Inside the exam room
1. You will be asked which hip is affected and about treatment and worse days. Explain trouble walking, climbing stairs, sitting, or dressing.
2. You will be asked to move your leg forward, backward, outward, inward, and rotate it. Tell the examiner when pain starts, where movement stops, and if a movement is unsafe.
3. You may be asked to repeat movements if safe. Explain what changes after activity or on worse days, how long it lasts, and support you need.
The examiner measures joint movement with a goniometer (angle-measuring tool).
How VA rates hip condition
Explain limits on lifting the knee, moving the leg sideways, walking, and sitting. The examiner measures movement and checks for a joint fixed in position or a bone injury. VA rates a hip fixed in position (ankylosis), motion loss, flail joint, and femur impairment under 38 CFR § 4.71a, DCs 5250–5255. Bending the hip to bring the knee forward (flexion) bands under DC 5252 are 45°/10%, 30°/20%, 20°/30%, and 10°/40%. Paired hip ratings may receive the extra adjustment for paired limbs (bilateral factor).
38 CFR § 4.71, Plate II: normal bending of the hip to bring the knee forward (flexion) is 0–125° and moving the leg out to the side (abduction) is 0–45°.
What each rating percentage means
Match the whole description with your exam and records. A single symptom or illustration does not decide your rating.
| Rating | What the rule requires |
|---|---|
| 60/70/90% | DC 5250: a hip fixed in position, classified as favorable, intermediate, or extremely unfavorable ankylosis |
| 10–40% | DC 5252: bending the hip to bring the knee forward (flexion) limited to 45°, 30°, 20°, or 10° |
| 80% | DC 5254: a hip with too little stability to work normally (flail joint) |
| 60–80% | DC 5255: a qualifying broken thigh bone that has not joined back together (nonunion) or false joint; a broken bone that healed out of alignment (malunion) is evaluated under the affected hip or knee codes |
Check these details in your records
The examiner uses a condition form called a Disability Benefits Questionnaire (DBQ). Compare these items with your own records and explain what actually happens in daily life.
- Bending the hip to bring the knee forward (flexion) limited to 45 degrees10%DC 5252
- Bending the hip to bring the knee forward (flexion) limited to 30 degrees20%DC 5252
- Bending the hip to bring the knee forward (flexion) limited to 20 degrees30%DC 5252
- Bending the hip to bring the knee forward (flexion) limited to 10 degrees40%DC 5252
- A clinician's records show a hip fixed in a position VA calls favorable (favorable ankylosis): fixed with the hip bent forward (flexion) between 20 and 40 degrees, with the leg slightly inward (adduction) or outward (abduction)60%DC 5250; stiffness alone is not a joint or spine fixed in position (ankylosis)
- A hip with too little stability to work normally (flail joint)80%DC 5254
What may happen in the exam room
- The examiner uses an angle-measuring tool (goniometer) as you move the leg forward, backward, outward, inward, and turn it
- When safe, the examiner checks you moving the joint, moves it for you, and checks movement with and without weight on it
- The examiner asks you to repeat a movement to see what changes
- The examiner watches how you walk and use a cane, walker, or other support
What the measurements tell you
- Angle where pain begins
- How far you can move after doing it at least three times
- How much movement you lose on worse days or after doing an activity several times
- Whether the joint is fixed
- What changes when you sit, use stairs, get dressed, or walk
Questions the examiner may cover
- How often do hip flare-ups occur and how long do they last?
- How far can you walk or sit before symptoms increase?
- Do you use a cane, crutch, or walker?
- Does the hip change how you walk or affect the back or opposite leg?
Questions to expect
Which hip movements stop, and what changes with use?
Explain: Describe dressing, sitting, stairs and walking. Report flares and repeated-use changes; the examiner measures the angles.
Rating connection: Hip flexion, extension and rotation or side movement use different codes. Each measured direction must be matched to its own row.
Is a joint fixed, or is a bone injury documented?
Explain: Identify surgery, aids and recorded fixation or fracture findings.
Rating connection: Ankylosis and femur injury have requirements different from ordinary limited motion.
Your answer outline
My [side] hip affects [specific task]. On a usual day, I can [amount or duration], but then [change]. When symptoms are worse, [difference and duration]. I use [actual adjustment or prescribed aid] to [effect].
Mark approximate dates and counts as estimates.
My notes: ________________________
Service connection records
1. How is this connected to your service?
For a direct claim, identify your current disability, what happened in service, and evidence linking them. Being on active duty or orders alone does not prove that link.
- Write the 5 Ws and how: who was there; what happened; when; where; why you were there; how the problem began. Add duty status, treatment, witnesses, and records. Mark uncertain dates as estimates.
- Guard or Reserve: find your orders, dates, duty type, and any line-of-duty records. Active duty, training, and drills have different rules.
- Secondary condition: it may start after service. Identify the service-connected condition and evidence that it caused or worsened this problem. A medical opinion may help explain the link.
- Started before service? Record what changed during service. Presumptive condition? Check the required diagnosis and service history; qualifying claims do not require separate proof of a link.
- Already service connected and seeking an increase? Focus on what has worsened and the records showing it.
If you do not know the cause, say so. Do not guess a medical connection.
Explain what changes in daily life
Describe both what you can do and what becomes difficult. Include how often it happens and how long it lasts.
- Describe the actual range-limiting point, not the furthest motion you can force.
- Explain difficulty putting on socks, entering a vehicle, climbing stairs, or rising from a chair.
- Describe changes in how you walk and which side bears extra weight.
Common mistakes to avoid
- Pushing through painful movement
- Saying it is fine today without describing flare-ups
- Confusing hip-joint motion with a separate thigh muscle injury
Records to get ready before the exam
- Hip and Thigh Conditions DBQ
- Imaging and bone and joint treatment notes
- Physical therapy movement measurements
- Prescription for a cane, walker, or other support
- Flare and walking-distance log
Preparation notes
- Identify the affected side and whether both hips are involved.
- Describe the worst typical functional day accurately.
Pain, repeated use, and worse periods
Pain and movement limits (DeLuca): Under 38 CFR §§ 4.40, 4.45, and 4.59, the examiner should address pain, weakness, tiring easily, difficulty controlling movement, repeated use, and flare-ups. Explain separately where pain begins and how far you can actually move. Follow the examiner's safety instructions; do not force movement or alter it to match a rating.
Official rating rule and code numbers
Use this source to check the full rule and its medical terms: 38 CFR 4.71a, DCs 5250-5255. Source review recorded 2026-09-04.
Could one health problem have caused another?
A condition VA has already linked to your service may cause another health problem or make it worse. VA calls this secondary service connection. Having both conditions does not prove the link. Your records need to show a current diagnosis and explain how the first condition or its treatment affected the second.
- Start with your records. Find the current diagnosis, the condition VA already linked to service, and evidence from someone qualified to explain the connection.
- Ask about cause and worsening. Did the first condition or its treatment cause the new disability, or make an existing disability worse? These are different questions. The rules call them causation under 38 CFR § 3.310(a) and aggravation under § 3.310(b). If both are raised by your records, the medical opinion should address both; answering only the cause question may not be enough (El-Amin).
- If treatment may be involved, collect the dates. List the medicine or surgery prescribed for the condition VA linked to service, the side effect, and the new diagnosis. Bring pharmacy records and dates when treatment started or stopped. A provider must explain the connection in your case; taking a medicine alone does not prove it.
- If weight gain may be involved, ask how it fits. Weight gain or obesity can be a step between the first condition and another diagnosed disability under VAOPGCPREC 1-2017. Obesity itself does not receive a VA disability rating.
- You do not need absolute certainty. VA uses the “at least as likely as not” standard and the reasonable-doubt rule under 38 CFR § 3.102. Ask a VA-accredited representative how the evidence applies to your claim.
- The same symptom cannot be counted twice. This is the rule against pyramiding in 38 CFR § 4.14. Mental-health diagnoses generally share one § 4.130 rating when they affect the same work and social abilities. Trouble sleeping may be a symptom rather than a separate disability.
- Check whether VA already assumes a link to service. Some conditions qualify based on where or when you served. These are called presumptive conditions. Examples can include chronic rhinitis, chronic sinusitis, hypertension after qualifying herbicide exposure, and type 2 diabetes. Sleep apnea (OSA) is not a PACT Act presumptive. Check eligibility before seeking a medical opinion about the link.
- An exam form and a medical opinion do different jobs. A Disability Benefits Questionnaire (DBQ) records the diagnosis and how severe it is. It may not explain why it is linked to service, often called a nexus. A VA-accredited veterans service organization (VSO) can help you file at no charge.
If another prescribed treatment may have caused a problem, ask your health care provider to record what happened and explain the connection in your case.
Sources: 38 CFR § 3.310 · 38 CFR § 4.14 · VA-accredited representatives
Other health problems to ask about
Use these notes to ask your provider about problems you already have. Your records must explain the connection. VA decides whether the condition is linked to service.
Bring records of changes in how you walk. Ask your provider whether the hip problem caused the back problem or made it worse.
Putting more weight on the other leg does not prove a link. Ask your provider whether it caused that problem or made it worse.
Choose the related health problems you want to discuss. Your preparation packet will include the notes you select and the full condition guides available for them.