Amputation Above the Knee VA Disability Rating
- Service connection requires a current diagnosis, an in-service event or exposure, and a medical link (nexus) between the two.
- VA assigns ratings of 60% to 100% under diagnostic code 5160-5163, using the criteria in the rating table below.
- The percentage assigned turns on Bone level, stump condition, prosthesis.
- Measured at the C&P exam: Goniometer, range of motion.
| Rating | Criteria |
|---|---|
| 60% | Amputation of the thigh, middle or lower thirds (diagnostic code 5162). |
| 60% | Amputation of the leg with a defective stump, where thigh amputation is recommended (diagnostic code 5163). |
| 80% | Amputation of the thigh, upper third: within one third of the distance from the perineum to the knee joint, measured from the perineum (diagnostic code 5161). |
| 90% | Complete amputation of the lower extremity: disarticulation, involving complete removal of the femur and intrinsic pelvic musculature (diagnostic code 5160). |
| 100% | Complete amputation of the lower extremity: trans-pelvic amputation, involving complete removal of the femur and intrinsic pelvic musculature along with any portion of the pelvic bones (diagnostic code 5160). |
Illustrative scenarios showing how the criteria above are applied. These are educational examples, not a prediction of any individual veteran's rating.
Amputation at the middle third of the thigh
Illustrates 60%Situation. The leg is amputated above the knee through the middle third of the thigh, and the veteran uses a prosthesis.
How the criteria apply. Amputation through the middle or lower thirds of the thigh rates 60 percent under diagnostic code 5162. Special monthly compensation for the anatomical loss of the foot is paid in addition.
Amputation at the upper third of the thigh
Illustrates 80%Situation. The amputation sits within the highest third of the distance from the perineum to the knee joint.
How the criteria apply. Amputation of the thigh at the upper third rates 80 percent under diagnostic code 5161. Disarticulation involving complete removal of the femur and intrinsic pelvic musculature rates 90 percent, and trans-pelvic amputation rates 100 percent, both under diagnostic code 5160.
The schedule rates lower extremity amputations by where the limb ends. Amputation through the middle or lower thirds of the thigh is 60 percent, and so is a lower leg amputation with a stump so defective that thigh amputation is recommended. Amputation through the upper third, the highest third of the distance from the perineum to the knee joint, is 80 percent. At the top, diagnostic code 5160 covers complete amputation of the lower extremity: disarticulation involving complete removal of the femur and intrinsic pelvic musculature is 90 percent, and trans-pelvic amputation, which also removes part of the pelvic bones, is 100 percent. On top of the schedular percentage, the amputation rule caps combined ratings for that extremity at the amputation level rating, and special monthly compensation adds a separate monthly amount because the loss of the foot is anatomical.
What VA looks at
The surgical level documented in the operative report, stump condition and revision history, prosthesis fit and tolerance, and the secondary problems amputation commonly produces: strain on the opposite leg and hips, back problems from gait change, phantom limb pain, and skin breakdown at the socket.
Common exam and DBQ topics
Amputation level and cause, stump health including neuromas and skin breakdown, prosthesis use and how many hours a day it is tolerated, falls and mobility aids, and secondary pain in the other leg, the hips, or the back.
Evidence that usually matters
Operative reports fixing the anatomical level, prosthetist records on fit and usage, rehabilitation notes, and treatment records for stump complications and secondary orthopedic problems.
Common misunderstandings
Special monthly compensation for the anatomical loss of the foot is paid in addition to the schedular rating, not instead of it. The amputation rule caps ratings on the amputated extremity, but strain injuries to the opposite leg, the hips, and the back are separate disabilities outside that cap when medically linked. Veterans using a prosthesis also qualify for an annual clothing allowance, which must be applied for separately.
Drawn directly from the VA Disability Benefits Questionnaire (DBQ). The examiner records each item below; the rating then maps to the table above.
- Bring or reference the operative report; the exact anatomical level of the amputation is what sets the schedular percentage.
- Show the examiner the stump: skin condition, neuromas, breakdown at the socket, and any revision surgeries.
- Describe prosthesis tolerance honestly: hours per day, terrain limits, and days the stump cannot tolerate it at all.
- Raise phantom limb pain and its treatment so the examiner documents it.
- Report pain or problems in the other knee and hip and in the back, because those are separate secondary claims outside the amputation rule's cap.
Small rules in the regulations decide a surprising number of claims. These are the ones that most often change a amputation above the knee outcome. None of this is legal advice; it is a map of where to look.
Your rating is based on how high the amputation is, and losing the use of the leg adds special monthly compensation on top. Make sure you claim the extra SMC money.
WhyAn above-knee amputation is rated on the level, with a higher level for amputations closer to the hip, and loss of use of the leg qualifies for special monthly compensation on top of the schedular rating. Claim the SMC.
38 CFR 4.71aWas this helpful?
- Pain and repeated motion have to be tested, not just one slow stretch
For a joint, the examiner is supposed to test range of motion after repeated use and record where pain begins, plus weakness, fatigue, and loss of coordination. Under 38 CFR 4.40, 4.45, and 4.59, that functional loss can push a rating above what a single measurement shows. The DeLuca and Mitchell decisions are where this comes from.
38 CFR 4.59 - A joint should be measured both ways, and against the other side
A joint exam is expected to record motion both active and passive, in weight bearing and non weight bearing, and to compare the injured joint with the opposite one. The Correia decision reads 38 CFR 4.59 to require this. If the report lists only one number, the exam may be incomplete.
38 CFR 4.59 - Flare ups count even if your joint behaved on exam day
If you have flare ups, the examiner is supposed to ask how bad they get and estimate the extra loss of motion during a flare, or explain why an estimate is not possible. The Sharp decision says the examiner cannot just write that it cannot be said without speculation. Describe your worst days clearly.
38 CFR 4.40
- What you and people around you witnessed is real evidence
You do not always need a doctor to prove a symptom you can see, hear, or feel. Statements from you, family, or fellow service members about things like pain, ringing in the ears, or panic attacks are competent lay evidence under 38 CFR 3.159. A clear buddy statement with dates and specifics can carry weight.
38 CFR 3.159 - A tie goes to you
When the evidence for and against a point is roughly equal, VA is required to decide in the veteran's favor. This benefit of the doubt rule lives in 38 CFR 3.102. You do not have to prove a claim beyond all doubt, only to bring the evidence to about even.
38 CFR 3.102 - An unbroken line of symptoms can stand in for a paper trail
For certain chronic conditions, showing symptoms that continued from service to now can help establish service connection even without a perfect record. This continuity of symptomatology idea comes from 38 CFR 3.303(b) and applies to the chronic diseases the regulation lists.
38 CFR 3.303 - If it happened in combat, your word can be enough that the event occurred
For anyone who served in combat, VA must accept your own account of what happened during that combat as proof the event took place, as long as it fits the conditions of your service, even when no record survives. This comes from 38 U.S.C. 1154(b). It does not by itself prove the injury, but it can establish the in service event.
38 U.S.C. 1154(b) - If it was not written down at entry, you are presumed to have entered healthy
Unless a condition was noted on your entrance exam, the law presumes you were sound when you entered service. To rebut that, VA has to show by clear and unmistakable evidence both that the condition existed before service and that service did not make it worse. See 38 CFR 3.304(b).
38 CFR 3.304 - You can reopen a denied claim with new and relevant evidence and keep your date
After a decision, a Supplemental Claim lets you add new and relevant evidence. If you file it within one year of the decision, you protect your original effective date, so back pay can reach further. See 38 CFR 3.2501.
38 CFR 3.2501 - Pain that limits you can be a disability on its own
You do not always need a separate named diagnosis. After the Saunders decision, pain that causes functional loss can itself be a disability for compensation. Describe exactly what the pain stops you from doing. This pairs with the functional loss rules in 38 CFR 4.40.
38 CFR 4.40 - Some conditions are presumed if they show up within a year of getting out
Certain chronic diseases, including hypertension, arthritis, and diabetes, that appear to a compensable degree within one year of leaving service are presumed connected to service, even without proof of a specific cause. See 38 CFR 3.307 and the list in 3.309.
38 CFR 3.309 - A diagnosis years later can still be service connected
A condition first diagnosed long after you left service can still be service connected if the evidence ties it back to something in service. You do not need a diagnosis while still in uniform. See 38 CFR 3.303(d).
38 CFR 3.303
- The same symptom is rated once, but separate problems are rated separately
VA cannot rate the same symptom twice, which is pyramiding under 38 CFR 4.14, but it can and should rate distinct problems on their own. A scar and the loss of motion under it, for example, can each be rated. The Esteban decision is the classic example.
38 CFR 4.14 - One service connected condition can open the door to another
A condition caused by, or made worse by, a service connected condition can be service connected too. Sleep apnea linked to weight gain from a service connected condition, or depression linked to chronic pain, are common examples. This secondary path is in 38 CFR 3.310.
38 CFR 3.310 - Your rating can change by time period
If a condition was worse during one stretch and better during another, VA can assign different ratings for those periods rather than one flat number. These are called staged ratings, and they flow from VA's duty to consider the whole recorded history under 38 CFR 4.1 and 4.2.
38 CFR 4.2 - Ratings are combined with a table, not added
Two disabilities at 50 and 50 do not make 100. VA combines them with the table in 38 CFR 4.25, working from the largest down, then rounds to the nearest 10 only at the very end. This is why a 30 and a 20 can land on 40, not 50.
38 CFR 4.25 - Matching injuries on both sides earn a hidden bonus
When you have disabilities affecting both arms, both legs, or paired muscle groups, VA adds an extra 10 percent of their combined value before folding in the rest, the bilateral factor. It is easy to overlook and can change your final number. Since April 16, 2023, the factor can only help: when leaving it off would produce a higher combined rating, VA must use the higher result. See 38 CFR 4.26.
38 CFR 4.26 - If the schedule does not fit your case, VA can rate outside it
When your disability picture is so unusual that the normal rating schedule does not capture it, for example frequent hospital stays or marked interference with work, VA can refer the case for an extraschedular rating. It is uncommon but real, under 38 CFR 3.321(b)(1).
38 CFR 3.321 - A painful joint earns at least the minimum rating
If a joint hurts when you move it, that painful motion is supposed to earn at least the minimum compensable rating, usually 10 percent, even when the joint still moves through a normal range. This comes from 38 CFR 4.59 and the Burton decision. Make sure pain on motion is written down.
38 CFR 4.59 - When you are between two ratings, the higher one should win
If your symptoms sit between two rating levels, VA is supposed to assign the higher one when your overall disability picture more nearly matches it. This is the reasonable doubt rule applied to ratings, in 38 CFR 4.7.
38 CFR 4.7 - You do not have to check every box on the list
The symptoms listed at each rating level are examples and guides, not a strict checklist. VA is not supposed to deny a level just because you do not have every single symptom named. See 38 CFR 4.21.
38 CFR 4.21
- You can lock in your start date before the full claim is ready
Filing an intent to file holds your effective date for up to a year while you gather evidence. If you complete the claim within that year, back pay can run from the intent to file date, not the later submission. See 38 CFR 3.155.
38 CFR 3.155 - Older ratings get harder to take away
A rating in place for 5 years is treated as stabilized, one in place for 10 years has protected service connection, and one in place for 20 years generally cannot be reduced below its level except for fraud. See 38 CFR 3.344, 3.957, and 3.951.
38 CFR 3.344 - VA cannot cut a rating without showing real, lasting improvement
To reduce a rating, VA generally has to show actual improvement under the ordinary conditions of life and work, not just one better exam. The rules are in 38 CFR 3.344, and a proposed reduction comes with notice and a chance to respond first.
38 CFR 3.344 - You can be paid at the 100 percent rate without a 100 percent rating
If service connected conditions keep you from holding steady, gainful work, VA can pay you at the 100 percent rate through TDIU, even if your combined rating is lower. Under the Rice decision, VA must consider TDIU whenever the record raises it, even if you never asked for it by name. See 38 CFR 4.16.
38 CFR 4.16 - Your back pay date is worth checking yourself
Your award usually runs from the date you filed or the date entitlement arose, whichever is later, with special rules for claims filed within a year of leaving service. Knowing your effective date under 38 CFR 3.400 is how you catch retroactive pay that came up short.
38 CFR 3.400 - A clear error in an old decision can be fixed back to day one
A final decision that contained a clear and unmistakable error can be revised at any time, and the correction runs back to the original date, not the date you pointed out the error. The bar is high: the error has to be undebatable. See 38 CFR 3.105(a).
38 CFR 3.105 - Needing help at home can add money on top of your rating
If you need help with everyday activities, or are largely confined to your home because of disability, you may qualify for Aid and Attendance or Housebound payments added to your monthly amount. See 38 CFR 3.350 and 3.352.
38 CFR 3.352 - Surgery can earn a temporary 100 percent rating while you heal
After certain surgeries, or when a service connected joint is immobilized in a cast, VA can grant a temporary 100 percent rating during recovery and then return you to your prior rating. It is easy to miss because you have to flag it. See 38 CFR 4.30.
38 CFR 4.30 - A long hospital stay can pay at 100 percent for that time
If you are hospitalized more than 21 days for a service connected condition, VA can pay you at the 100 percent rate for that period, then drop back to your regular rating afterward. See 38 CFR 4.29.
38 CFR 4.29 - Even a 0 percent rating is worth winning
A 0 percent rating still confirms the condition is service connected. That opens the door to secondary claims, to an increase later if it worsens, and can affect VA health care priority. Do not walk away from a noncompensable grant. See 38 CFR 4.31.
38 CFR 4.31 - A new law can pay you back to its start date
When a new law or presumption adds a condition, your benefits can reach back to the law's effective date, up to one year before you filed. This matters for PACT Act and other presumptive expansions. See 38 CFR 3.114.
38 CFR 3.114 - If VA later finds lost service records, your date can reach back
When VA later locates relevant official service records it did not have the first time, it must reconsider the claim, and the effective date can run back to your original filing, even years later. See 38 CFR 3.156(c).
38 CFR 3.156 - An increase can be backdated up to a year
For a condition that got worse, your higher rating can be paid up to one year before you filed, if the record shows the worsening was clearly there during that window. See 38 CFR 3.400(o)(2).
38 CFR 3.400 - One total rating plus 60 percent more can mean extra money
If you have a single disability rated 100 percent and other service connected disabilities adding to 60 percent or more, you may qualify for housebound special monthly compensation, paid on top of the 100 percent rate. See 38 CFR 3.350(i).
38 CFR 3.350
Find medical studies for Amputation Above the Knee
These search starters open PubMed and PubMed Central (the National Library of Medicine's free databases) pre-filled for this condition. Strong, peer reviewed studies can help a qualified provider write a more persuasive nexus opinion.
Studies on how this condition develops and what raises the risk.
Research on how this condition is associated with or follows another.
Systematic reviews and meta analyses that summarize many studies.
Read complete studies for free in PubMed Central.
You have three review lanes, pick the one that fits the situation.
Under the Appeals Modernization Act, a veteran has one year from a VA decision to file a Higher Level Review, a Supplemental Claim, or a Board Appeal, and filing within that one year window protects the original effective date.
Related conditions
Background reading
Supplemental articles that connect to this condition.
Total Disability based on Individual Unemployability lets a veteran be paid at the 100 percent rate even when the schedular combined rating is lower.
If a prosthetic, orthopedic device, or a prescribed skin medication wears out or stains your clothing, VA owes you a yearly lump-sum clothing allowance under 38 CFR 3.810. The 2025 amount is $1,024.50, and many rated veterans qualify without knowing it.
For severe service connected disabilities, VA offers one-time grants to adapt a home or buy and equip a vehicle. The FY2026 SAH maximum is $126,526, the SHA maximum is $25,350, and the automobile allowance is $27,074.99.
SMC pays extra for serious losses or for needing daily help, above or in place of the regular rate. Here are the letter levels K through S plus R and T, how Aid and Attendance and Housebound work, how you get SMC, and a worked SMC-S example.
Your rating may also qualify you for state-level benefits.
VA compensation is federal, but every state layers its own benefits on top. Many states reduce or waive property tax for disabled veterans, and many offer license, tuition, or vehicle benefits at various rating levels. The thresholds, dollar amounts, and eligibility rules vary widely from state to state, so the reliable answer is always your own state's guide.
Put this rating to work
Free calculators and a guide to turn a rating percentage into real numbers. Nothing is saved to a server; your figures stay on your device.
Add this condition to your other ratings using VA math, not simple addition.
See the 2026 monthly payment for a rating, including dependents.
Estimate retroactive pay from your effective date.
How one service connected condition can support a claim for another.
Most recent human review on this page, July 31, 2026. Below is the review history across this page, its citations, and the supplemental articles it links to.
- July 31, 2026conditionThis page
- July 5, 2026articleSpecial Monthly Compensation (SMC): Higher Pay Beyond 100 Percent
- July 5, 2026articleHousing and Auto Grants: SAH, SHA, and the Automobile Allowance
- July 5, 2026articleThe Annual Clothing Allowance: A Yearly Payment Most Veterans Miss
- July 5, 2026articleIndividual Unemployability (IU/TDIU)
- July 5, 2026citation38 CFR 4.71a Musculoskeletal Ratings
