The Hip and Thigh

Topics:

Loss of Use/Amputation of the Hip
Hip Replacement
Hip and Thigh Limitation of Motion
Too Much Motion or Dislocation
Hip and Thigh Bones
Pelvic Bones
Shortening of the Leg
Other Hip and Thigh Conditions
DBQ for Hip and Thigh Conditions
Principles that Apply

Reminder: The VA will give a Military Disability Rating for each service-connected condition a service member has, but the DoD will only rate service-connected conditions that make a service member Unfit for Duty.

 


Loss of Use/Amputation of the Hip

Code 5250: If the hip joint is frozen in place and cannot move at all, then it is rated depending on where it is frozen. If it is frozen so that the foot cannot reach the ground and crutches must be used, then it is rated 90%. If the hip is frozen at more than 40°, but the foot can reach the ground and crutches are not required, it is rated 70%. If it is frozen in a “favorable” position in flexion between 20° and 40° with only a small amount of adduction or abduction, it is rated 60%. “Favorable” means that if the hip is frozen, this is the best position it can be frozen in since it can still be used to support weight, etc. This is why it receives a lower rating.

adduction of the hip                                abduction of the hip                                  flexion of the hip

Code 5160: If the entire leg is amputated from the hip down, it is rated 90%.

Code 5161: If it is amputated below the hip, then it is rated 80%.

Code 5162: If it is amputated just above the knee, it is rated 60%.

Code 5163: If the leg has been amputated below the knee, but the stump is defective and another amputation is needed above the knee, it is rated 60%. (This code is rarely used.)

Code 5164: If it is amputated at the knee or below, but the knee cannot function normally, it is rated 60%.

Your condition may also qualify for additional compensation by the VA. Please see the Special Monthly Compensation page for more information.

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Hip Replacement

Code 5054: If either the entire head of the femur or entire head of the acetabulum has been replaced by a false joint prosthesis, then the condition is rated 100% for the first year after the surgery. (This period is mainly for the VA, but the DoD will also use it if the veteran is placed on TDRL before being permanently separated). After the 1-year period, the condition is given a permanent rating. If there is weakness and severe pain with motion that requires the use of crutches, then it is rated 90%. If there is weakness and severe pain, but it does not require crutches, then it is rated 70%. If the pain is not severe, but does limit the range of motion, then it is rated 50%. The minimum rating for a hip replacement is 30%.

If your condition rates 90% under this code, you may also qualify for additional compensation by the VA. Please see the Special Monthly Compensation page for more information.

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Hip and Thigh Limitation of Motion

Code 5251: If the hip is not frozen, but limited in extension and cannot move the leg backward more than 5°, then it is rated 10%.

extension of the hip

Code 5252: If the hip is limited in how far forward (flexion) it can move the leg, then it is rated under this code. If it cannot move the leg more than 10°, it is rated 40%. If it cannot raise the leg more than 20°, it is rated 30%. No more than 30° is rated 20%, and no more than 45° is rated 10%.

flexion of the hip

Code 5253: All other limitations of hip motion are rated under this code. If the hip cannot swing the leg out to the side (abduction) more than 10°, it is rated 20%. If it cannot move the leg inward across the other leg (adduction), it is rated 10%. If it cannot rotate the leg outward (toes point off to the sides) more than 15°, then it is rated 10%.

abduction of the hip                                    adduction of the hip                               outward rotation of the hip and thigh

All three of these codes for limited hip motion CAN be used together. So if the hip is limited in flexion, extension and abduction, then it can be rated three times, once under code 5251, once under code 5252, and once under code 5253. Each code can only be used once, however, so if the hip is limited in abduction and adduction, both are rated under the same code (5253) and so two ratings cannot be given.

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Too Much Motion or Dislocation

Code 5254: If the hip moves significantly too far in any direction and thus is unstable or can be easily dislocated, it is rated 80%.

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Hip and Thigh Bones

the femural bones

Code 5255: Any problems with the femur or femoral neck bones are rated under this code. If either is completely broken through and it causes loose or erratic leg motion, then it is rated 80%. If it is broken through but the leg motion is not loose and the leg can support weight with the help of a brace, then it is rated 60%. If it is fractured and has a false joint, it is rated 60%.

All other femur bone conditions are rated by how they affect the hip or knee joint. If they cause serious problems (can barely use the joint at all), then it is a 30% rating. If the joints can be used, but the condition significantly limits the amount of activity, then it is rated 20%. If the hip or knee joint is affected only slightly, then it is rated 10%.

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Pelvic Bones

the pelvic bones

Any condition of the pelvic bones is rated only on its symptoms. If the condition affects the movement and functioning of the hips, then it is rated on that limited functioning. For example, if the condition causes the hip to not be able to move the leg forward, then it is rated based on limited motion of forward flexion, code 5252. Similarly, if the condition affects the motion of the spine, then it is rated as lumbosacral strain, code 5237. If the pelvic bones are affected by a disease, like osteoporosis (code 5013), the condition is rated under that disease.

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Shortening of the Leg

Code 5275: If the bones in the leg have been shortened, then it is rated under this code. The shortening of the femur can occur because of trauma or surgery. This code and any other codes for the bones of the leg CANNOT be used together. Only one or the other. If the leg is more than 4 inches shorter, it is rated 60%. If it is 3.5 to 4 inches shorter, it is rated 50%. If it is 3 to 3.5 inches shorter, it is rated 40%. If it is 2.5 to 3 inches shorter, it is rated 30%. 2 to 2.5 inches is 20%, and 1.25 to 2 inches shorter is 10%.

If your leg has been shortened 3 ½ inches or more, you may also qualify for additional compensation by the VA. Please see the Special Monthly Compensation page for more information.

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Other Hip and Thigh Conditions

Diseases that affect the hip and thigh can be found on the Diseases of the Musculoskeletal System page and cancer in the hip and thigh can be found on the Cancer and Tumors of the Musculoskeletal System page. All other hip and thigh injuries or conditions will be rated analogously (see the Analogous and Equivalent Codes page) with the above ratings. The bottom line rule is to rate any condition under the code that BEST describes it, even if it is not exact.

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DBQ for Hip and Thigh Conditions

Here is the Disability Benefits Questionnaire (DBQ) used for hip and thigh conditions: Hip and Thigh DBQ.

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Principles that Apply

The Amputation Rule: Any ratings for the hip and leg cannot be combined to be more than 90% for the entire leg including the pelvic girdle, 80% for mid-thigh, 60% for low-thigh/knee (the knee is not able to function), and 40% for below the knee (knee is able to function).

Painful Motion: If pain is present with motion, then the minimum rating must be given.

The Joints: When rating arthritis, the hip is considered a major joint.

Special Monthly Compensation: If your condition makes it impossible to balance on or push off with your foot, you may qualify for the VA’s Special Monthly Compensation. You may also qualify if your leg has been amputated or if you are unable to rise to your feet without using your arms or other assistance.

Pyramiding: A single condition can only be rated once! However, if a nerve condition exists that is additional to the hip or thigh condition (not simply caused by it), then it can also be rated.

Probative Value: If two exams record the condition differently, the exam with the most thorough data and performed by the most qualified person in that specialty will be the exam the rating is based on.

A Tie Goes to the Veteran: If there are two equally strong exams with conflicting information, or if the condition can be equally rated under two different codes, then the one that gives the highest rating will be assigned. Every conflict should be resolved in favor of the higher rating.

Accurate Measurements: It is essential that the necessary information to rate your condition is recorded by the physician in your exam. All ranges of motion should be measured with a goniometer. With the information on this page, you should know what needs to be measured and recorded. Make sure this happens correctly to ensure that you receive a proper rating.

Hospital or Convalescent Ratings: Some conditions require periods of hospitalization or constant medical care (at-home nurse, etc.). Any condition that requires this is rated 100% during this intensive treatment. Once it ends, then the 100% rating will continue for a certain period. This period is 3 months unless another length (6 months, 1 year, etc.) is directly specified in the condition ratings. Some patients may need more time to recover than others, so the physician or Rating Authorities can lengthen this time period if they see fit.

Please see the Musculoskeletal Principles and the VASRD Principles pages for further guidance.

For muscle conditions, see The Buttock, Hip, and Thigh Muscles page.

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