Tibia and Fibula Impairment VA Disability Rating
Diagnostic Code 5262 · 38 CFR §4.71a
What Is It?
This code covers impairment of the tibia (shinbone) and fibula (the smaller bone running alongside it), including nonunion, malunion, and medial tibial stress syndrome (shin splints). The revised criteria now rate malunion based on the resulting knee or ankle disability under those specific diagnostic codes rather than the old slight/moderate/marked scale. A significant addition is the inclusion of MTSS (shin splints) with its own rating criteria based on treatment duration and responsiveness to conservative care and surgery. Nonunion with loose motion requiring a brace remains rated at 40 percent.
Rating Criteria
| Rating | Criteria |
|---|---|
| 40% | Nonunion of the tibia or fibula with loose motion requiring a brace. Malunion of the tibia or fibula is now rated under the knee or ankle diagnostic codes (5256, 5257, 5260, 5261 for the knee, or 5270, 5271 for the ankle), whichever provides the highest evaluation. |
| 30% | Medial tibial stress syndrome (shin splints) requiring treatment for 12 or more consecutive months and unresponsive to surgery and either shoe orthotics or other conservative treatment, both lower extremities. |
| 20% | Medial tibial stress syndrome (shin splints) requiring treatment for 12 or more consecutive months and unresponsive to surgery and either shoe orthotics or other conservative treatment, one lower extremity. |
| 10% | Medial tibial stress syndrome (shin splints) requiring treatment for 12 or more consecutive months and unresponsive to either shoe orthotics or other conservative treatment, one or both lower extremities. |
| 0% | Medial tibial stress syndrome (shin splints) with treatment for less than 12 consecutive months, one or both lower extremities. |
Evidence Needed
- Imaging showing the malunion or nonunion of the bone
- Range of motion measurements for both the knee and ankle on the affected side
- Documentation of any leg length discrepancy
- Records of braces or assistive devices prescribed
- Functional assessment describing weight-bearing ability and gait
C&P Exam Tips
- Bring current imaging showing the bone alignment
- Make sure both the knee and ankle are examined since tibia problems affect both joints
- Report any instability or loose motion in the leg
- Describe your weight-bearing tolerance and maximum walking distance
- Mention if you use a brace and how dependent you are on it
How to File
File under DC 5262 with imaging evidence of the bone impairment and functional assessments of both the knee and ankle. If the malunion has caused secondary arthritis in either joint, file those as separate secondary conditions.
Common Mistakes
Not having both the knee and ankle evaluated when the tibia connects to both Failing to document whether the condition is malunion or nonunion, which significantly affects the rating approach Not documenting brace use for nonunion cases, since the 40 percent rating requires evidence of a brace For shin splints claims, not having 12 consecutive months of documented treatment, which is required for a compensable rating Not understanding that malunion is now rated under the knee or ankle codes rather than the old slight/moderate/marked scale
Frequently Asked Questions
How is malunion of the tibia or fibula rated now?
Malunion is no longer rated on the old slight, moderate, or marked scale. Instead, the VA evaluates the resulting knee disability under diagnostic codes 5256, 5257, 5260, or 5261, or the resulting ankle disability under codes 5270 or 5271, and assigns whichever provides the highest evaluation. This means your knee and ankle function are assessed using those specific criteria.
Can I get a rating for shin splints under DC 5262?
Yes, medial tibial stress syndrome (shin splints) is now specifically included in DC 5262. To receive a compensable rating, you need documented treatment for at least 12 consecutive months showing the condition was unresponsive to shoe orthotics or other conservative treatment. Higher ratings require unresponsiveness to surgery as well.