Femur Impairment VA Disability Rating
Diagnostic Code 5255 · 38 CFR §4.71a
What Is It?
Femur impairment covers conditions affecting the thighbone including malunion where the bone healed in an improper position, nonunion where the bone failed to heal, and fracture of the femoral neck. The femur is the strongest bone in the body and femur injuries typically result from significant trauma such as vehicle accidents, falls from height, or blast injuries during military service. Even after treatment, femur injuries often leave lasting problems with leg length, alignment, and joint function.
Rating Criteria
| Rating | Criteria |
|---|---|
| 80% | Nonunion of the femur with loose motion creating a spiral or oblique fracture pattern, also called a flail joint equivalent. |
| 60% | Nonunion of the femur without loose motion where weight bearing is preserved with the aid of a brace, or fracture of the surgical neck with false joint. |
| 30% | Malunion of the femur with marked knee or hip disability. |
| 20% | Malunion of the femur with moderate knee or hip disability. |
| 10% | Malunion of the femur with slight knee or hip disability. |
Evidence Needed
- Imaging showing the malunion, nonunion, or fracture pattern
- Surgical records from initial treatment and any subsequent procedures
- Range of motion measurements for both the hip and knee on the affected side
- Leg length measurements comparing both sides
- Documentation of braces, assistive devices, or gait aids prescribed
- Functional assessment describing weight-bearing capability
C&P Exam Tips
- Bring imaging that clearly shows the bone alignment or healing status
- Make sure both the hip and knee are examined since femur problems affect both joints
- Report any leg length discrepancy and whether you use a shoe lift
- Describe pain with weight bearing and how far you can walk
- Mention if the leg feels unstable or if you rely on a brace
How to File
File under DC 5255 with imaging showing the bone condition and functional evidence of how it affects your hip and knee. If you have a leg length discrepancy, get it measured and documented. File secondary claims for any joint problems that developed because of the femur impairment.
Common Mistakes
Not having both the hip and knee evaluated since femur malunion affects both joints Failing to document leg length discrepancy which supports the malunion diagnosis Not getting current imaging to show the bone condition — old films from the initial injury may not show the current state Missing secondary claims for arthritis that developed in adjacent joints
Frequently Asked Questions
What is the difference between malunion and nonunion?
Malunion means the bone healed but in an incorrect position, causing alignment problems. Nonunion means the bone never fully healed and there remains a gap or false joint at the fracture site. Nonunion generally receives higher ratings because the bone cannot bear weight properly.
How do they determine if the disability is slight, moderate, or marked?
There is no specific range of motion cutoff for these categories. The examiner considers the overall impact on the hip and knee joints, including pain, motion loss, instability, and how much the malunion affects your ability to walk and function. Detailed documentation of all these factors helps support a higher characterization.