How the VA rates plantar fasciitis and flat feet
Feet carry the service, and the service shows up in the feet. Plantar fasciitis only got its own diagnostic code in 2021; before that it was rated by analogy to whatever seemed closest. Flat feet have had a code for decades, with tiers that turn on words like "pronounced." Here is what both actually require.
Foot conditions are rated in 38 CFR § 4.71a under codes 5276 through 5284. Two of them account for the majority of foot claims.
Plantar fasciitis: DC 5269
Added in the February 2021 musculoskeletal revision, DC 5269 rates plantar fasciitis on one question: has treatment worked?
| Rating | What the schedule requires |
|---|---|
| 10% | Plantar fasciitis, unilateral or bilateral, in every case that does not meet a higher tier. |
| 20% | No relief from both non-surgical and surgical treatment, one foot. |
| 30% | No relief from both non-surgical and surgical treatment, both feet. |
Two notes under the code matter. Note (1) says that with actual loss of use of the foot, the rating is 40%. Note (2) says that if surgery has been recommended but you are not a surgical candidate, you are rated under the 20% or 30% tier as applicable, which closes the trap where a veteran who cannot safely have surgery would otherwise be stuck at 10% forever.
In practice, 10% is the rating for nearly everyone, because the higher tiers require that surgery was done (or recommended and ruled out) and did not help. The 10% is a single rating whether one foot or both are involved, so the bilateral factor does not apply at that tier. A veteran with plantar fasciitis in both feet is at 10%, not 10% and 10%.
The higher tiers are a record of what was tried: stretching and physical therapy, orthotics, night splints, injections, then surgery or a surgical consult that declined you. Each step needs to be in a medical record, not just in your memory. If a podiatrist has told you surgery would not help or that you are not a candidate, ask for that to be written down. That sentence is the difference between 10% and 20% or 30%.
Flat feet (pes planus): DC 5276
Acquired flat foot is rated on severity, and the tiers distinguish one foot from both:
| Severity | What the schedule describes | Bilateral | Unilateral |
|---|---|---|---|
| Mild | Symptoms relieved by a built-up shoe or arch support. | 0% | 0% |
| Moderate | Weight-bearing line over or medial to the great toe, inward bowing of the Achilles tendon, pain on manipulation and use of the feet. | 10% | 10% |
| Severe | Objective evidence of marked deformity (pronation, abduction), pain on manipulation and use accentuated, indication of swelling on use, characteristic callosities. | 30% | 20% |
| Pronounced | Marked pronation, extreme tenderness of the plantar surfaces, marked inward displacement and severe spasm of the Achilles tendon on manipulation, not improved by orthopedic shoes or appliances. | 50% | 30% |
The moderate tier is a single 10% for one foot or both. From severe upward, the schedule gives its own bilateral number, which means the § 4.26 bilateral factor is not added on top, because the code already accounts for both feet. That is a common point of confusion.
The tier language is clinical, and the findings come from the examiner: where your weight-bearing line falls, whether the Achilles bows inward, callus patterns, swelling, how tender the arch is to pressure. What you contribute is the history of what has been tried and whether it helped, because "relieved by arch support" is the 0% tier and "not improved by orthopedic shoes or appliances" is the 50% tier.
The other foot codes
- DC 5284, foot injuries, other: moderate 10%, moderately severe 20%, severe 30%, with 40% for loss of use. Used for residuals of fractures, crush injuries, and conditions with no code of their own.
- DC 5280, hallux valgus (bunion): 10% for a severe case equivalent to amputation of the great toe, or after surgical resection of the metatarsal head.
- DC 5283, malunion or nonunion of tarsal or metatarsal bones: 10% to 30%.
- DC 5003 degenerative arthritis of the foot joints, with painful motion, rated under the painful-motion floor.
A veteran can have plantar fasciitis and flat feet rated separately, because they are different conditions with different criteria, provided the examiner attributes distinct findings to each. Where the symptoms genuinely overlap, the rater will pick one under the anti-pyramiding rule in § 4.14.
Service connection for feet
Foot complaints are everywhere in service records, which is the good news. Look for "foot pain," "heel pain," "pes planus" (often noted on the entrance exam), profiles limiting running or boots, orthotic prescriptions, and podiatry referrals.
The entrance-exam note cuts both ways. If flat feet were documented when you came in, the condition pre-existed service and the claim becomes one for aggravation under § 3.306: you have to show it got worse during service beyond its natural progression. A symptomatic progression in the STRs, from "asymptomatic pes planus" at entrance to profiles and podiatry visits later, is exactly that evidence. If the entrance exam was silent, you are presumed to have been sound on entry under § 3.304(b), and the VA has to prove otherwise with clear and unmistakable evidence.
Feet are also the start of a chain. A foot condition that changes how you walk is a standard primary for secondary knee, hip, and back claims, and a knee or ankle condition can be the primary for a foot claim the other way. See the secondary conditions guide.
The exam
The foot DBQ records the diagnosis, the objective findings for each tier, the treatment history, and functional loss. Bring your orthotics and any surgical or podiatry records. Describe the functional limits in specifics: how long you can stand, how far you can walk, the first steps in the morning, the shoes you cannot wear, the job tasks you have changed. Read Preparing for a C&P exam for the general approach.
The checklist
- A diagnosis for each foot condition claimed, naming the condition and the foot.
- The treatment record: orthotics, therapy, injections, surgery or a surgical consult.
- In-service foot complaints, and the entrance exam to show whether the condition was noted on entry.
- A statement on standing and walking tolerance and the daily activities affected.
- Each condition listed separately on the 21-526EZ, and each foot named.
READY214 keeps the diagnosis, service-link, severity, and impact evidence for each condition you claim, and maps the knee, hip, and back conditions that commonly follow a foot rating. Free, no account needed to look.