Hip arthritis claims are tricky because the hip is almost never where the problem started, it is where the problem landed after a bad knee or a stiff back changed how the veteran walks for years. By the time the hip breaks down, the connection back to the original condition is obvious to anyone who watches them move, but it is rarely documented well enough for the VA to follow it
Quick Answer
The VA rates hip arthritis based on limitation of motion in multiple directions, each under its own diagnostic code, with ratings from 10% to 40% depending on the direction and degree of motion lost. Most claims land at 10% because the C&P exam only measures one or two directions while the rest of the hip's limitations go unrated. Hip arthritis is also one of the most common secondary conditions tied to service-connected knee and back disabilities.
How Does the VA Rate Hip Arthritis?
The hip moves in five different directions, and the VA has a separate diagnostic code for almost every one of them. Flexion, which is lifting the leg forward, gets rated under one code. Extension, which is moving the leg backward, gets another. And then there is a third code that covers abduction (moving the leg outward), adduction (crossing the legs), and rotation (toeing out). Each direction has its own thresholds, and each can produce its own percentage.
For most veterans with degenerative hip arthritis, the starting point is 10% under the painful motion rule when X-rays confirm arthritis and there is documented pain with movement. That 10% applies even if the limitation of motion in each direction is not severe enough to meet the compensable thresholds on its own, which is the same floor that applies to every other arthritic joint.
Where hip arthritis gets underrated is that most exams only test flexion, maybe extension, and skip everything else. The inability to cross your legs, the rotation you lost years ago, the abduction that disappeared, those all have rating potential, and if they are not measured, they are not in the file.
Can You Get Separate Ratings for Different Hip Movements?
Yes, and this is the part most veterans don’t know about. The VA can assign separate ratings for flexion and extension if both are significantly limited, and the impairment code covering abduction, adduction, and rotation can produce its own rating on top of those. That means a single hip can carry more than one rating when the file supports it.
Here is how the rating percentages break down by direction of motion:
Flexion (lifting the leg forward)
Extension (moving the leg backward)
Impairment: abduction, adduction, and rotation
If your hip arthritis rating is 10% and the exam only tested how far forward you can lift your leg, there may be additional limitation in other directions that was never measured. Ask your provider to document all directions of motion, including abduction, adduction, and rotation, before your next exam or appeal.
Is Hip Arthritis Secondary to a Knee or Back Condition?
In most of the hip arthritis files we review, the answer is yes. The hip did not break down on its own. A knee injury changed how the veteran walks, the body shifted weight to compensate, and after years of absorbing that uneven load, the hip started to degenerate. Or a back condition altered posture and movement patterns, and the hip absorbed the downstream stress until the cartilage wore through.
The VA recognizes this secondary path, but the claim needs more than just both conditions existing in the record. It needs a provider opinion connecting the two, explaining how the altered movement from the knee or back contributed to the hip breaking down over time. Without that nexus, the VA treats them as separate, unrelated conditions, even when the connection is obvious to anyone watching the veteran walk across a room.
We also see hip arthritis developing secondary to foot and ankle conditions that changed weight distribution, and occasionally secondary to amputations or leg-length discrepancies that created asymmetric loading on the hip joint for years. The connection path matters less than whether it is clearly documented.
If you already have a service-connected knee or back condition and have developed hip pain since, check whether the connection between the two has ever been documented by a provider. In many cases, the altered movement pattern is obvious and well-supported in medical literature, but nobody ever put it in writing. That one missing nexus opinion is often the only thing standing between the hip and a secondary service connection.
What Happens at a C&P Exam for Hip Arthritis?
The C&P exam for hip arthritis is where most of the undercounting happens, because the examiner typically measures flexion, maybe extension, notes pain, and moves on. The full hip and thigh DBQ has fields for every direction of motion, including abduction, adduction, and rotation, but those fields only get filled if the examiner tests them.
On top of the direction-of-motion problem, the exam captures the hip at one point in time. A hip that moves reasonably well after warming up in the morning may be a completely different joint after standing for an hour, walking across a parking lot, or sitting in a car for 30 minutes. If the veteran doesn’t describe that pattern clearly, the examiner documents the warmed-up version and the rating reflects a hip that looks better than it performs in real life.
Where Claims Lose Ground During the Exam
- Only flexion gets measured. If the examiner skips abduction, adduction, rotation, and extension, those directions of motion are not in the file and cannot be rated. Before the exam, ask the examiner to test all hip movements, not just forward flexion.
- Not describing the walking pattern. If your hip has changed how you walk, how you get up from a chair, how you climb stairs, or how long you can stand, that needs to come through during the exam. The examiner should observe you walking and document any abnormality.
- Downplaying the bad days. If flare-ups lock the hip up three times a week and you can barely lift your leg during one, say that with specifics. Frequency, duration, and what you cannot do during a flare are the details that separate a 10% measurement from a file that reflects the real level of impairment.
Before your hip exam, write down which movements give you the most trouble. Not just "bending my leg" but the specific ones: getting in and out of a car (that is flexion and rotation), crossing your legs (adduction), stepping sideways (abduction), turning your foot outward (rotation). Those specifics tell the examiner which directions to test, and each one can contribute to the overall rating.
What Is the VA Rating After a Hip Replacement?
If hip arthritis progresses to the point where a total hip replacement is needed, the VA rating changes significantly. For one year following the surgery, the VA assigns a temporary 100% rating. After that year, the minimum permanent rating is 30%, even if the replacement went perfectly and you have no residual pain.
If there are residual symptoms after the replacement, the rating can go higher. Moderately severe residual weakness, pain, or limited motion supports 50%. Severely limiting residuals that require crutches or assistive devices support 70%. And significant painful motion or weakness with markedly limited function can support up to 90%.
One thing to keep in mind: while you are rated at 100% during that first year, the VA will schedule a follow-up exam to determine the permanent rating. That exam matters just as much as the original one, because it determines what you live with long-term. If the replacement still leaves you with pain, limited motion, or instability, all of that needs to be clearly documented at that follow-up.
Can Both Hips Be Rated Separately?
Yes. Each hip is rated independently based on its own findings, and when both are service-connected, the VA applies the bilateral factor. That adds 10% to the combined value of both hip ratings before calculating the total disability percentage. It is automatic when bilateral involvement is documented, but if the record does not clearly show both hips are affected, it can be missed.
We see bilateral hip arthritis often in veterans who had physically demanding roles, airborne operations, years of rucking, or prolonged exposure to vehicle vibration. We also see it when one hip breaks down secondary to a knee or back condition, and the other hip follows because it was absorbing the compensating load from the first hip. In that case, the second hip may be claimable as secondary to the first hip or to the original knee or back condition.
What Other Conditions Can Hip Arthritis Cause?
Hip arthritis does the same thing to the rest of the body that the knee or back did to the hip. It changes how you move, and over time that changed movement breaks down other joints and structures. We see the same cascade play out in file after file.
Radiculopathy
Compressed nerves in the lumbar spine get rated per leg, mild to severe. The most common and usually the highest-value secondary condition in back arthritis claims.
Learn more →Sciatica
Shooting pain from the lower back into the buttock and leg. Should not be buried inside the back rating. Each leg carries its own percentage.
Learn more →Depression
Chronic back pain grinds people down. When the decline in mental health tracks with the progression of the back condition, that is a claimable connection.
Learn more →GERD
Years of ibuprofen and naproxen for back pain tear up the stomach. If you have been on NSAIDs since active duty and have GI problems in the record, the medication trail is already there.
Learn more →Sleep Apnea
Spinal conditions that affect posture and positioning during sleep have a documented connection to obstructive sleep apnea. Not the most straightforward link, but when supported it adds to the combined picture.
Learn more →Hip Conditions
A stiff, arthritic back changes how you walk, and your hips absorb that change for years. If the hip problem came after the back problem and a provider connects the two, that secondary path is there.
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Example:
A veteran has a service-connected knee rated at 20%. The knee changed how they walk, and over the next decade, the right hip developed degenerative arthritis. The left hip started hurting a few years later from compensating for the right. Now there is back pain from the altered posture, reflux from a decade of ibuprofen, and depression from not being able to move the way they used to. The knee started it all, but none of the downstream conditions were ever filed. Each one has its own rating potential, and the combined picture looks very different from a single 20% knee rating.
What to Check Before Filing a Hip Arthritis VA Claim
Before filing, look at the file the way a rater will.
- Does the exam measure all directions of hip motion, or only flexion?
- If the hip is secondary to a knee or back condition, is there a provider opinion connecting the two?
- Are flare-ups documented with frequency, duration, and how they limit your movement?
- If both hips are affected, does the record clearly show bilateral involvement?
- If you had a hip replacement, does the follow-up exam reflect your residual limitations?
- Are secondary conditions from the hip, like back pain, opposite hip problems, or GERD from NSAIDs, documented and connected?
Most back arthritis claims that stay at 10% or 20% are not missing the diagnosis. They are missing the other rating paths that were never evaluated and the secondary conditions that were never filed.
How VetClaims Helps With Hip Arthritis Claims
We look at your file the same way a rater would, but before the rating happens. For hip arthritis claims, that means checking whether the exam captured all directions of motion, whether the secondary connection to the knee or back is clearly documented, whether both hips are accounted for, and whether the conditions the hip is causing downstream were ever filed.
Most veterans who come to us with a hip arthritis rating already have the diagnosis and a percentage. The question is whether that percentage reflects the full picture or just the one direction of motion the examiner happened to measure. We help you see where the file falls short and what it would take to close those gaps before filing or appealing.
FAQs About Hip Arthritis VA Ratings
What is the VA disability rating for hip arthritis?
Most hip arthritis claims land at 10% under the painful motion rule. Higher ratings depend on documented limitation in specific directions of motion, with flexion ratings going up to 40% and impairment ratings for abduction, adduction, and rotation adding on top of that. Each direction is rated under its own code.
Can hip arthritis be secondary to a knee condition?
Yes. This is one of the most common secondary connections we see. A service-connected knee injury that changed how the veteran walks can cause the hip to degenerate over time from absorbing the altered load. The claim needs a provider opinion documenting that connection.
Can hip arthritis be secondary to a back condition?
Yes. Back conditions that alter posture, pelvic tilt, or movement patterns can put abnormal stress on the hip joint. The same secondary connection path applies: a provider opinion tying the hip degeneration to the altered movement from the back.
Can I get more than 10% for hip arthritis?
Yes. The path is usually through documented limitation in specific directions of motion that hit compensable thresholds, through separate ratings for different directions of motion in the same hip, or through secondary conditions that the hip is producing in other parts of the body.
What is the VA rating after hip replacement?
A temporary 100% for one year following surgery, then a minimum 30% permanent rating. Residual pain, weakness, or limited motion can push that permanent rating to 50%, 70%, or up to 90% depending on severity.
Can both hips be rated?
Yes. Each hip is rated independently, and when both are service-connected, the VA applies the bilateral factor, which adds 10% to the combined value of both hip ratings before calculating the total disability percentage.
Is hip arthritis a presumptive condition?
Degenerative arthritis is classified as a chronic disease. If it developed to a compensable level within one year of discharge, the presumption of service connection applies. Most hip arthritis claims, however, are filed years later as secondary to another service-connected condition.