Getting the Highest VA Disability Rating for Ankle Pain

Ankle injuries are extremely common among service members. In fact, the incidence of ankle sprains is 5 times greater than among civilians. Beyond sprains, other conditions can also cause ankle instability, stiffness, and pain.

The VA rates each condition separately and can combine them to give a higher disability rating. This guide explains how the VA rates ankle disabilities, how to service connect them, and how to increase your VA disability rating.

What Is the VA Disability Rating for Ankle Pain?

Ankylosis of the ankle (diagnostic code 5270) and residual weakness and pain from ankle replacement are rated at 20% to 40%. Limited motion of the ankle (diagnostic code 5271) and other ankle disabilities are rated at 10% or 20%.

VA Ratings for Ankle Ankylosis (Diagnostic Code 5270)

Ankylosis occurs when the bones of the ankle joint fuse together, causing stiffness and loss of movement. It can result from severe arthritis, injury, surgery or prolonged immobilization.

The VA assigns ratings under Diagnostic Code 5270 based on the position and degree of fusion:

VA Rating	Condition
40%	Ankylosis in plantar flexion at more than 40°, or in dorsiflexion at more than 10°, or with abduction, adduction, inversion, or eversion deformity
30%	Ankylosis in plantar flexion between 30° and 40°, or in dorsiflexion between 0° and 10°
20%	Ankylosis in plantar flexion of less than 30°

Note: To qualify, you must provide medical evidence demonstrating complete immobility of the ankle joint, not merely limited motion.

VA Ratings for Limited Motion of the Ankle (Diagnostic Code 5271)

This diagnostic code is the most frequently used by the VA for ankle conditions. It evaluates your ankle’s range of motion and assigns a rating based on how restricted that motion is.

VA Rating	Condition
20%	Marked limitation of motion (less than 5 degrees dorsiflexion or less than 10 degrees plantar flexion)
30%	Moderate limitation of motion (less than 15 degrees dorsiflexion or less than 30 degrees plantar flexion)

VA Rating for Ankylosis of the Subastragalar or Tarsal Joint (Diagnostic Code 5272)

This diagnostic code applies when the smaller joints beneath the main ankle joint (the subastragalar or tarsal joints) become stiff and immobile. The VA assigns ratings based on whether you can place your foot on the ground when standing:

VA Rating	Condition
20%	Ankylosis in poor weight-bearing condition
10%	Ankylosis in good weight-bearing condition

A good weight-bearing position means your foot can be properly placed flat on the ground for normal standing and walking. A poor weight-bearing position means it cannot.

VA Rating for Malunion of Os Calcis or Astragalus (Diagnostic Code 5273)

Malunion occurs when a fracture heals in an abnormal position. The os calcis (calcaneus) is the heel bone, and the astragalus (talus) is the ankle bone that connects to the leg bones. The VA evaluates the degree of deformity based on X-rays, physical examination, and functional impact:

VA Rating	Condition
20%	Marked deformity
10%	Moderate deformity

A marked deformity is one that typically causes you to walk abnormally and makes it difficult to find comfortable footwear.

VA Rating for Astragalectomy (Diagnostic Code 5274)

An astragalectomy is a relatively rare surgical procedure that removes the talus (astragalus). Veterans who undergo a service-connected astragalectomy automatically receive a 20% disability rating.

VA Ratings for Ankle Replacement (Diagnostic Code 5056)

Ankle replacement (prosthesis) is a surgical procedure in which a surgeon removes the damaged ankle joint and replaces it with an artificial implant. The VA rates ankle replacement based on the recovery stage and severity of residual symptoms.

VA Rating	Condition
100%	For one year following implantation of the prosthesis
40%	Chronic residuals consisting of severe painful motion or weakness
20%–40%	Intermediate degrees of residual weakness, pain, or limited motion
20%	Minimum rating for ankle replacement

The VA rates intermediate degrees of residual weakness, pain, or limited motion within the 20%–40% range using the criteria from diagnostic codes 5270 or 5271.

Bilateral Ankle Ratings

If you have service-connected disabilities affecting both ankles, you may qualify for a higher rating through the VA’s bilateral factor. The VA recognizes that conditions affecting matching limbs create a greater overall disability than the sum of individual ratings. Therefore, it applies a small increase to the combined rating.

How the Bilateral Factor Works

The bilateral factor is calculated as follows:

• The VA adds 10% of the combined value of the bilateral disabilities
• The VA applies the bilateral factor before combining these ratings with your other service-connected conditions

The VA does not simply add 10% to your overall rating percentage. For example, if you have a 20% disability rating for your right ankle and a 10% rating for your left one, the combined value would be 28% (not 30%, due to the VA’s Combined Ratings Table).

The bilateral factor then adds 10% of 28%, which is 2.8%, resulting in a 30.8% rating, rounded to 31%.

To qualify, both ankle disabilities must be service-connected. However, they can have different diagnostic codes — for example, limited motion in one ankle and ankylosis in the other.

Service Connecting Ankle Disability

To obtain a VA rating for an ankle disability, the most common method is to establish a direct service connection. This requires meeting three essential criteria:

Criteria	Description
Current Diagnosis	You must have a recent diagnosis of an ankle disability confirmed by a medical professional.
In-Service Occurrence or Aggravation	You must identify an event, injury, or series of incidents during active duty that caused or worsened your condition. For example, rolling your ankle during training, sustaining an ankle sprain in combat, or slipping while performing duties.
Medical Nexus	A medical professional must provide evidence linking the in-service occurrence or aggravation to your current ankle disability.

Secondary Service Connection

You may also qualify for a VA rating by proving a secondary service connection. This occurs when an ankle disability develops as a result of another service-connected condition.

Example: If you sustained a service-connected right foot fracture and later developed an ankle disability in your left ankle due to overcompensating for the injury, you may qualify for a secondary service connection. A medical professional linking the two conditions must establish the connection. 

Secondary Conditions That Can Cause Ankle Instability and Pain

Several service-connected conditions can lead to secondary ankle disabilities, including:

• Rheumatoid arthritis 
• Gout 
• Diabetic neuropathy
• Foot conditions, such as pes planus (flat feet), plantar fasciitis, bunions, metatarsalgia
• Knee conditions, such as knee arthritis, meniscus tears, and knee replacement
• Back conditions, such as lumbar radiculopathy or spinal stenosis

Service Connection by Aggravation

If you had an ankle injury or disability before entering active military service, you may qualify for VA disability benefits if service worsened the condition.

Example: The rigorous demands of military training, deployments, or combat could aggravate a pre-existing ankle injury. If you can establish a service connection by aggravation, the VA may accept your claim. 

To succeed, you must provide medical evidence showing that your condition worsened beyond its natural progression during active service.

Obtaining a Higher VA Disability Rating for Ankle Pain

You can request a higher VA disability rating by filing VA Form 21-526EZ if your condition has worsened since your initial rating. 

Supporting your claim with statements from physicians, X-rays, MRIs, or CT scans can strengthen your case. You can also seek assistance from an accredited VA lawyer who can fight on your behalf.

Get a fREE case evaluation here

VA Secondary Conditions to Ankle Pain

Additional conditions often develop alongside ankle disabilities and can potentially lead to a higher combined rating. If these conditions are service-connected or related to your ankle pain, the VA may increase your overall disability rating. 

Common secondary conditions include:

• Sleep disorders secondary to chronic pain
• Degenerative or traumatic arthritis of the ankle joint, contributing to pain and further limitation of motion 
• Opposite ankle or foot conditions due to overcompensation 
• Knee or leg pain, resulting from compensating for ankle instability 
• Plantar fasciitis or hallux valgus (bunions) 
• Achilles tendonitis 
• Shin splints 
• Metatarsalgia 
• Peripheral neuropathy from nerve compression or damage 
• Depression or other mental health conditions caused by ankle pain 

Maximizing Your VA Rating for Ankle Pain

While many ankle disabilities receive ratings between 10% and 20%, more severe conditions can qualify for significantly higher ratings.

If your condition affects both ankles, has worsened over time, or has led to secondary conditions, you may be eligible for an increased combined rating. The key is providing clear medical evidence that reflects how your condition impacts your daily life.