Ankles take the first impact of every step, every jump, and every awkward landing on uneven ground. Repeated sprains in service - often treated at sick call, wrapped, and forgotten - leave ligaments that never fully recover. The VA rates ankle disabilities under 38 CFR 4.71a, primarily by motion. For how ankle and foot claims are decided, start with our service connection overview.
Limitation of motion - Diagnostic Code 5271
Normal ankle motion is 0 to 20 degrees of dorsiflexion and 0 to 45 degrees of plantar flexion. Diagnostic Code 5271 rates limitation of motion as marked at 20 percent and moderate at 10 percent, with the 2021 revision of the schedule tying marked limitation to less than 5 degrees of dorsiflexion or less than 10 degrees of plantar flexion.
Measurements are taken with a goniometer at the examination, which makes the examination the single most consequential appointment in an ankle claim.
Ankylosis - Diagnostic Code 5270
When the ankle is fixed rather than merely limited, Diagnostic Code 5270 applies, with evaluations up to 40 percent depending on the angle at which the joint is fixed and whether there is abduction, adduction, inversion, or eversion deformity. Related codes cover ankylosis of the subastragalar or tarsal joint (5272), malunion of the os calcis or astragalus (5273), and astragalectomy (5274).
Where veterans start
Every case is different, and there is no obligation at any step. When veterans want to understand what their records actually support, these are the two most common starting points:
- Medical records review
A licensed physician reviews your records for a $250 flat fee and identifies which foot and ankle conditions the available evidence may support. The fee is refunded in full if nothing supportable is identified.
- Nexus letter
When the records support one, a licensed provider writes the medical opinion that addresses the link between your foot or ankle condition and your service or an already service-connected disability.
Painful motion and function
Range of motion recorded at rest describes the best version of an ankle. 38 CFR 4.40 and 4.45 require the examiner to consider functional loss during flare-ups and after repeated use, and 38 CFR 4.59 entitles painful motion to at least the minimum compensable rating for the joint.
In practice that means an examination should document motion after repetitive use testing, describe what happens during a flare, and record instability, weakness, and fatigability. Where it does not, the assigned rating tends to describe an ankle the veteran does not actually have. The same dynamic is covered in detail in our knee painful motion guide and our knee C&P exam guide.
Arthritis of the ankle
Degenerative arthritis established by imaging is rated under Diagnostic Code 5003, which provides a compensable evaluation based on limitation of motion, or 10 percent where limitation is noncompensable but painful motion or X-ray evidence with involvement of two or more major joints is shown. Arthritis that manifests to a compensable degree within one year of separation may be presumptively service connected under 38 CFR 3.307 and 3.309(a).
Ankles and everything downstream
Reduced ankle dorsiflexion is one of the most direct contributors to plantar fascia strain, and a chronically unstable ankle changes gait in ways that load the knee, hip, and spine. Veterans with a service-connected ankle frequently have a supportable secondary claim they have never filed - see foot conditions secondary to knee and back and plantar fasciitis ratings.
If you are not sure which of those conditions your records would support, a medical records review answers that question before anything is filed.