely unfavorable hip ankylosis levels based on the fixed flexion position, adduction or abduction, and whether the foot reaches the ground.
A broken thigh bone that has not healed properly, sometimes moving like an extra joint where it should be solid.
DC 5255 rates femur fracture with nonunion and loose motion at 80 percent, nonunion without loose motion where weight bearing is preserved by a brace at 60 percent, and fracture of the surgical neck of the femur with a false joint at 60 percent.
imaging confirming nonunion or false joint; operative report; brace prescription records
A broken thigh bone that healed crooked rather than in its normal alignment.
Femur malunion must be evaluated under whichever of the hip or knee criteria yields the highest evaluation, rather than under a fixed percentage of its own within this hub.
Surgery that replaces or resurfaces the hip joint with a prosthesis.
DC 5054 provides a temporary 100 percent level after implantation, a minimum 30 percent evaluation, moderately severe and markedly severe residual levels, and a crutches-dependent residual level.
How high up the leg an amputation occurred, measured from a fixed anatomical reference point.
DC 5160-5162 rate trans-pelvic amputation (100 percent), hip disarticulation (90 percent), upper-third thigh amputation (80 percent), and middle-or-lower-third thigh amputation (60 percent) as separate levels.
Even if the schedular rating for Hip does not reach 100 percent, TDIU may still provide a pathway to compensation at the 100 percent rate, based on unemployability from this and/or other service-connected disabilities combined.
A lower schedular percentage does not by itself foreclose TDIU eligibility -- this hub computes only the schedular percentage for this specific condition and does not determine TDIU eligibility.
Why does hip ankylosis have three different levels?
DC 5250 separates hip ankylosis by the fixed position: favorable in flexion between 20 and 40 degrees with slight adduction or abduction, intermediate between the favorable and unfavorable positions, and extremely unfavorable with the foot not reaching the ground and crutches necessitated. These are different fixed positions, not interchangeable descriptions of the same finding.
What is the difference between thigh flexion, extension, abduction, adduction, and rotation?
Flexion bends the hip bringing the thigh up, extension straightens it, abduction moves the leg away from the body, adduction moves the leg across the body, and rotation turns the leg outward or inward. DC 5251 and DC 5252 rate flexion and extension, while DC 5253 rates abduction, adduction, and rotation findings.
What happens after hip replacement or resurfacing surgery?
DC 5054 provides a temporary 100 percent level for 4 months following hip resurfacing or replacement (Note (5)) -- shorter than the 1-year period used by the shoulder, elbow, wrist, and ankle replacement codes. Afterward, residuals requiring crutches are rated at 90 percent, markedly severe residuals at 70 percent, moderately severe residuals at 50 percent, and a minimum 30 percent evaluation applies when higher residual criteria are not documented.
Can I receive a separate ankylosis or limited-motion rating in addition to a hip replacement rating for the same hip?
No. 38 CFR 4.71a's Prosthetic Implants and Resurfacing heading states that when an evaluation is assigned under DC 5051-5056 for joint resurfacing or prosthetic replacement, an additional rating under 4.71a may not also be assigned for that same joint, unless otherwise directed. This is why a DC 5054 hip replacement rating stands on its own and is not combined with a separate DC 5250-5254 ankylosis or limitation-of-motion rating for the same hip.
How are hip and thigh amputation levels rated?
DC 5160-5162 rate amputation by level measured from the perineum toward the knee joint: trans-pelvic amputation with loss of intrinsic pelvic girdle muscles at 100 percent, disarticulation at the hip at 90 percent, upper-third thigh amputation at 80 percent, and middle-or-lower-third thigh amputation at 60 percent.
What is a flail hip joint?
A flail hip joint means the joint has lost normal stability and moves abnormally rather than being fixed in position. DC 5254 rates a flail hip joint at 80 percent.
What is femur malunion, and how is it rated?
Femur malunion is a fractured femur that healed in a misaligned position. It does not have its own fixed percentage under DC 5255; it must be evaluated under whichever of the hip (DC 5250-5254) or knee (DC 5256, 5257, 5260, or 5261) criteria yields the highest evaluation. This hub does not estimate that comparison and flags it as a review route; the hip/knee malunion comparison tool on this page lets you enter documented findings for each route and see them side by side, with the highest result identified.
Where can I find hip and thigh-level amputation figures?
Hip and thigh-level amputation under DC 5160-5162 is rated in the separate Amputations hub, which already owns those figures: trans-pelvic amputation (100 percent) or disarticulation (90 percent), upper-third thigh amputation (80 percent), and middle-or-lower-third thigh amputation (60 percent). This hub links to that hub rather than duplicating those rows.
Does pain automatically increase a hip percentage?
Pain matters when it affects documented motion or function, but pain by itself does not identify a route. The record still needs the specific finding the schedule asks about.
Does dominant or nondominant side matter for hip conditions?
No. Unlike several upper-extremity guides, the hip and thigh schedule does not use different percentages for a dominant versus nondominant side, and this hub does not calculate the VA bilateral factor.
Is this an active RatingScope assessment?
No. This Hip hub is educational only. Do not enter hip findings into another condition's assessment.
If my schedular rating for Hip is below 100%, can I still be compensated at the 100% rate?
Possibly, through TDIU (Total Disability rating based on Individual Unemployability, 38 CFR 4.16) -- a separate pathway to 100 percent compensation based on unemployability, from this and/or other service-connected disabilities combined, independent of whether the schedular rating itself reaches 100 percent. This hub computes only the schedular percentage and does not determine TDIU eligibility.
What separates the 10% rating from adjacent levels?
Higher levels move into more limited thigh flexion or abduction motion lost beyond 10 degrees, rather than a further degree of extension, adduction, or rotation limitation described at this level.
What separates the 20% rating from adjacent levels?
Higher levels move into more limited thigh flexion or the minimum route after total hip replacement, rather than a further degree of abduction loss.
What separates the 30% rating from adjacent levels?
Higher levels require thigh flexion limited to 10 degrees, or moderately severe residuals following hip replacement, rather than this level's findings.
What separates the 40% rating from adjacent levels?
Higher levels move into moderately severe hip replacement residuals or favorable hip ankylosis, rather than a further degree of limited flexion under DC 5252.
What separates the 50% rating from adjacent levels?
The next higher hip replacement level requires markedly severe residuals, while the minimum route and the lower flexion levels use different, less severe findings.
What separates the 60% rating from adjacent levels?
Higher levels require upper-third thigh amputation, intermediate hip ankylosis, or femur nonunion with loose motion, rather than this level's findings.
What separates the 70% rating from adjacent levels?
The next higher levels require residuals requiring crutches, unfavorable ankylosis, or hip disarticulation, rather than this level's findings.
What separates the 80% rating from adjacent levels?
Higher levels require residuals requiring crutches, unfavorable ankylosis, or hip disarticulation under DC 5054, 5250, or 5160, rather than this level's findings.
What separates the 90% rating from adjacent levels?
The next higher level requires the temporary post-procedure period following hip replacement or resurfacing, or trans-pelvic amputation with loss of intrinsic pelvic girdle muscles, rather than this level's findings.
What separates the 100% rating from adjacent levels?
After the temporary post-replacement period, chronic residual severity is evaluated using the crutches-dependent, markedly severe, moderately severe, or minimum-evaluation levels rather than a further step of this temporary or trans-pelvic level.
For hip and thigh-level amputation findings, see the Amputations hub, which already owns DC 5160-5162's figures: trans-pelvic amputation (100 percent) or disarticulation (90 percent), upper-third thigh amputation (80 percent), and middle-or-lower-third thigh amputation (60 percent). This hub does not recreate those rows.
If more than one condition is involved, combined-rating math is educational context and does not simply add percentages.
Ready when you are
Compare documented hip and thigh findings
Use diagnosis, ankylosis position, range-of-motion measurements, and replacement or femur-fracture history already documented in your records. Do not upload records or enter Social Security numbers, claim numbers, full dates of birth, or other sensitive identifiers. RatingScope does not infer missing medical findings or predict a VA decision.
Informational guidance only. RatingScope does not predict, decide, or guarantee VA outcomes.
38 CFR 4.16 - Total disability ratings for compensation based on unemployability (TDIU)
Official source for TDIU, a separate pathway to 100 percent compensation based on unemployability, independent of the schedular percentage. This hub does not determine TDIU eligibility.