VA Hip Range of Motion Ratings: DC 5251, 5252, and 5253

Thigh extension refers to moving the thigh backward behind the anatomical plane of the body. Normal hip extension reaches 20 degrees. Under Diagnostic Code 5251, if extension is limited to 5 degrees or less, a 10% disability rating is assigned. If extension is limited but exceeds 5 degrees, the measurement does not meet the compensable threshold under DC 5251 alone, though documented painful motion may qualify for DC 5251's 10% minimum compensable evaluation under 38 CFR 4.59.

Thigh flexion is the forward bending movement of the hip toward the chest. Normal hip flexion reaches 125 degrees. Under Diagnostic Code 5252, the rating schedule establishes four distinct percentage tiers based on measured forward motion: flexion limited to 45 degrees receives 10%, flexion limited to 30 degrees receives 20%, flexion limited to 20 degrees receives 30%, and flexion limited to 10 degrees receives 40%. The 40% tier represents the highest evaluation available for pure flexion restriction.

Diagnostic Code 5253 rates thigh impairment across three specific functional movement barriers. Unlike some other joints, DC 5253 does not use broad subjective tiers and contains no 30% evaluation. The schedule provides: 20% when abduction motion is lost beyond 10 degrees; 10% when adduction is limited so the veteran cannot cross legs; and 10% when rotation is limited so the affected leg cannot toe-out more than 15 degrees. Each criterion represents an objective physical milestone affecting daily posture, sitting, and ambulation.

Under 38 CFR 4.14, pyramiding prohibits evaluating the same disability or manifestation more than once. However, for the hip joint, separate evaluations may be assigned under DC 5251 (extension) and DC 5252 (flexion), or under DC 5253 (thigh impairment), provided each plane exhibits independent, documented functional loss. Because extension, flexion, and rotation are anatomically distinct motions, VA allows separate evaluations when the medical record establishes that distinct planes of motion meet published criteria without overlapping symptoms.

When hip range of motion does not reach the restricted degree thresholds of DC 5251, 5252, or 5253, veterans may still qualify for a compensable evaluation. 38 CFR 4.59 recognizes actually painful, unstable, or malaligned joints as entitled to at least the minimum compensable evaluation for the joint, where applicable. For the hip joint, where 10% is the lowest compensable rating under DC 5251, DC 5252, or DC 5253, establishing painful motion during active or passive testing warrants a 10% evaluation. Furthermore, under 38 CFR 4.40 and 4.45, functional loss due to weakness, fatigue, incoordination, or flare-ups must be evaluated to reflect real-world capacity.