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Plantar fasciitis and acquired flatfoot (pes planus) — the foot conditions that come from years of boots, rucks and concrete, and that anchor knee, hip and back claims above them. This guide quotes the actual rating criteria from 38 CFR Part 4 for diagnostic code 5269 / 5276, explains what the C&P examiner measures, covers the presumptive and secondary routes to service connection, and lists the reasons these claims come back denied — and how each gets fixed.
How the VA rates plantar fasciitis and flat feet in 2026 — the exact criteria
These are the criteria a VA rater applies, quoted from the rating schedule (§ 4.71a). Your rating is the highest level whose wording your evidence meets — and evidence that never uses these words tends to be rated at the bottom.
DC 5269 — Plantar fasciitis
| Rating | Criteria (38 CFR Part 4 wording) |
|---|---|
| 30% | No relief from both non-surgical and surgical treatment, bilateral |
| 20% | No relief from both non-surgical and surgical treatment, unilateral |
| 10% | Otherwise, unilateral or bilateral |
With actual loss of use of the foot, rate 40 percent. A veteran recommended for surgery who is not a surgical candidate is rated at the 20 or 30 percent level.
DC 5276 — Flatfoot, acquired
| Rating | Criteria (38 CFR Part 4 wording) |
|---|---|
| 50% | Pronounced (bilateral): marked pronation, extreme tenderness of plantar surfaces, marked inward displacement and severe spasm of the tendo achillis on manipulation, not improved by orthopedic shoes or appliances |
| 30% | Pronounced, unilateral; or severe, bilateral: objective evidence of marked deformity (pronation, abduction), pain on manipulation and use accentuated, indication of swelling on use, characteristic callosities |
| 20% | Severe, unilateral |
| 10% | Moderate: weight-bearing line over or medial to great toe, inward bowing of the tendo achillis, pain on manipulation and use of the feet, bilateral or unilateral |
| 0% | Mild: symptoms relieved by built-up shoe or arch support |
Honest ceiling: 30% — both feet, no relief from non-surgical AND surgical care.
What the C&P examiner measures
The examiner records pain on manipulation and use, swelling, callosities, the weight-bearing line, arch supports and orthotics, and whether surgical and non-surgical treatment have failed. Bring your orthotics and the podiatry records.
The questions that get at the rating criteria — answer them for yourself before the exam:
- First steps out of bed in the morning — does your heel light up?
- What have you tried for it — inserts, injections, anything? Did any of it actually work?
- One foot or both?
Service connection: presumptive, direct, or secondary
No presumption. Direct service connection from in-service treatment for foot pain, documented pes planus that worsened in service (aggravation of a pre-existing condition, 38 CFR 3.306), or the cumulative effect of the job.
Every service-connection claim has three legs: a current diagnosis (the C&P exam can supply it), an in-service event, injury, exposure or an already-connected condition, and a link between the two — which the VA's own examiner addresses at the exam for direct and secondary claims, and which the law supplies for presumptive ones. You do not need a private opinion to file; you need one only if the VA denies for lack of nexus, and a supplemental claim within one year keeps your effective date.
Secondary conditions veterans miss
Conditions that commonly develop because of this one can be service-connected on top of it, each with its own rating:
- Knees / hips / back from altered gait — Years of walking wrong builds real, ratable secondaries up the chain
What the medical literature says
Kaufman K.R. et al., American Journal of Sports Medicine 27(5):585-93 (1999) — The effect of foot structure and range of motion on musculoskeletal overuse injuries
Prospective military cohort (449 Navy trainees): pes planus and foot structure predict overuse injury in training. Why it matters: Flat feet / plantar fasciitis aggravated by service.
Scher D.L. et al., Journal of Bone and Joint Surgery (Am) 91:2867-72 (2009) — The incidence of plantar fasciitis in the United States military
Military-wide incidence data: plantar fasciitis is a documented burden of service, highest in Army/Marines. Why it matters: Establishes plantar fasciitis as a service-typical injury.
Why plantar fasciitis and flat feet claims get denied — and the fix
- Rated 0 or 10 percent for "mild" pes planus without pain on manipulation and use being recorded.
- Bilateral involvement rated as unilateral.
A denial is a grade on the evidence packet, not a verdict on you. Filed as a supplemental claim within one year, the fix keeps your original effective date.
Filing it right the first time
- Intent to File first. It locks your effective date for a year — back pay runs from that day, not from the day the package is ready.
- File everything at once. Every condition with a real symptom and a plausible route — direct, presumptive, secondary, increase — goes in one claim. The VA's duty to assist schedules the exam and pulls your records; a condition held back "for more evidence" only starts its clock later.
- Your statement in the criteria's words. A Statement in Support of Claim (VA Form 21-4138) that describes your worst days and your typical days using the language in the table above is the evidence the rater reads first.
- Your records. VA records through Blue Button, decision letters and code sheet from VA.gov, and private records from each doctor's office or patient portal — or a signed 21-4142 so the VA pulls them.
- Prepare for the exam. Know what the examiner measures (above) and answer honestly, including the bad days.
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See If You Qualify →Frequently asked questions
What is the VA rating for plantar fasciitis and flat feet?
Plantar Fasciitis and Flat Feet is rated under diagnostic code 5269 / 5276 (§ 4.71a) at 0%, 10%, 20%, 30%, 50%. The percentage depends on which criteria in the rating schedule your evidence meets — the full table is on this page.
What is the highest VA rating for plantar fasciitis and flat feet?
The highest schedular rating available is 50%. Typical grants land around 10%, but every case is decided on its own evidence.
Is plantar fasciitis and flat feet a presumptive condition?
No presumption. Direct service connection from in-service treatment for foot pain, documented pes planus that worsened in service (aggravation of a pre-existing condition, 38 CFR 3.306), or the cumulative effect of the job.
Can plantar fasciitis and flat feet be claimed as a secondary condition — or cause one?
Yes. Knees / hips / back from altered gait. A secondary condition is rated on top of the primary one, and the VA's own C&P examiner can supply the connecting opinion.
Do I need a nexus letter for plantar fasciitis and flat feet?
Not to file. The VA's duty to assist schedules a C&P exam where its own examiner addresses the connection, and presumptive conditions need no opinion at all. A private opinion becomes worth buying only if the VA denies for lack of nexus — a supplemental claim within one year keeps your original effective date.
Rating criteria verified against eCFR (38 CFR Part 4) — last reviewed 2026-09-19. Regulations change; confirm anything decision-critical at ecfr.gov.