The Ankle

Topics:

Ankle Joint
Ankle Replacement
Tarsal Joint
Talus and Heel Bones
Other Ankle Conditions
DBQ for Ankle 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.

The ankle is made up of two main bones, the talus and the calcaneus (heel), and two joints, the ankle joint and the tarsal joint.

The ankel joint

The VASRD often uses terms like “marked” and “moderate” when describing a disability. Unfortunately, the exact definition of these terms is up to interpretation by the Rating Authorities. It is impossible for us to say exactly what a “marked” disability is. The basic idea to keep in mind is that a marked condition is one that seriously limits the ability of the affected body part to function, a mild condition hardly limits the ability of the body part to function at all, and a moderate condition is somewhere in between. The ankel joint

To give you an idea, a markedly limited dorsiflexion of the ankle could be defined as between 0° and 10°, and a moderately limited dorsiflexion between 10° and 15°. Likewise, a markedly limited plantar flexion could be between 0° and 20°, and a moderately limited plantar flexion between 20° and 35°.

Remember: We can't guarantee that your Rating Authorities will define these terms the way we do, but the basic idea is how much the overall ability of the body part to function is affected by the condition.

 


Ankle Joint

Code 5270: If the ankle joint is frozen in place and cannot be moved, then it is rated depending on where it is frozen. If it is frozen in plantar flexion more than 40°, in dorsiflexion more than 10°, or in abduction, adduction, inversion or eversion, then it is rated 40%. If it is frozen in plantar flexion between 30° and 40° or in dorsiflexion between 0° and 10°, then it is rated 30%. A 20% rating is given if the ankle is frozen in plantar flexion less than 30°.

Flexion of the ankle          abduction and adduction of the ankle          Inversion and eversion of the ankle

Code 5271: If the ankle is not frozen, but limited in motion, then it is rated under this code. Normal range of motion for the ankle is 0° to 20° dorsiflexion and 0° to 45° plantar flexion. A 20% rating is given for a markedly limited range of motion and a 10% is given for a moderately limited range of motion.

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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Ankle Replacement

Code 5056: If the entire ankle joint has been replaced by a false joint prosthesis, then the condition is rated 100% for the first year after the surgery. This 1-year period begins after the one month allowed under principle §4.30 after being discharged from the hospital (this principle is mainly for the VA, but the DoD may also abide by this principle 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, then it is rated 40%. If the pain is not severe, but does limit the range of motion, then it is rated under the codes 5270 or 5271 discussed above. The minimum rating for a total ankle replacement, however, is 20% regardless of how much motion it has.

Note: This code is only for total ankle replacements. Partial replacements are rated on any symptoms that they cause, like limited motion.

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Tarsal Joint

Code 5272: The tarsal joint is only rated if it is frozen in place. If it is frozen in a “good” weight-bearing position, it is rated 10%. A good weight-bearing position would be one that allowed the foot to lie normally on the ground. Walking would still be fairly easy.

If it is frozen in a “poor” weight-bearing position, it is rated 20%. A poor position would be one that made it difficult for the foot to take weight, like inversion or eversion. Walking would be difficult.

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Talus and Heel Bones

Code 5273: If either of these bones are broken and do not heal properly or have any other kind of deformity, they are rated under this code. If the resulting foot deformity is moderate, then it is rated 10%. If, however, the resulting deformity is marked, then it is rated 20%.

Code 5274: If the talus bone is surgically removed to stabilize the ankle, it is rated 20%.

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Other Ankle Conditions

Diseases that affect the ankle can be found on the Diseases of the Musculoskeletal System page and cancer in the ankle can be found on the Cancer and Tumors of the Musculoskeletal System page. All other ankle injuries or conditions will either be rated analogously (see the Analogous and Equivalent Codes page) with the above ratings or on the condition itself. The bottom line rule is to rate any condition under the code that BEST describes it, even if it is not exact. So, if you have synovitis that affects the ankle, it is rated under code 5020 for synovitis.

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DBQ for Ankle Conditions

Here is the Disability Benefits Questionnaire (DBQ) used for ankle conditions: Ankle DBQ.

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Principles that Apply

The Amputation Rule: Any ratings for the ankle and foot cannot be combined to be more than 40%.

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

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 foot has been amputated.

The Joints: When rating arthritis, the ankle is considered a major joint, while the tarsal is considered a minor joint.

Pyramiding: A single condition can only be rated once! However, if a nerve condition exists that is additional to the ankle 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 range of motions 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.

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

For muscle conditions, see The Foot and Leg Muscles page.

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