An ACL tear does not get its own diagnostic code on the VA rating schedule. Instead, the VA rates the functional damage it leaves behind, most often instability under Diagnostic Code (DC) 5257, and often stacks that with separate ratings for meniscus damage, limited range of motion, or arthritis if the injury also produced those problems. A veteran with a torn or reconstructed ACL commonly lands at 10% to 30% for instability alone, and can reach 40% or higher once every ratable piece of the injury is combined correctly.
This guide breaks down exactly how the VA evaluates ACL tears and ACL reconstructions, what evidence moves you from a 10% to a 30% instability rating, and how to stack multiple codes on one knee without running into the pyramiding rule. For flexion and extension rating tables in more depth, see our general VA knee disability rating guide.
Why the ACL Doesn't Have Its Own Diagnostic Code
The VA Schedule for Rating Disabilities (VASRD), found at 38 CFR 4.71a, rates the knee by functional impairment, not by the specific ligament or structure that failed. A torn anterior cruciate ligament produces knee instability, which the VA captures under DC 5257, "recurrent subluxation or lateral instability." If your ACL tear also damaged your meniscus, or left you with reduced flexion or extension after surgery, those get their own separate codes.
This matters for your claim strategy. Your C&P examiner and your VA rater are not looking for the words "ACL tear" in your file. They are looking for documented instability, locking, effusion (swelling), and measured range of motion. Make sure your medical evidence describes the functional symptoms in those terms, not just the diagnosis.
DC 5257: Instability from ACL Laxity
DC 5257 is the primary code used for ACL-related knee problems, whether or not you had surgery. It rates the knee based on how much it buckles, gives way, or partially dislocates (subluxates) during normal activity.
| Rating | Severity | Typical Evidence |
|---|
| 10% | Slight instability | Occasional giving way, mild laxity on Lachman or anterior drawer test |
| 20% | Moderate instability | Regular episodes of buckling, moderate laxity, may require a hinged knee brace |
| 30% | Severe instability | Frequent giving way with falls, gross laxity on exam, reliance on a brace and/or assistive device |
To reach the higher end of this range, your record needs specifics. A note that says "patient reports occasional knee pain" supports 10% at best. A note documenting three buckling episodes in the last six months, a positive Lachman test with 2+ laxity, and a prescribed hinged brace supports 20% to 30%. Keep a symptom log with dates and circumstances (stairs, uneven ground, pivoting) and bring it to your C&P exam.
What If You Had ACL Reconstruction Surgery?
A successful ACL reconstruction does not eliminate your entitlement to a rating. Many veterans assume that once surgery "fixes" the ligament, there is nothing left to rate. In practice, most reconstructed knees have residual symptoms that remain ratable years after surgery, including:
- Residual instability. Grafts (patellar tendon, hamstring, or allograft) can stretch or fail over time, and even a well-healed graft rarely restores 100% of native ligament stability.
- Limited range of motion. Scar tissue and post-surgical stiffness can permanently limit flexion or extension, rated under DC 5260 and DC 5261.
- Post-traumatic arthritis. ACL injuries frequently accelerate arthritis in the joint, ratable under DC 5010 (traumatic arthritis) when X-rays confirm degenerative changes.
- Painful or unstable scarring. A surgical scar that is painful or unstable can be separately rated under the scar diagnostic codes.
If you had ACL reconstruction and were rated only for the surgery itself without a follow-up evaluation for these residuals, you may be under-rated. File a claim for each residual symptom separately, supported by imaging and exam findings.
Meniscus Damage Alongside ACL Tears
ACL tears frequently occur alongside meniscus tears, since both structures absorb the same twisting force. If your meniscus was also damaged, you may qualify for an additional rating under a separate code from your instability rating.
| Diagnostic Code | Condition | Rating |
|---|
| DC 5258 | Dislocated (torn) meniscus with frequent locking, pain, and effusion | 20% |
| DC 5259 | Symptomatic removal of meniscus (after partial or full meniscectomy) | 10% |
Because DC 5257 (instability) and DC 5258/5259 (meniscus) rate different anatomical problems, they can typically be combined without violating the pyramiding rule under 38 CFR 4.14, as long as the symptoms being rated are distinct. Your instability rating should reflect ligament laxity and buckling. Your meniscus rating should reflect locking, catching, and effusion. If your VA rater denies a combined rating by claiming pyramiding, request clarification on which symptoms overlap and appeal if the denial does not hold up.
Stacking Ratings for One ACL-Injured Knee
A single knee can carry multiple separate ratings when the underlying conditions are distinct. A common combination for a service-connected ACL tear looks like this:
Example: Post-reconstruction ACL with meniscus tear and limited flexion
- DC 5257 (moderate instability): 20%
- DC 5258 (meniscus with locking and effusion): 20%
- DC 5260 (flexion limited to 30 degrees): 20%
- VA combined rating: approximately 49%, rounded to 50%
The VA does not add these percentages directly. It uses the combined ratings table, applying each additional rating to the portion of function not already accounted for by the prior rating. Three 20% ratings on paper do not equal 60%, they land closer to 49-50% once combined correctly. Use the VA's official combined ratings table or an online combined rating calculator to check the math on your own award letter.
Extension loss (DC 5261) can also be added to this stack if your knee cannot fully straighten after surgery, and if your other leg or hip has developed a secondary condition from compensating for the ACL knee, that adds further to your combined rating.
Building the Medical Evidence for Your ACL Claim
Three things move an ACL-related VA claim forward: a current diagnosis, an in-service event, and a medical nexus connecting the two.
- Current diagnosis. MRI or arthroscopy report confirming the ACL tear, meniscus involvement if present, and any post-surgical imaging showing hardware, graft status, or arthritic changes.
- In-service event. Documentation of the injury during service (a sick call visit, a physical therapy referral, a line-of-duty investigation) or evidence of repetitive strain from your military occupational specialty (infantry, airborne, combat arms roles with heavy load-bearing and jumping).
- Nexus opinion. A statement from a physician, ideally one familiar with VA claims, explicitly linking your current ACL-related symptoms to the documented in-service event or to a service-connected condition that caused it secondarily.
If your ACL tear happened after service but was caused by a service-connected condition, such as a service-connected ankle or hip problem that altered your gait and overloaded your knee, you can pursue secondary service connection instead of direct connection.
What to Expect at the C&P Exam
The Compensation and Pension exam is where the rating gets built. For ACL-specific claims, the examiner should perform:
- Lachman test and anterior drawer test to assess ACL laxity directly. Make sure the results, including the degree of laxity (1+, 2+, 3+), are recorded in your exam notes.
- Range of motion measurement with a goniometer for both flexion and extension, including after repetitive use under the DeLuca factors.
- Assessment of locking, catching, or effusion if meniscus involvement is suspected.
- Review of any brace, cane, or assistive device you use and why.
Describe your worst days, not just how your knee performs on the day of the exam. If your knee buckles more after a full workday of standing, on stairs, or during physical activity, say so explicitly. A brief statement submitted alongside your exam, or a buddy statement from someone who has witnessed a buckling episode, strengthens the record.
2026 VA Compensation Rates
These monthly rates are effective December 1, 2025, following a 2.8% cost-of-living adjustment. Payments are tax-free.
| Disability Rating | Monthly Payment (No Dependents) |
|---|
| 10% | $180.42 |
| 20% | $356.66 |
| 30% | $552.47 |
| 40% | $795.84 |
| 50% | $1,132.90 |
| 60% | $1,435.02 |
| 70% | $1,808.45 |
Veterans rated at 30% or higher receive additional monthly amounts for a spouse, children, or dependent parents.
If Your ACL Rating Feels Too Low
Veterans with ACL injuries are commonly under-rated because their claim only lists "knee condition" without breaking out instability, meniscus damage, and range-of-motion loss as separate issues. If your rating decision does not reflect the full scope of your injury, you have three paths:
Supplemental Claim. Submit new and relevant evidence, such as updated imaging, a private nexus opinion, or a fresh C&P exam showing worsened laxity or locking, that was not part of the original decision.
Higher-Level Review. Ask a senior adjudicator to review the existing evidence for an error, such as a missed separate rating for meniscus damage that should have been combined with your instability rating.
Board of Veterans Appeals. If a Supplemental Claim or Higher-Level Review does not resolve the issue, appeal to the Board for review by a Veterans Law Judge. This route takes longer but allows for a full re-examination of the case.
A private orthopedic opinion that specifically addresses ACL laxity, meniscus status, and range of motion, and ties each finding to the VASRD rating criteria, is often the difference between a partial rating and a fully accurate one.
Using Benefits Navigator to Check Additional Eligibility
Many veterans with a service-connected ACL injury also qualify for other federal and state benefits programs. The free Benefits Navigator screener checks eligibility for SNAP, Medicaid, LIHEAP, and other programs based on your income and household size, in addition to VA benefits. Veterans rated 100% or with TDIU often qualify for state-level property tax exemptions, vehicle registration discounts, and other benefits that vary by state.
Frequently Asked Questions
What VA diagnostic code covers an ACL tear?
There is no single diagnostic code labeled "ACL tear." The VA rates the functional impairment the tear causes, most commonly instability under DC 5257. If the injury also caused meniscus damage or limited range of motion, those get separate diagnostic codes (DC 5258/5259 for meniscus, DC 5260/5261 for flexion and extension).
Can I get a VA rating after successful ACL reconstruction surgery?
Yes. A successful surgery does not remove your entitlement to a rating if you have residual instability, limited range of motion, arthritis, or a painful surgical scar. Most reconstructed knees retain some ratable residual symptoms, and you should be evaluated specifically for these rather than assuming the surgery closed the claim.
What is the highest rating for ACL-related instability alone?
Under DC 5257, the highest single rating for instability is 30%, reserved for severe instability with frequent giving way, gross laxity on exam, and typically reliance on a brace or assistive device. Higher combined ratings come from stacking DC 5257 with meniscus, flexion, extension, or arthritis codes for the same knee.
Can I get separate ratings for ACL instability and a torn meniscus in the same knee?
Yes, in most cases. DC 5257 (instability) and DC 5258 or 5259 (meniscus) rate distinct symptoms, ligament laxity versus locking and catching, and can typically be combined without violating the VA's pyramiding rule, as long as the evidence clearly distinguishes the two sets of symptoms.
Does the VA rate ACL injuries higher if I need a knee brace?
A prescribed brace or assistive device is strong evidence supporting a higher instability rating under DC 5257, since it documents that your medical provider determined the knee needs external support. It is evidence, not an automatic rating bump, so make sure the reason for the brace (frequency and severity of buckling) is documented alongside it.
How long does it take to get a VA decision on an ACL claim?
Most VA disability claims take 3 to 6 months from submission to decision, though claims involving multiple diagnostic codes for one knee, such as combined instability, meniscus, and range-of-motion ratings, can take longer due to the additional development needed. Submitting a fully developed claim with all imaging, exam findings, and nexus statements upfront typically shortens the timeline.
