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VA Rating Assistant

DC 5260 · 38 CFR 4.71a

Knee and Lower Leg C&P Exam Prep

To document the current severity of your knee and lower leg condition(s) so VA can assign an accurate disability rating under 38 CFR - 4.71a. The examiner will record all diagnoses, range of motion measurements, functional loss, instability, and other residuals that impact your daily activities and employment.

Format:
Interview + Physical
Typical duration:
30-45 minutes
DBQ form:
Knee_and_Lower_Leg (Knee_and_Lower_Leg)
Examiner:
Physician or Physician Assistant

What the examiner evaluates

  • Active and passive range of motion (flexion and extension) for both knees, both weight-bearing and non-weight-bearing
  • Pain on motion, including precise degree where pain begins and where it limits movement
  • Functional loss from pain, weakness, fatigability, and incoordination under DeLuca factors
  • Additional limitation during flare-ups and after repetitive use over time
  • Instability (lateral, medial, anterior, posterior) including frequency and severity
  • Locking, effusion, and swelling episodes
  • Crepitus on passive ROM testing
  • Ankylosis severity and position (favorable or unfavorable)
  • Leg length discrepancy
  • Atrophy of disuse via thigh/calf circumference measurements
  • Prior surgeries (meniscectomy, arthroscopy, ACL repair, total knee replacement, resurfacing)
  • Assistive devices currently used (cane, brace, crutches, walker, wheelchair)
  • Radiographic evidence (x-ray, MRI, CT) findings
  • Scarring from prior surgeries
  • Functional impact on occupational and daily activities

Exam typically conducted in a VA clinic or contract examiner facility. You may be asked to walk, squat, or demonstrate range of motion. Wear loose-fitting clothing to allow easy access to both knees. If you use a brace or assistive device, bring it to the exam. In most states you have the right to record the examination - check your state law and notify the examiner at the start.

Measurements and tests

Knee Flexion - Active Range of Motion (AROM)

What it measures: How far you can bend your knee toward your buttock under your own power without assistance. Normal is 0-140 degrees.

What to expect: The examiner uses a goniometer and asks you to bend your knee as far as you can while seated or lying down. They will note the exact degree where you stop AND the degree where pain begins.

Critical thresholds

  • Flexion limited to 45- or less 30% rating under DC 5260
  • Flexion limited to 60- or less 20% rating under DC 5260
  • Flexion limited to 90- or less 10% rating under DC 5260
  • Flexion limited to more than 90- Non-compensable (0%) under DC 5260 but may qualify under analogous codes or DeLuca factors

Tips

  • Bend your knee only to the point where you truly feel pain - do not push through pain to impress the examiner
  • If you can bend further but experience significant pain at a lesser degree, clearly state 'I feel pain at [X] degrees but I can push to [Y] degrees with severe pain'
  • Perform the movement at your actual functional pace - do not rush
  • If your knee locks, catches, or gives way during the movement, say so immediately

Pain considerations: Under DeLuca v. Brown, the degree at which pain begins on motion is separately recorded and can support a higher effective rating even if the endpoint ROM appears adequate. Always verbalize when pain begins during movement.

Knee Extension - Active Range of Motion (AROM)

What it measures: How far you can straighten your knee. Normal is 0 degrees (fully straight). Loss of full extension is rated under DC 5261.

What to expect: You will be asked to straighten your leg from a bent position. The examiner notes any extension lag (inability to fully extend). Even a few degrees of extension loss can be ratable.

Critical thresholds

  • Extension limited to 45- (cannot straighten beyond 45- of flexion) 50% rating under DC 5261
  • Extension limited to 30- 40% rating under DC 5261
  • Extension limited to 20- 30% rating under DC 5261
  • Extension limited to 15- 20% rating under DC 5261
  • Extension limited to 10- 10% rating under DC 5261
  • Extension limited to 5- 0% (non-compensable) under DC 5261

Tips

  • If you cannot fully straighten your knee while lying flat, do not force it - allow the leg to rest at its natural limit
  • Extension loss is often underreported because veterans compensate without realizing it; lie flat and let gravity show your true extension
  • Contractures from prior injury or surgery are a common cause of extension loss - mention your surgical history

Pain considerations: Pain at end-range extension and pain preventing full extension should both be verbalized clearly to the examiner.

Passive Range of Motion (PROM) with Crepitus Assessment

What it measures: ROM achieved when the examiner moves your knee without your active muscle effort, plus detection of crepitus (grinding, clicking, or grating sensations) indicating cartilage damage.

What to expect: The examiner will gently flex and extend your knee while you relax. They will note if passive ROM differs from active ROM, and whether crepitus, localized tenderness, or pain occurs during passive movement.

Critical thresholds

  • Passive ROM greater than active ROM by >5- Suggests pain is a primary limiting factor - supports DeLuca-based functional loss argument
  • Crepitus present on passive motion Documents objective evidence of intra-articular pathology; supports arthritis diagnosis

Tips

  • Relax your leg completely during passive testing - do not assist or resist the movement
  • If the examiner's movement of your knee causes pain, say so immediately and describe the quality (sharp, aching, burning)
  • Crepitus you feel as popping or grinding should be verbalized: 'I feel grinding in my knee when you move it'

Pain considerations: Pain on passive motion is recorded separately from pain on active motion and supports a finding of objective evidence of painful motion under 38 CFR - 4.59.

Weight-Bearing vs. Non-Weight-Bearing ROM

What it measures: Per Correia v. McDonald (28 Vet. App. 158), the examiner must test ROM under both weight-bearing and non-weight-bearing conditions when clinically feasible.

What to expect: You may be asked to perform a partial squat or walk and then have ROM measured while standing (weight-bearing), and separately while seated or lying (non-weight-bearing). The lower measurement should be used for rating.

Critical thresholds

  • Weight-bearing ROM worse than non-weight-bearing The more limited weight-bearing measurement should be used for rating - potentially higher rating

Tips

  • If weight-bearing causes more pain or limitation than lying down, clearly state this to the examiner
  • Do not skip the weight-bearing test - if the examiner does not perform it, politely note that you experience more limitation when bearing weight
  • If walking or squatting during weight-bearing causes significant pain, describe it in detail

Pain considerations: Weight-bearing ROM is often more limited and more representative of your true functional impairment during daily activities like walking, climbing stairs, and standing.

Repetitive Use / Flare-Up Assessment

What it measures: Under DeLuca v. Brown and Mitchell v. Shinseki, the examiner must assess whether your ROM worsens after repetitive use over time, or during flare-up periods. This is the most commonly missed ratable factor.

What to expect: The examiner will ask you to describe your condition during flare-ups and after repeated use. They may also perform ROM testing after having you walk or perform repetitive movements, then remeasure.

Critical thresholds

  • ROM measurably worse after repetitive use Supports a higher effective rating based on functional loss beyond baseline ROM
  • Flare-ups cause significant pain, weakness, fatigability, or incoordination Must be documented; can push rating to next higher level under 38 CFR - 4.40 and - 4.45

Tips

  • Before the exam, write down what your knee feels like at its worst - not just on an average day
  • Describe flare-up frequency (how many times per week/month), duration (hours to days), and severity (scale of 1-10)
  • Describe activities that trigger flare-ups: stairs, long walks, standing more than 20 minutes, sitting in a car
  • After repetitive use testing, tell the examiner if you feel more pain, stiffness, or weakness than before the exam started

Pain considerations: If the examiner fails to ask about flare-ups and repetitive use, proactively say: 'I want to make sure you document what my knee is like during a flare-up. On a bad day, my flexion is much worse and I cannot [specific activity].'

Instability Testing (Lateral, Medial, Anterior, Posterior)

What it measures: Objective joint instability rated separately under DC 5257. The examiner applies stress to assess ligament integrity.

What to expect: The examiner will apply valgus (outward) and varus (inward) stress to your knee in slight flexion, and may perform Lachman or anterior/posterior drawer tests for cruciate integrity.

Critical thresholds

  • Slight instability (less than 6mm laxity) 10% under DC 5257
  • Moderate instability (6-9mm laxity) 20% under DC 5257
  • Severe instability (10mm or more laxity) 30% under DC 5257

Tips

  • DC 5257 (instability) is rated separately from DC 5260 (flexion limitation) - both can be awarded simultaneously for the same knee
  • Describe giving-way episodes: how often, what causes them, whether you have fallen due to knee giving out
  • Mention if you wear a brace specifically to prevent the knee from giving way

Pain considerations: Instability is an independent rating pathway - do not allow the conversation to focus solely on pain and ROM if you also have documented instability.

Circumference Measurement - Thigh/Calf Atrophy

What it measures: Muscle atrophy of disuse compared to the contralateral extremity. Measured in centimeters at a consistent anatomical landmark.

What to expect: The examiner uses a tape measure to compare the circumference of your affected thigh or calf to the unaffected side at the same location.

Critical thresholds

  • Measurable circumference difference between legs Objective evidence of disuse atrophy supporting functional loss and higher rating

Tips

  • Do not flex your muscles during measurement - remain relaxed
  • Mention if you have been less active due to knee pain, as this explains atrophy of disuse

Pain considerations: Atrophy supports your description of functional limitation - a smaller muscle circumference correlates with weakness and reduced endurance you describe.

Rating criteria by percentage

30%

Flexion of the knee limited to 45 degrees or less under DC 5260.

Key symptoms

  • Cannot bend knee past 45 degrees
  • Severe pain stopping motion well before normal range
  • Inability to kneel, squat, or climb stairs normally
  • Significant functional limitation in employment and daily activities

From 38 CFR: DC 5260: Flexion limited to 45- = 30%. Combined with separately rated instability (DC 5257) or extension loss (DC 5261), combined ratings can exceed 30%.

20%

Flexion of the knee limited to 60 degrees or less under DC 5260.

Key symptoms

  • Cannot bend knee past 60 degrees
  • Pain on motion limiting functional flexion below anatomical endpoint
  • Difficulty with stairs, getting in and out of vehicles, low seating
  • Swelling or effusion episodes limiting motion

From 38 CFR: DC 5260: Flexion limited to 60- = 20%. Note: DeLuca factors can support rating at the 30% level even if measured ROM is between 45- and 60- if pain, weakness, and fatigability are documented as causing additional functional loss.

10%

Flexion of the knee limited to 90 degrees or less under DC 5260.

Key symptoms

  • Cannot bend knee past 90 degrees (cannot achieve right angle)
  • Pain beginning well before 90 degrees
  • Difficulty with prolonged sitting, driving, or activities requiring knee bend past 90-
  • Functional limitation not fully captured by single ROM measurement

From 38 CFR: DC 5260: Flexion limited to 90- = 10%. Veterans with limitation between 90- and 140- are rated at 0% under DC 5260 alone, but DeLuca functional loss, instability (DC 5257), or painful motion under - 4.59 may support a compensable rating.

0%

Flexion greater than 90 degrees - technically non-compensable under DC 5260 alone, but functional loss, instability, painful motion, or analogous conditions may still support a compensable rating.

Key symptoms

  • Measurable pain on motion even if ROM appears near normal
  • Fatigability and weakness limiting prolonged activity
  • Instability requiring a brace
  • Recurrent effusion or locking episodes

From 38 CFR: Under 38 CFR - 4.59, painful motion in a joint is entitled to at least the minimum compensable rating for the joint. Under DeLuca, functional loss after repeated use or during flare-ups can bring the effective rating up even when baseline ROM is greater than 90-.

Describing your symptoms accurately

Pain on Motion

How to describe it: Be specific about where in the range of motion pain begins, the quality (sharp, stabbing, aching, burning), intensity (0-10 scale), and radiation. State what activities reproduce it and how long pain lasts afterward.

Example: On my worst days, I feel a sharp stabbing pain at about 30 degrees of flexion - well before I reach my maximum. I cannot walk more than a block without 7/10 pain, and my knee throbs for several hours after any activity. Stairs require me to lead with my good leg every single step.

Examiner listens for: The degree at which pain begins (not just the endpoint), radiation patterns, quality of pain, and whether pain causes you to stop the motion - these are all separately documented in the DBQ pain-on-motion fields.

Avoid: Do not say 'it hurts a little' or minimize with 'I manage.' Say precisely: 'Pain begins at approximately [X] degrees and reaches a [Y]/10 by [Z] degrees, forcing me to stop.'

Weakness and Fatigability

How to describe it: Describe how quickly your knee fatigues with activity, how strength diminishes over the course of a day or after exertion, and specific tasks you can no longer perform or must pace yourself through.

Example: After walking for about 15 minutes, my quadriceps feel like they are giving out. By the end of a workday, my knee feels so weak I have to use my hands to get up from a chair. I used to be able to stand for 8 hours - now I cannot manage 2 hours without needing to sit.

Examiner listens for: How fatigability affects your work capacity, activities of daily living, and whether weakness has caused you to fall or nearly fall. The DBQ has separate checkboxes for weakness and fatigability that must be checked to be ratable.

Avoid: Do not say 'I get tired sometimes.' Say: 'My knee weakens significantly after [specific duration or activity], which limits me to [specific functional capacity] before I must rest.'

Flare-Ups

How to describe it: Describe your worst episodes: what triggers them, how often they occur, how long they last, the severity of symptoms during a flare-up versus your baseline, and whether you need additional treatment (ice, medication, rest, elevation) during them.

Example: I experience flare-ups two to three times per week, often triggered by standing for more than 20 minutes or going up stairs. During a flare-up, my knee swells visibly, I cannot flex past 30 degrees compared to my usual 70 degrees, and the pain is 9/10. I am essentially bedridden for that day and into the next morning.

Examiner listens for: Quantifiable worsening of ROM and function during flare-ups compared to baseline - this is the DeLuca standard. The examiner must document whether flare-ups cause additional functional loss beyond what is measured at the exam.

Avoid: Do not let the examiner document only your baseline exam-day ROM as your full picture. Proactively state: 'What you are measuring today is not my worst day. During a flare-up, I cannot bend my knee past approximately [X] degrees.'

Instability and Giving Way

How to describe it: Describe how often your knee gives way, what you are doing when it happens, whether you have fallen, and whether you use a brace specifically to prevent giving way. Separately rateable under DC 5257.

Example: My knee gives way completely about twice a week - usually when I step off a curb or try to turn quickly. I have fallen three times in the past year because of it. I now wear a hinged brace whenever I leave the house to prevent falls.

Examiner listens for: Frequency of giving-way episodes, activities that cause them, history of falls, and whether a brace is prescribed for instability (not just pain). This is independently ratable and should not be omitted.

Avoid: Do not fail to mention instability because you are focused on pain or ROM. Instability is separately rated and can add significantly to your combined evaluation.

Functional Impact on Daily Activities and Employment

How to describe it: Describe specific activities you can no longer do or do with difficulty: climbing stairs, kneeling, squatting, walking distances, driving, carrying objects, recreational activities, and work tasks. Be concrete and quantitative.

Example: I cannot kneel at all. I cannot climb more than one flight of stairs without stopping. I cannot drive for more than 20 minutes because of the pain from maintaining the knee bent in the car. I had to give up my job as a warehouse worker because I cannot stand for more than 2 hours or lift while bending. I need a shower chair because I cannot stand safely on my bad leg.

Examiner listens for: Specific occupational and activities-of-daily-living limitations that demonstrate how the condition impairs your ability to function. The DBQ has fields for interference with sitting, standing, and locomotion disturbance.

Avoid: Do not say 'I manage.' Describe the compensatory strategies you use (sitting more, avoiding certain movements, using handrails, etc.) because they reveal the true impact of your disability.

Common mistakes to avoid

Performing ROM to your maximum during the exam even when it causes significant pain

Why: The examiner records the endpoint and may not separately document where pain began. Your rating is based on functional ROM - where pain limits you - not your anatomical maximum under duress.

Do this instead: Stop at the degree where you have significant, limiting pain. Clearly say: 'I can push a little further but this is where pain forces me to stop in daily life.' The examiner should record both the pain-onset degree and the endpoint.

Impact: Can mean the difference between 20% and 30% (or 10% vs. 20%) under DC 5260

Describing only your average day, not your worst days

Why: VA rating is meant to capture the full range of your disability, including during flare-ups. M21-1 instructs examiners to document worst-day functioning under the DeLuca standard.

Do this instead: Always describe what your knee is like at its worst - frequency and duration of bad episodes - and contrast with your average day. Say: 'On my worst days, which happen [X times per week], I cannot [specific function].'

Impact: May prevent recognition of additional functional loss that supports a higher rating at any level

Failing to mention instability as a separate symptom

Why: DC 5257 (knee instability) is rated independently from flexion limitation under DC 5260. Many veterans receive only one rating when they qualify for both, resulting in a lower combined evaluation.

Do this instead: Explicitly tell the examiner about every episode of the knee giving way, buckling, or feeling unstable. Mention whether you wear a brace for instability and whether you have fallen.

Impact: Missing DC 5257 entirely - can be worth 10%, 20%, or 30% as an independent rating

Not mentioning flare-ups during the examination

Why: If you feel okay on exam day, examiners may only record baseline ROM and not document the DeLuca factors that capture your true functional impairment during worse periods.

Do this instead: Proactively raise flare-ups at the start of the exam: 'I want to make sure we discuss my condition during flare-ups, not just today's presentation.' Then quantify frequency, triggers, duration, and ROM during flare-ups.

Impact: Affects rating at every level - consistently the most impactful underreported factor

Forgetting to mention all assistive devices you use

Why: Braces, canes, crutches, and walkers are documented on the DBQ and reflect severity of your condition. Unreported assistive devices are unverified and may not appear in the examiner's report.

Do this instead: Bring every assistive device you use to the exam. Tell the examiner you use it, how often, when prescribed, and why. This includes knee braces, compression sleeves with rigid support, and any mobility aids.

Impact: Relevant to overall severity documentation; also affects SMC consideration at higher combined ratings

Minimizing symptoms due to stoic military culture

Why: Phrases like 'it's not that bad,' 'I push through it,' or 'I've dealt with worse' lead examiners to underestimate severity. Your job is accurate - not modest - communication.

Do this instead: Be precise and factual. Use specific numbers (degrees, minutes, distances, frequency) to describe your limitations. 'I can walk 100 yards before pain forces me to stop' is far more useful than 'I can walk short distances.'

Impact: Affects every rating level; veterans who minimize consistently receive lower ratings than their actual disability warrants

Not distinguishing between weight-bearing and non-weight-bearing ROM if they differ

Why: Per Correia v. McDonald, both must be tested. Weight-bearing ROM is often more limited and reflects true functional impairment. If you do not distinguish, the better non-weight-bearing measurement may be used alone.

Do this instead: If walking or standing increases your pain and limitation, say explicitly: 'My knee is much more limited when I am on my feet bearing weight compared to when I am seated or lying down.'

Impact: Can affect rating by one full level (e.g., 10% to 20%) if weight-bearing ROM is meaningfully worse

Prep checklist

  • critical

    Write a detailed worst-day symptom narrative

    Document your worst-day flexion and extension ability, pain levels (0-10), specific activities you cannot perform, frequency of flare-ups, and anything that makes the condition worse. Bring this written summary to the exam and read from it if needed.

    before exam

  • critical

    Gather all relevant medical records

    Collect x-ray, MRI, and CT reports; operative notes from prior knee surgeries; physical therapy records documenting ROM deficits; and any treating physician notes documenting instability, effusion, or limitations. VA is required to review these under Sharp v. Shulkin.

    before exam

  • critical

    Document all current medications for knee pain

    List all prescription and over-the-counter medications, injections (cortisone, hyaluronic acid), and any other treatments (TENS unit, ice/heat therapy, bracing) along with frequency and reason for use.

    before exam

  • critical

    Identify the precise degree where your pain begins during flexion

    Sit at home and slowly bend your knee while noting at what approximate angle pain becomes significant enough to limit your daily function. This is the DeLuca pain-onset degree you will report during the exam.

    before exam

  • recommended

    List all assistive devices you use

    Note the type (hinged brace, soft sleeve, cane, crutches), when prescribed, why prescribed (pain vs. instability), and how frequently you use each device.

    before exam

  • recommended

    Document your occupational limitations

    Write down specifically how your knee condition affects your current or most recent job - standing duration, walking requirements, kneeling, stairs, lifting while bending. If you changed jobs or left employment due to your knee, document this.

    before exam

  • recommended

    Review your service connection basis and prior ratings

    Know your current rating (if any), how your claim is characterized (direct service connection vs. secondary), and the date of your original claim. This context helps you understand what the examiner is evaluating.

    before exam

  • critical

    Wear loose, easy-to-remove clothing

    Shorts or pants that can be easily rolled above the knee are ideal. The examiner needs full visual and physical access to both knees for measurement and instability testing.

    day of

  • critical

    Bring all assistive devices to the exam

    Bring your brace, cane, crutches, or any other device you use. Wear or carry your knee brace as you would normally use it. This provides physical evidence to the examiner.

    day of

  • critical

    Do not take extra pain medication before the exam

    Take only your normal prescribed dose at your normal time. Taking extra medication to reduce pain before the exam can cause your ROM to appear better than it functionally is on a typical day, potentially lowering your rating.

    day of

  • recommended

    Arrive early and note any increased pain from travel

    If the drive or walk to the exam increased your knee pain, tell the examiner immediately. This is legitimate clinical information relevant to flare-up and functional capacity assessment.

    day of

  • recommended

    Notify examiner of your right to record the exam

    In most states veterans have the right to audio or video record their C&P exam. Check your state law, bring recording equipment if permitted, and inform the examiner at the start: 'I would like to record this examination.'

    day of

  • critical

    Stop range of motion at your functional pain limit

    Do not push through significant pain to reach your anatomical maximum. Stop when pain would normally stop you in daily life and clearly state the degree: 'This is where pain stops me. I could go a bit further but this is my real functional limit.'

    during exam

  • critical

    Verbalize pain onset degree separately from endpoint

    Explicitly state: 'Pain begins at approximately [X] degrees and becomes limiting at [Y] degrees.' Do not wait for the examiner to ask - this DeLuca factor must be in the record.

    during exam

  • critical

    Proactively describe flare-ups and worst-day functioning

    Do not assume the examiner will ask. After ROM testing, volunteer: 'I want to make sure you have my worst-day presentation documented. During a flare-up, which happens [X times per week], my knee is much more limited - I cannot flex past approximately [Y] degrees and the pain is [Z]/10.'

    during exam

  • critical

    Mention instability if present

    Clearly state: 'My knee gives way [frequency]. This has caused me to fall [number] times. I wear a brace specifically to prevent this.' This ensures DC 5257 instability is evaluated separately.

    during exam

  • critical

    Describe all functional limitations concretely

    Mention what you cannot do: kneel, squat, climb stairs, drive long distances, stand for extended periods, walk more than [specific distance]. Use precise measurements (time, distance, frequency) rather than vague descriptors.

    during exam

  • recommended

    Correct the examiner if they skip required tests

    If the examiner does not test weight-bearing ROM, does not ask about flare-ups, or does not test for instability, politely note it: 'I notice we haven't done the weight-bearing range of motion yet - I experience significantly more limitation when standing.'

    during exam

  • critical

    Write down everything that happened within 24 hours

    Document what was tested, what was said, what the examiner wrote down, and anything that felt incomplete or inaccurate. This contemporaneous record is valuable if you need to appeal.

    after exam

  • critical

    Request a copy of the completed DBQ

    You have the right to obtain a copy of your C&P exam report. Request it through your VA MyHealtheVet account, through your VSO, or via a FOIA request. Review it carefully for errors or omissions.

    after exam

  • recommended

    File a supplemental statement if findings were inaccurate or incomplete

    If the DBQ report misrepresents your symptoms, omits documented flare-ups, or fails to address DeLuca factors, submit a written statement to your VSO or VA within the claim period correcting the record with specific, factual details.

    after exam

Your rights during a C&P exam

  • You have the right to have the examiner review all relevant records in your claims file before completing the DBQ, per Sharp v. Shulkin (29 Vet. App. 26, 2017). If the examiner has not reviewed your records, you may note this.
  • You have the right to an adequate examination that addresses all DeLuca factors (pain, weakness, fatigability, incoordination, flare-ups, and repetitive use), per DeLuca v. Brown (8 Vet. App. 202, 1995) and M21-1, Part IV, Subpart i, 3.B.1.g.
  • You have the right to have both weight-bearing and non-weight-bearing ROM tested when clinically feasible, per Correia v. McDonald (28 Vet. App. 158, 2016).
  • You have the right to request a new or additional C&P examination if the original exam is inadequate, incomplete, or fails to address all claimed conditions.
  • In most states you have the right to audio or video record your C&P examination. Verify the law in your state and inform the examiner before beginning.
  • You have the right to bring a representative, advocate, or support person to your C&P examination. Check current VA policy, as this may vary by facility.
  • You have the right to submit a written statement correcting or supplementing the examiner's report if the DBQ does not accurately reflect your condition.
  • You are entitled to the benefit of the doubt under 38 U.S.C. - 5107(b) when there is an approximate balance of positive and negative evidence regarding your claim.
  • Under 38 CFR - 4.59, a veteran is entitled to at least the minimum compensable rating for a joint that is painful on motion, even if measured ROM does not meet a specific percentage threshold.
  • You have the right to request that the examiner document your condition as it exists during flare-ups, not only on the exam date, per M21-1 guidance on worst-day reporting.

Related conditions

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This C&P exam preparation guide is for educational purposes only and does not constitute legal, medical, or claims advice. Always consult with a qualified Veterans Service Organization (VSO) representative or VA-accredited attorney for guidance specific to your claim. Never exaggerate, minimize, or fabricate symptoms during a C&P examination.