Military life invites physical exertion and wear-and-tear injuries. In-service events often cause significant hip pain and can lead to chronic disability. This guide explains how to service connect hip pain and get an accurate VA disability rating.
How the VA Rates Hip Pain
VA ratings for hip conditions range between 10% and 90%. This depends on the cause of the injury, pain levels and impact on your body’s function. The VA also applies the bilateral factor if both hips are affected.
VA Ratings for a Bilateral Hip Condition
If both hips are service connected, the VA combines the disability ratings from each hip and increase it by 10% of its value. For example, two hips rated at 10% each result in a combined rating of 21%. You can estimate your combined (including bilateral) disability rating with the VA disability calculator.
What Is the Maximum VA Rating for Hip Pain?
- 90% Rating: Assigned for extremely unfavorable ankylosis or a hip replacement requiring crutches.
- 80% Rating: Assigned for a femur fracture or a completely unstable (flail) hip joint.
- 100% (Temporary) Rating: Granted immediately following hip replacement surgery.
- 10% Rating: The minimum for limitation of extension or flexion.
It can be difficult to get the correct disability rating for hip conditions. If you were underrated by the VA, we may be able to help.
Ratings by Hip Condition
Hip pain can stem from an injury, muscle strain or underlying physical condition. Each is service-connected in various ways and with very different disability ratings. The most common ones are for ankylosis of the hip and limitation of motion.
Ratings for Ankylosis of the Hip (Diagnostic Code 5250)
Ankylosis refers to the fusion of the hip joint causing stiffness and immobility.
- 90% Rating: Extremely unfavorable ankylosis where feet cannot touch ground, requiring crutches
- 70% Rating: Intermediate ankylosis
- 60% Rating: Favorable ankylosis with hip between 20 to 40 degrees flexion and slight adduction/abduction
Hip Fracture VA Rating (Diagnostic Code 5255)
Fractures in the upper thighbone (femur) that affect the hip joint are rated at 60% or 80%. Service connection is often straightforward when documented in service records, following a fall, training accident, or combat injury.
Hip Replacement VA Ratings (Diagnostic Code 5054)
100% Rating: For 4 months following implantation of prosthesis or resurfacing (starting after the 1-month total rating assigned under § 4.30 following hospital discharge).
90% Rating: Following implantation of prosthesis with painful motion or weakness such as to require the use of crutches
70% Rating: For markedly severe residual weakness, pain, or limited range of motion
50% Rating: For moderately severe residuals including weakness, pain, or limited motion
30% Rating: Minimum rating for total hip replacement
| When the 100% evaluation period ends, resurfacing is evaluated under diagnostic codes 5250 through 5255. |
Ratings for Arthritis of the Hip (Diagnostic Code 5003)
Hip osteoarthritis happens when the cushion-like cartilage in the hip joint wears down over time. When the cartilage wears away, the bones in the hip rub together, causing pain and making it harder to move.
For veterans, this often comes from years of hard physical work, running, and carrying heavy gear during service. The VA rates hip osteoarthritis at 10% or 20% based on X-ray evidence. These ratings are not combined with ratings based on limitation of motion.
LEARN MORE ABOUT ARTHRITIS RATINGS →Hip Range of Motion VA Ratings
When hip pain causes limited motion without ankylosis, the VA rates the hip condition based on how it reduces the veteran’s range of movement.
Limitation of Extension (5251):
- 10% Rating: Extension limited to 5 degrees
Limitation of Flexion (5252):
- 40% Rating: Limited to 10 degrees
- 30% Rating: Limited to 20 degrees
- 20% Rating: Limited to 30 degrees
- 10% Rating: Limited to 45 degrees
Impairment of Thigh (5253):
- 20% Rating: Motion lost beyond 10 degrees (limited abduction).
- 10% Rating: Cannot cross legs (limited adduction).
- 10% rating: Cannot toe-out more than 15 degrees (limited rotation of affected leg).
Hip Impingement VA Rating
Hip impingement, also known as femoroacetabular impingement (FAI) is often rated analogously using the diagnostic codes for limited hip motion, impairment of the thigh, or under the painful motion rule (38 CFR § 4.59). The ratings range from 10% to 40%.
Common Military Activities Leading to Service-Connected Hip Impingement
- Repetitive physical training with heavy load bearing
- Parachute jumps with hard landings
- Carrying heavy gear for extended periods
- Combat or training injuries
- Repetitive movements in confined spaces (vehicles, aircraft, etc.)
Many people with hip impingement also have associated labral tears, which can cause more pain and functional limitations and therefore increase the overall disability rating.
Hip Labral Tear VA Disability Rating
Hip labral tears are typically rated analogously under Diagnostic Codes 5251-5253 for limitation of motion or using the painful motion rule. Under DC 5252 for limitation of flexion of the thigh, VA ratings based on limited hip range of motion go from 10% to 40%.
Hip labral tears often occur during physical training, obstacle courses, or from falls during service, but may also develop gradually from repetitive motions required in military occupations.
Hip Strain VA Rating
Hip strain from overuse or injury of muscles or tendons around the hip can be rated based on severity and functional limitations:
- 10% to 40% under DC 5252 (limitation of flexion).
- Under DC 5253 (impairment of thigh).
- Under muscle injury codes in the case of muscle damage.
VA Ratings for Hip Pain from Tuberculosis (Diagnostic Code 5001)
Tuberculosis of the hip joint, also called tuberculous arthritis of the hip, happens when tuberculosis bacteria start destroying the hip joint cartilage and bone, causing gradual hip pain and limited range of motion.
Active tuberculosis receives a 100% disability rating. Once the disease is inactive, the VA rates the residuals effects like hip joint damage, pain, or limited motion. This is a presumptive condition.
Direct and Secondary Service Connection
To prove your hip condition is connected to your military service, you must establish three elements:
- Current Diagnosis: You must have a current medical diagnosis for a hip condition, not just pain symptoms.
- In-Service Event: Documentation of an injury, disease, or event that occurred during your service.
- Medical Nexus: A medical opinion linking your current condition to the in-service event.
| Many hip conditions develop from other service-connected disabilities, such as nerve damage or spine conditions that put additional strain on the hips. |
Common Secondary Connections
- Altered Gait: Hip pain caused by changes in how you walk due to a service-connected knee or ankle disability.
- Back condition: Hip degeneration resulting from a service-connected back issue.
- Musculoskeletal Disabilities: Hip pain from compensating for other service-connected injuries.
- Medication Side Effects: Osteoporosis and subsequent hip issues from medications prescribed for service-connected conditions (including epilepsy, PTSD, and others).
- Illness: Hip pain resulting from service-connected cancer, like leukemia or bone cancer.
- Nerve Issues: Hip pain from pinched nerves related to service-connected sacroiliitis or sciatica.
Presumptive Conditions: Do You Qualify?
In certain situations, the VA presumes a condition is related to military service. This means you do not need to provide evidence of the connection. The following conditions may qualify.
- Arthritis of the Hip: This qualifies if it manifests to a compensable degree within one year of discharge. It is automatically presumed for former Prisoners of War (POWs), especially post-traumatic osteoarthritis
- Tuberculosis of the Hip Joint: This is presumed service-connected if it becomes active within 3 years of separation from service. It also applies within 3 years for veterans who served before August 19, 1968.
- Multi-Symptom Illnesses: Gulf War Veterans may qualify under Gulf War presumptions for unexplained chronic multi-symptom illnesses that include joint pain affecting the hip.
| If you don’t benefit from a VA presumption, or if your claim is complex, an accredited VA lawyer can help you win the case. Hill & Ponton has over 30 years of experience fighting on behalf of veterans and winning appeals with back pay to the date of the initial claim. |
Winning Service Connection After Being Denied
The VA often says that if you don’t have a certain disability at this current moment then they can’t service-connect you for that. Find out how to not let this happen to you.
Attorney Shannon Brewer takes a deep dive into the case of a veteran with hip arthritis and other health issues that she ultimately proved to be connected to frostbite in service, in spite of an initial denial:
If you were denied VA benefits for your hip disability, our legal team may be able to help you. Get a free evaluation of your case today.
Get a Free case evaluationThe VA Process: How to Get Disability for Hip Pain
Prepare and File the Claim
To secure a rating for hip pain, you must build a strong case through evidence and clear documentation.
1. Gather Medical Evidence:
- Military Records: Collect medical documents showing hip issues or related injuries that occurred during your service.
- Post-Service Records: Provide medical documentation of ongoing treatment since your discharge.
- Private physician opinions and diagnoses.
2. Establish Service Connection:
- Nexus Letter: Obtain a statement from your doctor connecting your hip condition to military service.
- Continuous Symptoms: Document that your hip problems have persisted since service.
- Buddy Statements: Gather written accounts from fellow service members who witnessed your injury or symptoms.
3. File Your Claim:
- Submit VA Form 21-526EZ for new claims.
- Submit VA Form 20-0995 for supplemental claims if previously denied.
Attend the C&P Exam
The VA will likely schedule a Compensation and Pension (C&P) exam. Here’s how to prepare for it.
1. Bring Documentation:
- Gather all your medical and service records relating to your hip pain.
- Include a detailed personal journal documenting how your hip pain affects daily activities.
- Bring a list of all treatments you’ve tried and their effectiveness.
2. Be Honest About Pain Levels:
- Describe your pain on your worst days, not just how you feel the day of the exam
- Explain how the hip pain limits your mobility and activities
- Discuss flare-ups: frequency, duration, and severity
3. Describe Functional Impact:
- Discuss how your hip condition affects your ability to work.
- Explain limitations in standing, walking, sitting, and other movements.
- Describe how your condition has changed/progressed over time.
Appeal the VA Decision
If the VA denies your claim or underrates your condition, you have several options:
- Higher-Level Review: A senior reviewer examines the existing evidence for errors.
- Supplemental Claim: Submit new and relevant evidence to support your case.
- Board of Veterans’ Appeals: Appeal directly to the Board of Veterans’ Appeals.
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