Plantar fasciitis VA rating, foot pain and flat feet

Plantar fasciitis has had its own diagnostic code only since February 2021, and its tiers turn on whether treatment has worked. Flat feet have had a code for decades, with tiers that turn on words like "pronounced." Here is what both actually require.

Last reviewed October 2026 · Not legal advice, VA.gov always controls

VA rates service-connected plantar fasciitis under diagnostic code (DC) 5269: 10% for one or both feet, 20% for one foot and 30% for both feet when neither non-surgical nor surgical treatment has brought relief, and 40% for actual loss of use of the foot. If surgery was recommended but you are not a surgical candidate, the 20% or 30% criteria apply. Flat feet and other foot conditions have their own criteria (38 CFR § 4.71a).

Foot conditions are rated in 38 CFR § 4.71a under code 5269 and codes 5276 through 5284. Two of them, plantar fasciitis (DC 5269) and acquired flat foot (DC 5276), are covered in detail below, and several of the others are summarized after them.

Plantar fasciitis: DC 5269

Added in the February 2021 musculoskeletal revision, DC 5269 rates plantar fasciitis on one question: has treatment worked?

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.

Unless both non-surgical and surgical treatment have failed to bring relief, or surgery was recommended and the veteran is not a surgical candidate, the rating is 10%. Actual loss of use of the foot is rated 40% under Note (1), whatever the tier. The 10% is a single rating whether one foot or both are involved, so on its own the bilateral factor does not apply at that tier (the exception, again, is when a separate condition of one of the legs, or of both arms, is also rated). A veteran with plantar fasciitis in both feet is at 10%, not 10% and 10%.

Flat feet (pes planus): DC 5276

Acquired flat foot is rated on severity, and the tiers distinguish one foot from both:

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 main exception in the M21-1 is when a separate condition of one of the legs, such as a knee, is also rated: then the bilateral factor does apply, to the foot rating and that leg rating together.

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 actual foot injuries, such as fractures and crush injuries, and, by analogy, for foot conditions that have 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.

Plantar fasciitis and flat feet are different diagnoses, but they are usually not rated separately. The M21-1 tells raters that both sets of criteria compensate the same thing, foot pain, so when both are service connected the symptoms are evaluated together under whichever code gives the higher rating, to avoid pyramiding under § 4.14. The exception is injury: if one or both conditions came from an injury to the foot, a single rating under DC 5284 for the combined conditions can be assigned instead when that is more favorable.

Service connection for feet

Start with the service treatment records (STRs). Look for "foot pain," "heel pain," "pes planus" (which may be 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: the record has to show the condition got worse during service. Once it does, aggravation is presumed, and the VA can rebut that only with clear and unmistakable evidence that the worsening was the condition's natural progress. 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 to overcome that the VA needs clear and unmistakable evidence both that the condition existed before service and that service did not aggravate it.

Feet are also the start of a chain. A foot condition that changes how you walk can be the primary condition for a secondary knee, hip, or back claim under § 3.310, when medical evidence links the two, 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 Foot DBQ also asks whether there are scars related to a foot condition or its treatment, and if so sends the examiner to the skin questionnaire. A scar from foot surgery is evaluated under the scar criteria rather than the foot codes; the scar guide explains when a surgical scar is rated.

The checklist

1. A diagnosis for each foot condition claimed, naming the condition and the foot.
2. The treatment record: orthotics, therapy, injections, surgery or a surgical consult.
3. In-service foot complaints, and the entrance exam to show whether the condition was noted on entry.
4. A statement on standing and walking tolerance and the daily activities affected.
5. Each condition listed separately on the 21-526EZ, and each foot named.

Sources

• 38 CFR § 4.71a, Diagnostic Codes 5269 and 5276 through 5284: the foot rating criteria, including the plantar fasciitis tiers and both notes, and the flatfoot bilateral and unilateral percentages.
• 38 CFR § 4.26, Bilateral factor: when 10% of the combined bilateral value is added, and the 2023 exception that allows the more favorable calculation.
• 88 FR 22914 (Apr. 14, 2023): the interim final rule adding § 4.26(d), effective April 16, 2023, and adopted without change at 88 FR 89307 (Dec. 27, 2023).
• 38 CFR § 4.20, Analogous ratings: how an unlisted condition, such as heel spurs, is rated under a closely related code.
• 38 CFR § 4.40, Functional loss: functional loss due to pain as part of a musculoskeletal disability.
• 38 CFR § 4.63, Loss of use of hand or foot: VA's definition of loss of use, written for special monthly compensation, which the Foot DBQ's remaining-function question repeats.
• 38 CFR § 3.304(b), Presumption of soundness: a condition counts as noted at entry only if the entrance exam recorded it.
• 38 CFR § 3.306, Aggravation of preservice disability: an in-service increase is presumed to be aggravation unless clear and unmistakable evidence shows natural progress.
• 86 FR 8142 (Feb. 4, 2021): the correction that gave plantar fasciitis its final code, DC 5269, in the musculoskeletal revision effective February 7, 2021.
• M21-1, Part V, Subpart iii, Chapter 1, Section B, Topic 5: VA's rating procedures for the feet, including rating pes planus and plantar fasciitis together and the limits on DC 5284.
• M21-1, Part V, Subpart iv, Chapter 1, Section C, Topic 4.b: when the bilateral factor applies to a code that gives one evaluation for both sides.
• Foot Conditions, Including Flatfoot (Pes Planus) Disability Benefits Questionnaire: the exam form, including its plantar fasciitis questions on treatment response and surgical candidacy.