VA Disability Rating for Hip Replacement (Prosthetic)
Diagnostic Code 5054 · 38 CFR §4.71a
What Is It?
Hip replacement surgery involves replacing the damaged hip joint with an artificial joint made of metal, plastic, or ceramic components. It may be needed because of degenerative arthritis from years of military physical demands, hip fractures from service injuries, or avascular necrosis where the bone dies from disrupted blood supply. After surgery, pain relief can be significant, but some limitation in range of motion may remain, and certain movements must be avoided to prevent dislocation. Under Note (3) to the prosthetic implants table, the term prosthetic replacement in DC 5054 means a total replacement of the head of the femur or of the acetabulum, and the 90, 70, 50 and 30 percent rows sit under that heading.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Hip resurfacing or replacement, for four months following implantation of the prosthesis or resurfacing. Under Note (5) to the prosthetic implants table, this four-month period commences after the initial grant of the one-month total rating assigned under 38 CFR 4.30 following hospital discharge. |
| 90% | Following implantation of prosthesis with painful motion or weakness such as to require the use of crutches. |
| 70% | Markedly severe residual weakness, pain or limitation of motion following implantation of prosthesis. |
| 50% | Moderately severe residuals of weakness, pain or limitation of motion. |
| 30% | Minimum evaluation, total replacement only. At the conclusion of the 100 percent evaluation period, resurfacing is evaluated under DC 5250 through DC 5255, for which the schedule sets no minimum evaluation. |
Evidence Needed
- Surgical records documenting the hip replacement
- Evidence connecting the hip condition to military service
- Post-surgical range of motion measurements
- Documentation of gait abnormality or use of assistive devices
- Records of ongoing pain and functional limitations
C&P Exam Tips
- Demonstrate your hip range of motion including flexion, extension, and rotation
- Bring any assistive devices you use such as a cane or walker
- Describe movements you must avoid to prevent dislocation
- Explain how the replacement affects walking, sitting, and climbing stairs
- Mention any leg length discrepancy after surgery
How to File
File under DC 5054 for hip replacement. The 100 percent rating runs for four months and, under Note (5), commences after the initial grant of the one-month total rating assigned under 38 CFR 4.30 following hospital discharge, so it generally ends about five months after discharge rather than a year after surgery. After that period, the minimum rating of 30 percent applies to a total replacement; the schedule sets no minimum evaluation for resurfacing. Document all residual limitations including pain, weakness, and motion restrictions for the best chronic residual rating.
Common Mistakes
- Not filing immediately after surgery to start the 100 percent rating, or expecting it to run a year, when DC 5054 assigns four months commencing after the one-month 38 CFR 4.30 total that follows hospital discharge.
- Minimizing residual symptoms during the follow-up evaluation.
- Not documenting the need for assistive devices.
- Failing to file for secondary conditions in the back and opposite leg.
- Expecting a second 38 CFR 4.71a rating for the same joint: under Note (1) to the prosthetic implants table, when an evaluation is assigned for joint resurfacing or the prosthetic replacement of a joint under DCs 5051 through 5056, an additional rating under 38 CFR 4.71a may not also be assigned for that joint, unless otherwise directed.
Frequently Asked Questions
What is the minimum rating after hip replacement?
The minimum rating for chronic residuals is 30 percent, and under DC 5054 it applies to a total replacement only. The schedule sets no minimum evaluation for hip resurfacing, which is evaluated under DC 5250 through DC 5255 once the 100 percent period ends. Above that minimum, DC 5054 assigns 50 percent for moderately severe residuals of weakness, pain or limitation of motion, 70 percent for markedly severe residuals, and 90 percent where painful motion or weakness requires the use of crutches.
What if my hip replacement wears out and needs revision?
A revision begins a new four-month 100 percent period, but Note (2) evaluates a revision in the same manner as the original procedure only if all the original components are replaced. File for the increased rating as soon as the revision surgery is scheduled or performed.