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C&P Exam Prep: Thigh, Impairment of (Limitation of Abduction, Adduction, or Rotation)
DBQ Overview
Interview + Physical- Form Name
- Hip_and_Thigh
- Form Code
- Hip_and_Thigh
- Page Count
- 13
- Examiner Type
- Physician or Physician Assistant
- Estimated Duration
- 30-45 minutes
- Exam Format
- Interview + Physical
What to Expect During Your Exam
Exam Overview
To document the current severity of thigh impairment affecting abduction, adduction, or rotation of the hip joint, establish how these limitations functionally impair the veteran, and assign an accurate disability rating under 38 CFR 4.71a DC 5253.
What the examiner evaluates:
- Active and passive range of motion for hip abduction, adduction, internal rotation, and external rotation
- Whether pain occurs on active motion, passive motion, at rest, or with weight-bearing versus non-weight-bearing
- Functional loss due to pain, weakness, fatigability, and incoordination (DeLuca factors)
- Whether limitation worsens after repetitive use or during flare-ups
- Objective findings such as muscle atrophy, deformity, swelling, or instability
- Gait disturbance, interference with standing, sitting, and locomotion
- Use of assistive devices such as canes, crutches, walker, brace, or wheelchair
- Leg length discrepancy
- History of surgery including hip replacement, resurfacing, arthroscopy, or fracture repair
- Diagnosis type (osteoarthritis, post-traumatic arthritis, avascular necrosis, bursitis, tendinopathy, heterotopic ossification, etc.)
- Whether the condition affects ability to perform occupational or daily activities
The exam is most commonly conducted in person at a VA facility or contractor clinic. In some cases, telehealth or records-based review may occur. You have the right to ask how the exam will be conducted in advance. Bring all relevant medical records, imaging reports, and a written summary of your symptoms to ensure accuracy.
Typical duration: 30-45 minutes
Hip Abduction (Active and Passive)
The degree to which you can move your leg outward away from the midline of your body. Normal abduction is approximately 45-50 degrees.
What to expect:
You will likely be asked to lie on your back or stand while the examiner moves your leg outward and measures the angle with a goniometer. Both active (you move) and passive (examiner moves) measurements will be taken. Weight-bearing and non-weight-bearing positions may both be tested per Correia requirements.
Key thresholds:
- Motion lost beyond 10 degrees (abduction less than approximately 35-40 degrees) — 20% rating under DC 5253 for limitation of abduction
Tips:
- Move only as far as you can without pushing through significant pain - do not over-perform
- Inform the examiner immediately when pain begins during the movement, not just at the endpoint
- If your motion varies day to day, tell the examiner this represents a good day versus your typical or worst day
- Ensure both weight-bearing and non-weight-bearing positions are tested if applicable to your condition
- If abduction is worse after walking or prolonged activity, say so explicitly
Pain considerations: Pain during abduction can limit functional motion beyond what the goniometer captures at endpoint. Tell the examiner specifically where the pain is (groin, lateral hip, thigh), its intensity on a 0-10 scale, and whether it stops you from completing the movement. Under DeLuca v. Brown, the examiner must document whether pain causes additional functional loss beyond the measured ROM.
Hip Adduction (Active and Passive)
The degree to which you can move your leg inward across the midline of your body. Normal adduction is approximately 20-30 degrees. For DC 5253 purposes, the key functional benchmark is whether you can cross your legs.
What to expect:
The examiner will ask you to move your leg toward and across the midline, or may ask directly whether you can cross your legs. Both active and passive ranges will be documented. The examiner will note whether crossing legs is possible.
Key thresholds:
- Cannot cross legs (adduction functionally absent or severely limited) — 10% rating under DC 5253 for limitation of adduction
Tips:
- Demonstrate adduction truthfully - if crossing legs causes pain or is impossible, say so clearly
- Describe any compensatory movements you use (leaning the body, using your hand to lift the leg)
- Mention if adduction limitation affects daily activities like getting into a car, sitting cross-legged, or putting on shoes
- If adduction worsens with hip swelling or inflammation, describe flare-related changes
Pain considerations: Pain with adduction is frequently felt in the groin, inner thigh, or hip. Communicate whether the pain is sharp, aching, or burning, and whether it radiates. Note that pain limiting you from completing the crossing of your legs is functionally equivalent to an adduction deficit even if end-range passive motion shows some movement.
Hip Internal and External Rotation (Active and Passive)
Internal rotation measures the inward turn of the hip; external rotation measures the outward turn. Normal internal rotation is approximately 35-45 degrees; normal external rotation is approximately 45-60 degrees. For DC 5253, the key benchmark for rotation is whether you can toe-out more than 15 degrees with the affected leg.
What to expect:
You will likely be seated or supine. The examiner bends your knee to 90 degrees and rotates the lower leg as a lever to measure hip rotation. Both active and passive measurements will be taken. The examiner may also observe your gait and foot position while walking.
Key thresholds:
- Cannot toe-out more than 15 degrees with the affected leg — 10% rating under DC 5253 for limitation of rotation
Tips:
- If you have pain or stiffness with rotation, describe whether it is present at the start of movement or only near the endpoint
- Mention if rotation is worse in the morning, after sitting for prolonged periods, or after physical activity
- If your gait is affected (e.g., you walk with the foot turned inward or outward to compensate), describe this to the examiner
- Bring up whether rotation limitation makes tasks like driving, climbing stairs, or pivoting difficult
Pain considerations: Rotation limitation is often accompanied by pain deep in the hip joint or posterior hip region. If internal rotation is particularly painful and limited, this may indicate underlying pathology (e.g., avascular necrosis, FAI, osteoarthritis) that should be documented. Communicate pain with rotation at all points in the arc of motion.
Hip Flexion and Extension (Active and Passive, Supplemental)
Flexion and extension of the hip are separately rated under DC 5252 (flexion) and DC 5251 (extension), but the examiner will measure all hip motions during this exam. Normal flexion is 0-125 degrees; normal extension is 0-30 degrees.
What to expect:
The examiner will also document flexion (bending the knee toward the chest) and extension (moving the leg behind the body). These measurements feed into additional rating considerations and may support a higher overall combined evaluation.
Key thresholds:
- Flexion limited to 45 degrees — 10% under DC 5252 (separate from DC 5253)
- Extension limited to 0 degrees — 10% under DC 5251 (separate from DC 5253)
Tips:
- All hip motions are evaluated on the same DBQ, so accurately report limitations in all planes of motion
- Flexion and extension limitations may be rated separately from and in addition to abduction/adduction/rotation limitations
- Ensure the examiner tests both the affected and unaffected side for comparison
Pain considerations: Document pain with flexion (common during activities like sitting, stair climbing, putting on footwear) and with extension (common during standing, walking, sleeping on stomach). Flare-related worsening of all hip motions should be described.
Repetitive Use Testing (DeLuca Factors)
Whether repeated use of the hip over a period of time results in additional limitation of motion or functional loss beyond the initial measurement. Under DeLuca v. Brown, examiners must address pain, weakness, fatigability, and incoordination with repeated use.
What to expect:
The examiner may ask you to perform repeated movements and then re-measure ROM. More commonly, the examiner will ask you to describe how your hip performs after prolonged use and whether ROM changes throughout the day. The examiner must document this even if formal repetitive testing is not performed.
Key thresholds:
- Additional functional loss after repetitive use that brings ROM to a lower rating threshold — Can push rating to next higher level under DeLuca
Tips:
- Explicitly tell the examiner: 'After walking for 10 minutes, my abduction worsens and I can no longer move my leg as far outward'
- Describe morning stiffness, end-of-day worsening, and post-activity pain increases
- Use specific examples: 'After grocery shopping, I limp noticeably and cannot rotate my hip to turn around'
- Ask the examiner directly if they have documented your description of worsening with use
Pain considerations: Fatigue-related functional loss is a legitimate component of your rating. Describe how your hip feels after a full workday, after climbing stairs, or after household activities. Fatigue of the hip abductors (gluteus medius) is particularly relevant for abduction limitation.
Flare-Up Assessment
The frequency, duration, and severity of flare-ups and how they worsen hip abduction, adduction, and rotation beyond baseline measurements taken on the day of the exam.
What to expect:
The examiner will ask whether you experience flare-ups. You must be prepared to describe them in detail. The examiner must document your self-report of flare-up severity and its effect on ROM and function, per M21-1 and Mitchell v. Shinseki.
Key thresholds:
- Flare-up ROM that crosses a rating threshold (e.g., abduction lost beyond 10 degrees during flare) — Examiner must consider flare-up severity in rating assessment
Tips:
- Prepare a written description of your worst flare-up to bring to the exam
- Include: triggers, duration, frequency (e.g., 2-3 times per week), what motions are affected, pain level (0-10), and what you cannot do during a flare
- State clearly: 'During a flare, I cannot abduct my hip past X degrees and I cannot walk without a cane'
- Ask the examiner to document your flare-up description in the DBQ
Pain considerations: Flare-up pain is often significantly worse than baseline. Be specific about what precipitates flares (weather changes, overactivity, prolonged standing), how long they last, and what level of activity you can perform during a flare versus on a baseline day.
Rating Criteria Breakdown
| Rating % | Criteria | Key Symptoms |
|---|---|---|
| 20% | Limitation of abduction of the thigh where motion is lost beyond 10 degrees. This means abduction is restricted to less than approximately 35-40 degrees from neutral (less than the first 10 degrees of abduction beyond normal neutral starting position lost, but actually abduction restricted such that more than 10 degrees of the normal arc is lost). Under 38 CFR 4.71a DC 5253, a 20% rating applies when abduction motion loss exceeds 10 degrees. |
CFR: 38 CFR 4.71a DC 5253: 'Limitation of abduction of [thigh], motion lost beyond 10 degrees - 20 percent' |
| 10% | Either (1) limitation of adduction where the veteran cannot cross their legs, OR (2) limitation of rotation where the veteran cannot toe-out more than 15 degrees with the affected leg. Each of these criteria independently warrants a 10% rating. Note: Under 38 CFR 4.68, the same disability cannot be rated twice, but if both adduction and rotation are limited and both would independently rate 10%, VA must avoid pyramiding by applying the higher or most appropriate single evaluation unless they are distinct disabilities. |
CFR: 38 CFR 4.71a DC 5253: 'Limitation of adduction of [thigh], cannot cross legs - 10 percent'; 'Limitation of rotation of [thigh], cannot toe-out more than 15 degrees, affected leg - 10 percent' |
| 0% | Thigh impairment present but abduction motion lost is 10 degrees or less, adduction allows crossing of legs, and rotation allows toe-out beyond 15 degrees. A 0% rating may be assigned where the condition is diagnosed and service-connected but does not meet the minimum criteria for a compensable rating. Veterans should still document all symptoms as functional loss under DeLuca factors may support a higher evaluation. |
CFR: No explicit 0% criteria defined in DC 5253; 0% applies when criteria for 10% or 20% are not met but a diagnosis exists. |
20% Limitation of abduction of the thigh where motion is lost be ...
Limitation of abduction of the thigh where motion is lost beyond 10 degrees. This means abduction is restricted to less than approximately 35-40 degrees from neutral (less than the first 10 degrees of abduction beyond normal neutral starting position lost, but actually abduction restricted such that more than 10 degrees of the normal arc is lost). Under 38 CFR 4.71a DC 5253, a 20% rating applies when abduction motion loss exceeds 10 degrees.
Key Symptoms
- Inability to move leg outward beyond a restricted range
- Pain with lateral hip movement
- Trendelenburg gait or hip drop when walking
- Difficulty with activities requiring leg spread (getting out of a car, mounting stairs sideways)
- Weakness of hip abductor muscles (gluteus medius and minimus)
- Possible leg length discrepancy contributing to abduction limitation
CFR: 38 CFR 4.71a DC 5253: 'Limitation of abduction of [thigh], motion lost beyond 10 degrees - 20 percent'
10% Either (1) limitation of adduction where the veteran cannot ...
Either (1) limitation of adduction where the veteran cannot cross their legs, OR (2) limitation of rotation where the veteran cannot toe-out more than 15 degrees with the affected leg. Each of these criteria independently warrants a 10% rating. Note: Under 38 CFR 4.68, the same disability cannot be rated twice, but if both adduction and rotation are limited and both would independently rate 10%, VA must avoid pyramiding by applying the higher or most appropriate single evaluation unless they are distinct disabilities.
Key Symptoms
- Inability to cross legs when seated
- Restricted inward movement of the thigh across midline
- Inability to toe-out with the affected leg beyond 15 degrees
- Altered gait with in-toeing or restricted pivot
- Pain with internal or external rotation
- Difficulty with activities such as putting on shoes and socks, pivoting, or driving
- Groin or deep hip pain with rotation or adduction
CFR: 38 CFR 4.71a DC 5253: 'Limitation of adduction of [thigh], cannot cross legs - 10 percent'; 'Limitation of rotation of [thigh], cannot toe-out more than 15 degrees, affected leg - 10 percent'
0% Thigh impairment present but abduction motion lost is 10 deg ...
Thigh impairment present but abduction motion lost is 10 degrees or less, adduction allows crossing of legs, and rotation allows toe-out beyond 15 degrees. A 0% rating may be assigned where the condition is diagnosed and service-connected but does not meet the minimum criteria for a compensable rating. Veterans should still document all symptoms as functional loss under DeLuca factors may support a higher evaluation.
Key Symptoms
- Mild pain with hip motion
- Slight stiffness without significant functional loss
- Condition diagnosed but minimally symptomatic on exam day
CFR: No explicit 0% criteria defined in DC 5253; 0% applies when criteria for 10% or 20% are not met but a diagnosis exists.
How to Describe Your Symptoms
Pain During Hip Abduction
How to describe:
Describe the location (lateral hip, groin, outer thigh), quality (sharp, stabbing, deep ache), intensity (0-10 scale), and what triggers the pain. Be specific about whether pain occurs at the start of movement, mid-arc, or at end range. Distinguish resting pain from movement-triggered pain.
Worst-day example:
“On my worst days, attempting to move my right leg outward causes an immediate sharp pain (8/10) along my outer hip that stops me from moving beyond about 20 degrees. I cannot step over objects or get out of a car without significant pain. After walking for more than 5 minutes, the pain intensifies to the point where I have to stop and rest.”
What the examiner listens for:
Specific degrees of movement before pain onset, whether pain limits motion before structural end-range is reached, consistency of symptom description, and correlation between reported pain and observable guarding or movement hesitation during examination.
Understatements to avoid:
Saying 'it hurts a little when I move it' without specifying how much the pain restricts movement. Saying 'I manage' or 'I push through it' which suggests the limitation is not functionally significant. Failing to mention that pain onset occurs early in the arc of motion, not just at the endpoint.
Inability to Cross Legs (Adduction Limitation)
How to describe:
Directly state whether you can or cannot cross your legs. If you can attempt it but cannot complete it, describe how far you get and what stops you (pain, mechanical block, weakness). Describe which daily activities are affected: putting on socks/shoes, sitting in certain chairs, getting into vehicles, sexual activity.
Worst-day example:
“I cannot cross my right leg over my left leg at all. When I try, I feel a stabbing pain deep in my hip and groin at about 15 degrees of adduction that stops me completely. I have to bend forward and use my hands to lift my leg to put on my socks every morning. I cannot sit in bucket seats or cross-legged positions.”
What the examiner listens for:
Clear statement of inability to cross legs, functional consequences in activities of daily living, whether the limitation is pain-mediated or structural, and whether adduction is consistently limited rather than variable.
Understatements to avoid:
Saying 'it's uncomfortable to cross my legs' rather than 'I cannot cross my legs.' Attempting to demonstrate crossing your legs during the exam in a way that suggests you can complete the movement. Failing to describe the daily-life consequences of not being able to adduct adequately.
Rotation Limitation and Toe-Out Restriction
How to describe:
Explain whether your foot naturally turns outward and whether you can intentionally increase that outward toe position with the affected leg. Describe if you walk with a specific foot position to compensate for pain. Mention activities affected: pivoting, turning, driving, twisting to reach objects.
Worst-day example:
“With my left leg, I cannot turn my foot outward (toe-out) more than about 10 degrees without a deep, grinding pain inside the hip joint. When I try to pivot or turn while standing, the pain is sharp enough to make me grab onto something for support. I've adjusted my walking so my foot points straight ahead to avoid the pain, but this causes me to trip more often.”
What the examiner listens for:
Objective limitation in ability to externally rotate the hip to achieve toe-out beyond 15 degrees, presence of crepitus or pain on rotation testing, description of gait adaptations, and whether compensatory movements create secondary problems.
Understatements to avoid:
Failing to specify which direction of rotation is limited (internal versus external). Not mentioning that your gait has changed because of the rotation limitation. Underreporting the impact on activities that require pivoting, such as driving, climbing stairs, or recreational activities.
Fatigue and Weakness of Hip Muscles
How to describe:
Describe how quickly your hip muscles tire during activity, whether your leg gives out or buckles, and how long you can walk or stand before the hip becomes too fatigued to continue. Distinguish between pain-limited endurance and true muscle weakness.
Worst-day example:
“After walking for about two blocks, the muscles on the outside of my hip completely fatigue and I develop a noticeable limp. My hip feels like it 'gives way' when stepping off a curb. By the end of a 4-hour work shift on my feet, I cannot move my leg outward at all without severe weakness and pain.”
What the examiner listens for:
Trendelenburg sign on examination (hip drop during single-leg stance), documented hip abductor muscle weakness, and correlation between reported fatigability and observable gait abnormality or muscle testing results.
Understatements to avoid:
Describing only pain without describing weakness or fatigue, which are separately evaluated DeLuca factors. Saying 'I get tired' without connecting it specifically to the hip musculature and its effect on abduction, adduction, or rotation function.
Flare-Ups
How to describe:
Describe the frequency (how many times per week or month), duration (hours or days), severity during flares (what you cannot do), and triggers (weather, activity, prolonged sitting or standing). Explain how your ROM and function during a flare compares to your baseline day and your worst day.
Worst-day example:
“I have flare-ups about 3-4 times per week, lasting 1-2 days each. During a flare, my hip abduction is almost zero - I cannot step sideways at all and walk only with a pronounced limp. The pain increases to 9/10 and I need my cane constantly. I cannot dress myself, drive, or stand for more than a few minutes. My worst flare this past month lasted 3 days and required me to stay in bed most of the first day.”
What the examiner listens for:
Specific, consistent description of flare-up frequency and functional impact, whether flare severity would push ROM measurements to a higher rating threshold, and whether the veteran is being examined on a baseline versus flare day.
Understatements to avoid:
Saying 'I have flare-ups sometimes' without providing frequency and duration. Failing to tell the examiner explicitly that today may be a relatively good day and your typical or worst-day function is significantly worse. Not requesting that the examiner document the flare-up description in the DBQ.
Functional Impact on Daily Life and Work
How to describe:
Provide specific, concrete examples of activities you can no longer perform or perform with difficulty due to the hip impairment. Connect the limitation in abduction, adduction, or rotation to specific tasks. Include occupational impact.
Worst-day example:
“Because I cannot abduct my hip adequately, I cannot get in and out of a standard vehicle without using my arms to lift my leg. I stopped attending my child's sports events because I cannot walk on uneven ground. At work, I can no longer perform warehouse duties that require lateral movement. I have had to request accommodations and have missed approximately 6 days of work in the past 3 months due to flare-ups.”
What the examiner listens for:
Specific activities affected, consistency between reported limitations and clinical findings, evidence of occupational impact, and whether assistive devices or home modifications have been required.
Understatements to avoid:
Providing only vague statements like 'it affects my life' without specific examples. Failing to connect the hip's abduction, adduction, and rotation limitations to their concrete functional consequences. Not mentioning missed work, activity modifications, or home adaptations.
Common Mistakes to Avoid
Over-performing range of motion during the examination
Adrenaline, exam anxiety, and the desire to appear cooperative can cause veterans to push through pain and demonstrate greater ROM than they actually have in daily life. This results in measured ROM that does not reflect true functional capacity.
Instead: Move your hip only as far as you can comfortably and accurately. Stop when you feel significant pain. Tell the examiner 'this is where I experience pain' rather than pushing to the endpoint. The examiner should document the pain endpoint separately from the mechanical end-range.
Impact: Can prevent reaching 20% for abduction or 10% for adduction/rotation if measured angles appear normal.
Failing to describe flare-up severity and its effect on ROM
Many veterans report only their current, stable baseline symptoms without explaining that flare-ups result in significantly worse ROM. The rating is supposed to reflect the average impairment over time, including flare-up periods.
Instead: Explicitly tell the examiner: 'Today is a relatively good day. During my typical flare-ups, my abduction is reduced to approximately X degrees and I cannot walk without a cane.' Ask the examiner to document this statement in the DBQ.
Impact: Can result in 0% or 10% when flare-up severity would support 10% or 20%.
Not mentioning all three motion limitations (abduction, adduction, rotation)
DC 5253 covers three separate types of motion limitation. Veterans often focus on one primary complaint and forget to describe limitations in all three planes. Each can be independently evaluated.
Instead: Before your exam, note whether you have limitation in (1) moving your leg outward (abduction), (2) crossing your legs (adduction), and (3) turning your foot outward (external rotation) or inward (internal rotation). Report each limitation separately.
Impact: Missing adduction or rotation limitations can result in a 10% loss of rating for each omitted criterion.
Omitting DeLuca factors: weakness, fatigability, and incoordination
DC 5253 ratings are based on ROM measurements, but additional functional loss due to pain, weakness, fatigability, and incoordination must also be documented under DeLuca v. Brown. Failing to report these factors leaves rating-relevant information out of the DBQ.
Instead: Describe each DeLuca factor specifically: 'My hip abductors fatigue after walking two blocks (fatigability). I have lost hip abductor strength and my leg buckles (weakness). My hip catches and gives way on uneven ground (incoordination). All of these worsen after repeated use.'
Impact: Omitting DeLuca factors may prevent the examiner from recommending a higher rating where baseline ROM measurements are borderline.
Not informing the examiner that today is a good day compared to typical function
C&P exams often occur on days when the veteran has rested, taken medication, or is less symptomatic than usual. The examiner measures what they observe. If the veteran does not clarify that today is atypical, the rating will be based on an unrepresentative snapshot.
Instead: At the start of the exam, state: 'I want to note that today is not a typical day for me. On an average day/my worst days, my symptoms are [describe]. I may be performing better than usual today.' Document this in writing and hand it to the examiner.
Impact: Can affect all rating levels, particularly where borderline measurements appear close to a threshold.
Failing to disclose assistive device use
Use of a cane, brace, or other assistive device is documented on the DBQ and supports a finding of greater functional impairment. Many veterans leave their cane at home or do not mention they use one because they feel embarrassed or believe the exam is only about range of motion.
Instead: Bring any assistive devices you use to the exam. If you use a cane intermittently (especially during flares or after prolonged activity), say so. If your doctor prescribed a cane or brace, bring documentation.
Impact: Failure to disclose can undermine evidence of functional impairment at any rating level.
Not connecting hip symptoms to a specific service-related event or diagnosis
The DBQ asks the examiner to document the history of the condition and any nexus to military service. If the veteran cannot articulate when the condition began, how it relates to service activities, or what diagnosis has been given, the examiner may document an incomplete history.
Instead: Prepare a written timeline: when symptoms first appeared, what service activities may have caused or aggravated them, when you first sought treatment, what diagnoses you have received, and what the current treatment plan is. Bring this to the exam.
Impact: Insufficient nexus documentation affects the claim overall, not just a specific rating level.
Prep Checklist
Before Your Exam
Day Of
During the Exam
After the Exam
Your Rights During a C&P Exam
- You have the right to be examined in person by a qualified physician or physician assistant. If your exam is conducted via telehealth or records review only, you may challenge the adequacy of the examination.
- You have the right to record your C&P examination in most states. Check your state's recording laws before the exam and inform the examiner if you intend to record.
- You have the right to submit written statements, medical records, and lay evidence before or after your C&P examination. This evidence must be considered by the rater.
- You have the right to request a copy of the completed DBQ and all examination findings. Review the document carefully for accuracy.
- Under Correia v. McDonald (28 Vet.App. 158, 2016), you have the right to have active range of motion, passive range of motion, and both weight-bearing and non-weight-bearing testing performed if clinically indicated for your condition.
- Under DeLuca v. Brown (8 Vet.App. 202, 1995), the examiner must address whether pain, weakness, fatigability, or incoordination causes additional functional loss beyond the measured ROM. An examination that fails to address these factors may be legally inadequate.
- Under Mitchell v. Shinseki (25 Vet.App. 32, 2011), the examiner must document your self-reported description of flare-up severity and functional impact, even if a flare cannot be directly observed during the examination.
- You have the right to bring a representative, family member, or VSO to your C&P examination. Check the specific VA or contractor clinic policy in advance.
- You have the right to challenge an inadequate examination and request a new or supplemental examination. Contact your VSO, Regional Office, or an accredited claims agent or attorney if you believe your examination was inadequate.
- You have the right to be treated with dignity and respect during the examination. If the examiner is dismissive, rushes the exam, or refuses to document your reported symptoms, you may file a complaint with the VA or the contracting company (QTC, LHI, VES).
- You have the right to submit a Lay Statement (VA Form 21-10210) or a buddy statement to support your claim. These statements can describe your functional limitations, flare-ups, and daily impact in your own words.
- You are not required to exaggerate or fabricate symptoms. Accurately and completely describing your actual condition and its functional impact is sufficient - and is your right.
Related Conditions
- Thigh, Limitation of Flexion of Rated under DC 5252, this condition addresses hip flexion limitation and is evaluated on the same Hip and Thigh DBQ. Many veterans have concurrent limitations in flexion and in abduction/adduction/rotation. Each is rated separately under its respective DC, and combined ratings apply. Ensure flexion is fully documented during the same exam.
- Hip, Limitation of Extension of Rated under DC 5251, extension limitation of the hip is evaluated on the same DBQ. Extension limited to 0 degrees rates at 10%. Veterans with DC 5253 impairment frequently also have extension limitations that should be independently documented and rated.
- Hip, Ankylosis of If hip motion is completely lost (ankylosis), DC 5250 applies and provides higher rating criteria than DC 5253. If the hip is fused in a favorable position (20 40 degrees of flexion), a 60% rating applies; unfavorable ankylosis rates at 90%. Veterans with severe DC 5253 limitation approaching ankylosis should ensure the examiner considers whether DC 5250 applies.
- Hip Joint Replacement (Total or Resurfacing) Veterans who have undergone total hip replacement are rated under DC 5054 with a minimum 100% rating for one year post surgery, followed by evaluation based on residuals. If a veteran with DC 5253 has since had hip replacement, DC 5054 may provide a higher evaluation. The same DBQ covers both original and replacement hip conditions.
- Osteoarthritis of the Hip Osteoarthritis is a common underlying diagnosis causing DC 5253 impairment. It may be rated under DC 5003 (degenerative arthritis) if ROM limitation does not meet specific DC criteria, or under the applicable motion DC (5251, 5252, 5253) when ROM criteria are met. Ensure the examiner documents the diagnosis and uses the most favorable applicable DC.
- Avascular Necrosis of the Hip Avascular necrosis (AVN) of the femoral head is a serious underlying pathology that often causes severe limitation of abduction, adduction, and rotation. AVN may be rated under the motion DCs (5251, 5252, 5253) or under DC 5255 (femur, impairment of) or analogous codes depending on severity. Ensure AVN is documented as a separate diagnosis if present.
- Trochanteric Bursitis / Trochanteric Pain Syndrome Trochanteric bursitis causes lateral hip pain that limits abduction and may be rated under DC 5252, 5253, or DC 5019 (bursitis). If separately diagnosable and causing additional functional loss, it may support a supplemental rating. Ensure the examiner documents all separately diagnosed conditions on the DBQ.
- Sciatic Nerve Condition / Radiculopathy Hip conditions rated under DC 5253 may cause or be associated with secondary sciatic nerve involvement or radiculopathy. If you experience radiating pain, numbness, or tingling into the thigh or leg, this may represent a separately ratable neurological condition under DC 8520 or related codes. Ensure the examiner documents any neurological symptoms.
- Leg Length Discrepancy Leg length discrepancy is evaluated on the same DBQ and can result from hip pathology or surgery. It is separately rated under DC 5275 (shortening of the lower extremity) depending on the degree of shortening. Ensure discrepancy is measured in centimeters and documented if present.
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This C&P exam preparation guide is for educational purposes only and does not constitute legal, medical, or claims advice. Always consult with a qualified Veterans Service Organization (VSO) representative or VA-accredited attorney for guidance specific to your claim. Never exaggerate, minimize, or fabricate symptoms during a C&P examination.