40% (Foot amputation or loss of use)
Highest listed pathwayThis level describes forefoot amputation proximal to the metatarsal bones with more than one-half metatarsal loss, or loss of use of the foot.
What separates the next level: This is the highest documented level for this family. Toe-level amputation patterns that do not reach the forefoot are rated separately under DC 5170-5173.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5166 lists forefoot amputation proximal to the metatarsal bones with more than one-half metatarsal loss at 40 percent. DC 5167 lists loss of use of the foot at 40 percent.
- Qualification explanation
- These are two separate routes under different diagnostic codes. Amputation is an actual surgical or traumatic loss, while loss of use is a functional determination that the foot cannot be used as though it were amputated. The record needs to identify which finding actually applies.
- Examples
- The forefoot is amputated proximal to the metatarsal bones with more than one-half metatarsal loss.; The foot is so severely affected that no effective function remains, supporting a loss-of-use determination.
- Medical evidence
- Foot DBQ amputation and functional-impact sections; Operative report for amputation level; Orthopedic specialist notes supporting a loss-of-use determination
- Functional impact examples
- The foot cannot bear weight or perform standing, walking, or balance tasks.; Reliance on a prosthesis, brace, or assistive device for mobility.
- Common misconceptions
- Loss of use requires a functional determination, not simply severe pain or weakness.; Amputation level is measured by metatarsal involvement, not simply described as a forefoot injury.
- Related topics
- forefoot amputation; loss of use of the foot
- Source context
- 38 CFR 4.71a; 5166, 5167; Current educational Foot Conditions guide; deterministic assessment support is not active.
0% (Toe amputation)
Next: 10% (Toe amputation)This level describes amputation of one or two toes other than the great toe, without metatarsal involvement.
What separates the next level: Higher levels move into metatarsal-head removal, great-toe involvement, or amputation of three or more toes, rather than a further degree of this finding.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5172 lists amputation of one or two toes other than the great toe, without metatarsal involvement, at 0 percent.
- Qualification explanation
- The record needs to identify which toes are amputated and confirm no metatarsal bone is involved.
- Examples
- One toe other than the great toe is amputated without metatarsal involvement.; Two toes other than the great toe are amputated without metatarsal involvement.
- Medical evidence
- Foot DBQ amputation section; Operative report identifying amputated toes and metatarsal status
- Functional impact examples
- Balance or gait changes may still be real even when the record only supports a 0% pathway.; Footwear fit and toe-off mechanics may be affected.
- Common misconceptions
- 0% does not mean the amputation is unimportant, only that this specific route does not reach a compensable percentage.; Which toes are involved changes the applicable diagnostic code.
- Related topics
- toe amputation; metatarsal involvement
- Source context
- 38 CFR 4.71a; 5172; Current educational Foot Conditions guide; deterministic assessment support is not active.
10% (Toe amputation)
Next: 20% (Toe amputation)This level can describe great toe amputation without metatarsal involvement, or amputation of three or four toes not including the great toe.
What separates the next level: Higher levels require metatarsal-head removal, great-toe involvement in a multi-toe pattern, or amputation of all toes, rather than this level's findings.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5171 lists great toe amputation without metatarsal involvement at 10 percent. DC 5173 lists amputation of three or four toes not including the great toe at 10 percent.
- Qualification explanation
- These are two separate routes under different diagnostic codes. The record needs to identify whether the great toe or a group of other toes is involved.
- Examples
- The great toe is amputated without metatarsal involvement.; Three or four toes, not including the great toe, are amputated.
- Medical evidence
- Foot DBQ amputation section; Operative report identifying amputated toes and metatarsal status
- Functional impact examples
- Difficulty with push-off during walking when the great toe is affected.; Balance and gait changes when multiple toes are amputated.
- Common misconceptions
- Great toe involvement and other-toe involvement use different diagnostic codes even where the percentage matches.; Metatarsal involvement is a distinct finding from toe-only amputation.
- Related topics
- great toe amputation; three or four toe amputation
- Source context
- 38 CFR 4.71a; 5171, 5173; Current educational Foot Conditions guide; deterministic assessment support is not active.
20% (Toe amputation)
Next: 30% (Toe amputation)This level can describe amputation of one or two toes other than the great toe with removal of the metatarsal head, or amputation of three or four toes including the great toe.
What separates the next level: The next higher level requires great-toe metatarsal-head removal or amputation of all toes without metatarsal loss, rather than this level's findings.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5172 lists amputation of one or two toes other than the great toe with removal of the metatarsal head at 20 percent. DC 5173 lists amputation of three or four toes including the great toe at 20 percent.
- Qualification explanation
- These are two separate routes under different diagnostic codes. Metatarsal-head removal should not be assumed without a documented operative finding, and great-toe involvement changes which route applies.
- Examples
- One or two toes other than the great toe are amputated with the metatarsal head removed.; Three or four toes, including the great toe, are amputated.
- Medical evidence
- Foot DBQ amputation section; Operative report confirming metatarsal head removal or great-toe involvement
- Functional impact examples
- Reduced forefoot support and push-off strength when a metatarsal head is removed.; Greater gait and balance impact when the great toe is included in a multi-toe amputation.
- Common misconceptions
- Metatarsal head removal is a specific surgical finding, not simply a description of a severe amputation.; Great-toe inclusion changes the applicable diagnostic code for a multi-toe pattern.
- Related topics
- metatarsal head removal; three or four toe amputation including great toe
- Source context
- 38 CFR 4.71a; 5172, 5173; Current educational Foot Conditions guide; deterministic assessment support is not active.
30% (Toe amputation)
Next: 40% (Foot amputation or loss of use)This level can describe amputation of all toes without metatarsal loss, transmetatarsal amputation with up to half of metatarsal loss, or great toe amputation with removal of the metatarsal head.
What separates the next level: This is the highest documented level for the toe amputation family. Forefoot amputation proximal to the metatarsal bones with more than one-half metatarsal loss moves into the separate foot amputation and loss-of-use family.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5170 lists amputation of all toes without metatarsal loss, or transmetatarsal amputation with up to half of metatarsal loss, at 30 percent. DC 5171 lists great toe amputation with removal of the metatarsal head at 30 percent.
- Qualification explanation
- These are two separate routes under different diagnostic codes. DC 5170 itself has two qualifying findings at the same 30 percent level (all-toes amputation without metatarsal loss, or transmetatarsal amputation with up to half of metatarsal loss) -- the record needs to identify which DC 5170 finding applies, or whether it is instead DC 5171's great toe with metatarsal head removal.
- Examples
- All toes are amputated with no metatarsal bone lost.; A transmetatarsal amputation is documented with up to half of the metatarsal bones lost.; The great toe is amputated with the metatarsal head removed.
- Medical evidence
- Foot DBQ amputation section; Operative report confirming metatarsal status for the great toe or all toes
- Functional impact examples
- Significant loss of push-off and balance when all toes are amputated.; Substantial forefoot support loss when the great toe metatarsal head is removed.
- Common misconceptions
- All-toes amputation without metatarsal loss is a distinct finding from forefoot amputation proximal to the metatarsal bones.; Transmetatarsal amputation with up to half of metatarsal loss is a separate, equally valid DC 5170 route at the same 30 percent level -- not a lesser or unrated finding.; Great toe metatarsal head removal is a more proximal finding than great toe amputation alone.
- Related topics
- all toes amputated; great toe metatarsal head removal
- Source context
- 38 CFR 4.71a; 5170, 5171; Current educational Foot Conditions guide; deterministic assessment support is not active.
0% (Flatfoot)
Next: 10% (Flatfoot)This level describes mild acquired flatfoot with symptoms relieved by a built-up shoe or arch support.
What separates the next level: Higher levels require moderate, severe, or pronounced flatfoot findings that are not relieved by a built-up shoe or arch support.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5276 lists mild acquired flatfoot with symptoms relieved by a built-up shoe or arch support at 0 percent.
- Qualification explanation
- The record needs to document that symptoms are relieved by a built-up shoe or arch support, not simply that flatfoot is diagnosed.
- Examples
- Flatfoot symptoms are documented as relieved by an arch support or built-up shoe.
- Medical evidence
- Foot DBQ flatfoot severity section; Treatment notes describing arch support or built-up shoe relief
- Functional impact examples
- Symptoms may still be real even when the record only supports a 0% pathway.; Footwear modification may adequately manage this level.
- Common misconceptions
- A flatfoot diagnosis alone does not establish this specific relieved-by-support finding.; Unilateral or bilateral involvement should still be documented even at this level.
- Related topics
- mild flatfoot; arch support relief
- Source context
- 38 CFR 4.71a; 5276; Current educational Foot Conditions guide; deterministic assessment support is not active.
10% (Flatfoot)
Next: 20% (Flatfoot)This level describes moderate acquired flatfoot, whether unilateral or bilateral.
What separates the next level: Higher levels separate severe and pronounced flatfoot by unilateral versus bilateral involvement.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5276 lists moderate acquired flatfoot, bilateral or unilateral, at 10 percent.
- Qualification explanation
- This is the only flatfoot level rated the same whether unilateral or bilateral; other levels distinguish unilateral from bilateral findings.
- Examples
- Moderate flatfoot is documented in one foot.; Moderate flatfoot is documented in both feet.
- Medical evidence
- Foot DBQ flatfoot severity section; Imaging or examination findings describing moderate severity
- Functional impact examples
- Increasing difficulty with prolonged standing or walking.; Arch support alone may not fully relieve symptoms at this level.
- Common misconceptions
- This is the only flatfoot level where unilateral and bilateral involvement share the same percentage.; Moderate severity is a specific clinical finding, not a general description of foot pain.
- Related topics
- moderate flatfoot; unilateral or bilateral
- Source context
- 38 CFR 4.71a; 5276; Current educational Foot Conditions guide; deterministic assessment support is not active.
20% (Flatfoot)
Next: 30% (Flatfoot)This level describes severe acquired flatfoot, unilateral.
What separates the next level: Higher levels require severe bilateral, pronounced unilateral, or pronounced bilateral findings.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5276 lists severe acquired flatfoot, unilateral, at 20 percent.
- Qualification explanation
- The record needs to document severe severity in one foot specifically; bilateral severe flatfoot is rated at a different level.
- Examples
- Severe flatfoot is documented in one foot only.
- Medical evidence
- Foot DBQ flatfoot severity section; Imaging or examination findings describing severe severity and affected side
- Functional impact examples
- Marked difficulty with standing, walking, or weight-bearing tasks on the affected foot.
- Common misconceptions
- Severe unilateral and severe bilateral flatfoot are rated at different percentages.; Severity should come from documented clinical findings, not a general flatfoot diagnosis.
- Related topics
- severe flatfoot; unilateral
- Source context
- 38 CFR 4.71a; 5276; Current educational Foot Conditions guide; deterministic assessment support is not active.
30% (Flatfoot)
Next: 50% (Flatfoot)This level can describe severe acquired flatfoot, bilateral, or pronounced acquired flatfoot, unilateral.
What separates the next level: The next higher level requires pronounced flatfoot documented in both feet.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5276 lists severe acquired flatfoot, bilateral, at 30 percent, and pronounced acquired flatfoot, unilateral, at 30 percent.
- Qualification explanation
- These are two separate findings that share the same percentage. The record needs to identify whether the finding is severe-bilateral or pronounced-unilateral.
- Examples
- Severe flatfoot is documented in both feet.; Pronounced flatfoot is documented in one foot only.
- Medical evidence
- Foot DBQ flatfoot severity section; Imaging or examination findings describing severe or pronounced severity and affected side
- Functional impact examples
- Marked bilateral difficulty with standing, walking, or weight-bearing tasks.; Significant single-foot impairment when pronounced severity is documented unilaterally.
- Common misconceptions
- Severe-bilateral and pronounced-unilateral are different findings that happen to share a percentage.; Pronounced severity is a distinct, more severe finding than severe severity.
- Related topics
- severe flatfoot bilateral; pronounced flatfoot unilateral
- Source context
- 38 CFR 4.71a; 5276; Current educational Foot Conditions guide; deterministic assessment support is not active.
50% (Flatfoot)
Highest listed pathwayThis level describes pronounced acquired flatfoot, bilateral.
What separates the next level: This is the highest documented level in the acquired flatfoot family.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5276 lists pronounced acquired flatfoot, bilateral, at 50 percent.
- Qualification explanation
- This is the highest documented level for the flatfoot family and requires pronounced severity documented in both feet.
- Examples
- Pronounced flatfoot is documented in both feet.
- Medical evidence
- Foot DBQ flatfoot severity section; Imaging or examination findings describing pronounced severity in both feet
- Functional impact examples
- Severe bilateral difficulty with standing, walking, and weight-bearing tasks.
- Common misconceptions
- Pronounced severity requires more than a general severe-pain description.; This level requires bilateral involvement, not just one severely affected foot.
- Related topics
- pronounced flatfoot bilateral
- Source context
- 38 CFR 4.71a; 5276; Current educational Foot Conditions guide; deterministic assessment support is not active.
10% (Weak foot)
Highest listed pathwayThis level describes bilateral weak foot, rated by the underlying condition, with a minimum 10 percent evaluation.
What separates the next level: There is no separate higher weak-foot level in this hub; more severe underlying conditions may be rated under their own applicable diagnostic code.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5277 lists bilateral weak foot, rated by the underlying condition with a minimum 10 percent evaluation.
- Qualification explanation
- The record needs to document the underlying condition producing weak foot; this route does not have separate higher levels of its own beyond the minimum evaluation.
- Examples
- Bilateral weak foot is documented and rated by the underlying condition.
- Medical evidence
- Foot DBQ weak foot section; Treatment records describing the underlying condition
- Functional impact examples
- Reduced foot strength and stability may affect standing, walking, or balance.
- Common misconceptions
- Weak foot is rated bilaterally, not as a unilateral finding.; This is a minimum evaluation tied to the underlying condition rather than an independent severity scale.
- Related topics
- bilateral weak foot; minimum evaluation
- Source context
- 38 CFR 4.71a; 5277; Current educational Foot Conditions guide; deterministic assessment support is not active.
0% (Claw foot)
Next: 10% (Claw foot)This level describes slight acquired claw foot.
What separates the next level: Higher levels require great-toe dorsiflexion with ankle limitation, all-toes dorsiflexion, or marked contraction findings.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5278 lists slight acquired claw foot at 0 percent.
- Qualification explanation
- The record needs to document a slight claw foot finding rather than a more advanced dorsiflexion or contraction pattern.
- Examples
- Slight claw foot is documented on examination.
- Medical evidence
- Foot DBQ claw foot section; Examiner notes describing toe position and severity
- Functional impact examples
- Symptoms may still be real even when the record only supports a 0% pathway.
- Common misconceptions
- 0% does not mean claw foot is unimportant, only that this route does not reach a compensable percentage.; Claw foot severity is a specific graded finding, not a general foot-shape description.
- Related topics
- slight claw foot
- Source context
- 38 CFR 4.71a; 5278; Current educational Foot Conditions guide; deterministic assessment support is not active.
10% (Claw foot)
Next: 20% (Claw foot)This level describes acquired claw foot with the great toe dorsiflexed and some limitation of ankle dorsiflexion.
What separates the next level: Higher levels require all toes tending to dorsiflexion, rather than the great toe alone.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5278 lists acquired claw foot with the great toe dorsiflexed and some limitation of ankle dorsiflexion at 10 percent.
- Qualification explanation
- The record needs to document both the great-toe dorsiflexion finding and some limitation of ankle dorsiflexion together. Like DC 5276's moderate flatfoot tier, this is a level rated the same at 10 percent whether the finding is unilateral or bilateral.
- Examples
- The great toe is documented as dorsiflexed with some limitation of ankle dorsiflexion.
- Medical evidence
- Foot DBQ claw foot section; Range-of-motion measurements for ankle dorsiflexion
- Functional impact examples
- Difficulty with push-off and ankle bending during walking.
- Common misconceptions
- This level requires both the great-toe finding and the ankle-dorsiflexion limitation, not either alone.; This is a distinct finding from severe unilateral hallux rigidus reviewed under DC 5281.; This 10 percent tier is rated the same whether unilateral or bilateral -- like DC 5276's moderate flatfoot tier, it is not doubled for bilateral involvement.
- Related topics
- great toe dorsiflexion; ankle dorsiflexion limitation
- Source context
- 38 CFR 4.71a; 5278; Current educational Foot Conditions guide; deterministic assessment support is not active.
20% (Claw foot)
Next: 30% (Claw foot)This level describes acquired claw foot with all toes tending to dorsiflexion, unilateral.
What separates the next level: Higher levels require the same all-toes finding documented bilaterally, or marked contraction findings.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5278 lists acquired claw foot with all toes tending to dorsiflexion, unilateral, at 20 percent.
- Qualification explanation
- The record needs to document that all toes, not just the great toe, tend toward dorsiflexion, and that the finding is in one foot.
- Examples
- All toes in one foot are documented as tending to dorsiflexion.
- Medical evidence
- Foot DBQ claw foot section; Examiner notes describing toe position across all toes
- Functional impact examples
- Increasing difficulty with footwear fit and weight-bearing on the affected foot.
- Common misconceptions
- All-toes involvement is a more extensive finding than the great-toe-only level.; Unilateral and bilateral all-toes findings are rated at different percentages.
- Related topics
- all toes dorsiflexion unilateral
- Source context
- 38 CFR 4.71a; 5278; Current educational Foot Conditions guide; deterministic assessment support is not active.
30% (Claw foot)
Next: 50% (Claw foot)This level can describe acquired claw foot with all toes tending to dorsiflexion, bilateral, or marked contraction, unilateral.
What separates the next level: The next higher level requires marked contraction documented in both feet.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5278 lists acquired claw foot with all toes tending to dorsiflexion, bilateral, at 30 percent, and marked contraction, unilateral, at 30 percent.
- Qualification explanation
- These are two separate findings that share the same percentage. The record needs to identify whether the finding is bilateral all-toes dorsiflexion or unilateral marked contraction.
- Examples
- All toes in both feet are documented as tending to dorsiflexion.; Marked contraction is documented in one foot only.
- Medical evidence
- Foot DBQ claw foot section; Examiner notes describing toe position and contraction severity and affected side
- Functional impact examples
- Substantial bilateral difficulty with footwear fit and weight-bearing.; Substantial single-foot impairment when marked contraction is documented unilaterally.
- Common misconceptions
- Bilateral all-toes dorsiflexion and unilateral marked contraction are different findings that happen to share a percentage.; Marked contraction is a more severe finding than toes tending to dorsiflexion.
- Related topics
- all toes dorsiflexion bilateral; marked contraction unilateral
- Source context
- 38 CFR 4.71a; 5278; Current educational Foot Conditions guide; deterministic assessment support is not active.
50% (Claw foot)
Highest listed pathwayThis level describes acquired claw foot with marked contraction, bilateral.
What separates the next level: This is the highest documented level in the acquired claw foot family.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5278 lists acquired claw foot with marked contraction, bilateral, at 50 percent.
- Qualification explanation
- This is the highest documented level for the claw foot family and requires marked contraction documented in both feet.
- Examples
- Marked contraction is documented in both feet.
- Medical evidence
- Foot DBQ claw foot section; Examiner notes describing bilateral marked contraction
- Functional impact examples
- Severe bilateral difficulty with footwear fit, standing, and walking.
- Common misconceptions
- This level requires bilateral involvement, not just one severely affected foot.; Marked contraction is a specific graded finding, not a general foot-deformity description.
- Related topics
- marked contraction bilateral
- Source context
- 38 CFR 4.71a; 5278; Current educational Foot Conditions guide; deterministic assessment support is not active.
10% (Metatarsalgia)
Highest listed pathwayThis level describes anterior metatarsalgia or Morton's disease, unilateral or bilateral.
What separates the next level: There is no separate higher metatarsalgia level in this hub; more severe or structurally distinct forefoot findings are rated under other diagnostic codes such as DC 5283 or DC 5284.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5279 lists anterior metatarsalgia or Morton's disease, unilateral or bilateral, at 10 percent.
- Qualification explanation
- This is a single level rated the same whether the finding is unilateral or bilateral.
- Examples
- Anterior metatarsalgia is documented in one or both feet.; Morton's disease is documented in one or both feet.
- Medical evidence
- Foot DBQ forefoot pain section; Treatment notes describing metatarsalgia or Morton's disease
- Functional impact examples
- Forefoot pain with standing or walking on hard surfaces.
- Common misconceptions
- Unilateral and bilateral metatarsalgia are rated at the same percentage.; Generic forefoot pain is not automatically metatarsalgia or Morton's disease without the specific clinical finding.
- Related topics
- anterior metatarsalgia; Morton's disease
- Source context
- 38 CFR 4.71a; 5279; Current educational Foot Conditions guide; deterministic assessment support is not active.
10% (Hallux valgus)
Highest listed pathwayThis level can describe hallux valgus operated with resection of the metatarsal head, or severe hallux valgus equivalent to amputation of the great toe.
What separates the next level: This is the only documented hallux valgus level in this hub. Severe unilateral hallux rigidus under DC 5281 is a separate pending review route rated as severe hallux valgus, and must not be combined with claw foot findings.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5280 lists hallux valgus operated with resection of the metatarsal head at 10 percent, and severe hallux valgus equivalent to amputation of the great toe at 10 percent.
- Qualification explanation
- These are two separate findings that share the same percentage and diagnostic code. The record needs to identify whether the route is a documented operative resection or a severity finding equivalent to great-toe amputation.
- Examples
- Hallux valgus surgery included resection of the metatarsal head.; Hallux valgus severity is documented as equivalent to amputation of the great toe.
- Medical evidence
- Foot DBQ hallux valgus section; Operative report confirming metatarsal head resection; Examiner notes describing severity equivalent to great toe amputation
- Functional impact examples
- Difficulty with footwear fit and push-off strength.
- Common misconceptions
- Operated and severity-equivalent hallux valgus are different findings that happen to share a percentage.; Severe unilateral hallux rigidus is reviewed under this same percentage but through a separate DC 5281 review route, not a DC 5280 finding of its own.
- Related topics
- hallux valgus; metatarsal head resection; hallux rigidus review route
- Source context
- 38 CFR 4.71a; 5280; Current educational Foot Conditions guide; deterministic assessment support is not active.
0% (Hammer toe)
Next: 10% (Hammer toe)This level describes hammer toe of single toes.
What separates the next level: The higher level requires hammer toe of all toes, unilateral, without claw foot.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5282 lists hammer toe of single toes at 0 percent.
- Qualification explanation
- The record needs to document that hammer toe involves single toes rather than all toes of one foot.
- Examples
- Hammer toe is documented in a single toe.
- Medical evidence
- Foot DBQ hammer toe section; Examiner notes describing which toes are affected
- Functional impact examples
- Footwear fit and toe-contact discomfort may still be real even when the record only supports a 0% pathway.
- Common misconceptions
- 0% does not mean hammer toe is unimportant, only that this route does not reach a compensable percentage.; Single-toe hammer toe is a distinct finding from an all-toes pattern.
- Related topics
- hammer toe single toes
- Source context
- 38 CFR 4.71a; 5282; Current educational Foot Conditions guide; deterministic assessment support is not active.
10% (Hammer toe)
Highest listed pathwayThis level describes hammer toe of all toes, unilateral, without claw foot.
What separates the next level: This is the highest documented level for the hammer toe family. Claw foot findings are rated separately under DC 5278.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5282 lists hammer toe of all toes, unilateral, without claw foot, at 10 percent.
- Qualification explanation
- The record needs to document that all toes of one foot are affected, and that claw foot is not also documented for the same foot, since the schedule treats these as separate findings.
- Examples
- Hammer toe is documented across all toes of one foot, without a separate claw foot finding.
- Medical evidence
- Foot DBQ hammer toe section; Examiner notes confirming all-toes involvement and absence of claw foot
- Functional impact examples
- Footwear fit and gait changes when all toes of one foot are affected.
- Common misconceptions
- Hammer toe and claw foot are separate diagnostic findings and should not be documented together for the same toes under this route.; This level requires all toes of one foot, not a single-toe finding.
- Related topics
- hammer toe all toes unilateral; without claw foot
- Source context
- 38 CFR 4.71a; 5282; Current educational Foot Conditions guide; deterministic assessment support is not active.
10% (Tarsal or metatarsal malunion)
Next: 20% (Tarsal or metatarsal malunion)This level describes moderate malunion or nonunion of tarsal or metatarsal bones.
What separates the next level: Higher levels require moderately severe or severe malunion or nonunion findings.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5283 lists moderate malunion or nonunion of tarsal or metatarsal bones at 10 percent.
- Qualification explanation
- The record needs to document moderate severity specifically; more severe findings are rated at higher levels under the same diagnostic code.
- Examples
- Moderate malunion of a tarsal bone is documented on imaging.; Moderate nonunion of a metatarsal bone is documented on imaging.
- Medical evidence
- Foot DBQ tarsal and metatarsal section; Imaging confirming malunion or nonunion and severity
- Functional impact examples
- Forefoot or midfoot pain and instability with weight-bearing.
- Common misconceptions
- A past fracture history is not the same as documented current malunion or nonunion.; Severity should come from imaging and clinical findings, not symptom labels alone.
- Related topics
- moderate malunion; tarsal bones; metatarsal bones
- Source context
- 38 CFR 4.71a; 5283; Current educational Foot Conditions guide; deterministic assessment support is not active.
20% (Tarsal or metatarsal malunion)
Next: 30% (Tarsal or metatarsal malunion)This level describes moderately severe malunion or nonunion of tarsal or metatarsal bones.
What separates the next level: The next higher level requires severe malunion or nonunion. A separate note references actual loss of use of the foot, which is a cross-reference to DC 5167 rather than a fixed DC 5283 percentage.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5283 lists moderately severe malunion or nonunion of tarsal or metatarsal bones at 20 percent.
- Qualification explanation
- The record needs to document moderately severe severity specifically, distinguishing it from the moderate and severe levels under the same diagnostic code.
- Examples
- Moderately severe malunion of a tarsal or metatarsal bone is documented on imaging.
- Medical evidence
- Foot DBQ tarsal and metatarsal section; Imaging confirming malunion or nonunion and moderately severe severity
- Functional impact examples
- Increasing forefoot or midfoot instability and pain with weight-bearing.
- Common misconceptions
- Moderately severe is a distinct clinical grade between moderate and severe, not simply worse pain.; This level does not itself establish actual loss of use of the foot; that is a separate, higher cross-referenced finding.
- Related topics
- moderately severe malunion; loss of use cross-reference
- Source context
- 38 CFR 4.71a; 5283; Current educational Foot Conditions guide; deterministic assessment support is not active.
30% (Tarsal or metatarsal malunion)
Highest listed pathwayThis level describes severe malunion or nonunion of tarsal or metatarsal bones.
What separates the next level: The DC 5283 note states directly that with actual loss of use of the foot, rate 40 percent -- the same DC 5167 figure documented in the Foot Amputation and Loss of Use section. This hub does not determine whether actual loss of use is present, since that is a functional determination the record has to establish, but the rate itself is not in question once it is.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5283 lists severe malunion or nonunion of tarsal or metatarsal bones at 30 percent.
- Qualification explanation
- This is the highest documented level under DC 5283 itself; a separate note references actual loss of use of the foot as a cross-reference rather than a further DC 5283 percentage.
- Examples
- Severe malunion or nonunion of a tarsal or metatarsal bone is documented on imaging.
- Medical evidence
- Foot DBQ tarsal and metatarsal section; Imaging confirming malunion or nonunion and severe severity
- Functional impact examples
- Marked forefoot or midfoot instability and pain with weight-bearing.
- Common misconceptions
- This is the highest fixed DC 5283 percentage; the loss-of-use note is a cross-reference, not a further DC 5283 tier.; Severe malunion is a specific imaging-confirmed finding, not a general pain description.
- Related topics
- severe malunion; loss of use cross-reference
- Source context
- 38 CFR 4.71a; 5283; Current educational Foot Conditions guide; deterministic assessment support is not active.
10% (Other foot injury)
Next: 20% (Other foot injury)This level describes moderate other foot injury.
What separates the next level: Higher levels require moderately severe or severe other-foot-injury findings.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5284 lists moderate other foot injury at 10 percent.
- Qualification explanation
- The record needs to document a moderate foot injury that is not otherwise represented by a more specific diagnostic code in this hub.
- Examples
- A moderate foot injury not otherwise classified is documented in treatment records.
- Medical evidence
- Foot DBQ other foot injury section; Treatment records describing the injury and severity
- Functional impact examples
- Foot pain or instability with standing or walking.
- Common misconceptions
- This DC 5284 route applies only when a more specific diagnostic code in this hub does not already describe the finding.; Moderate severity is a specific clinical grade, not a general injury description.
- Related topics
- moderate other foot injury
- Source context
- 38 CFR 4.71a; 5284; Current educational Foot Conditions guide; deterministic assessment support is not active.
20% (Other foot injury)
Next: 30% (Other foot injury)This level describes moderately severe other foot injury.
What separates the next level: The next higher level requires severe other-foot-injury findings.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5284 lists moderately severe other foot injury at 20 percent.
- Qualification explanation
- The record needs to document moderately severe severity specifically, distinguishing it from the moderate and severe levels under the same diagnostic code.
- Examples
- A moderately severe foot injury not otherwise classified is documented in treatment records.
- Medical evidence
- Foot DBQ other foot injury section; Treatment records describing the injury and moderately severe severity
- Functional impact examples
- Increasing difficulty with standing, walking, or weight-bearing tasks.
- Common misconceptions
- Moderately severe is a distinct clinical grade between moderate and severe, not simply worse pain.; This route applies only when a more specific diagnostic code in this hub does not already describe the finding.
- Related topics
- moderately severe other foot injury
- Source context
- 38 CFR 4.71a; 5284; Current educational Foot Conditions guide; deterministic assessment support is not active.
30% (Other foot injury)
Highest listed pathwayThis level describes severe other foot injury.
What separates the next level: The DC 5284 note states directly that with actual loss of use of the foot, rate 40 percent -- the same DC 5167 figure documented in the Foot Amputation and Loss of Use section. This hub does not determine whether actual loss of use is present, since that is a functional determination the record has to establish, but the rate itself is not in question once it is.
Review CFR criteria, examples, and evidence
- Official CFR language
- DC 5284 lists severe other foot injury at 30 percent.
- Qualification explanation
- This is the highest documented level under DC 5284 itself; a separate note references actual loss of use of the foot as a cross-reference rather than a further DC 5284 percentage.
- Examples
- A severe foot injury not otherwise classified is documented in treatment records.
- Medical evidence
- Foot DBQ other foot injury section; Treatment records describing the injury and severe severity
- Functional impact examples
- Marked difficulty with standing, walking, or weight-bearing tasks.
- Common misconceptions
- This is the highest fixed DC 5284 percentage; the loss-of-use note is a cross-reference, not a further DC 5284 tier.; This route applies only when a more specific diagnostic code in this hub does not already describe the finding.
- Related topics
- severe other foot injury; loss of use cross-reference
- Source context
- 38 CFR 4.71a; 5284; Current educational Foot Conditions guide; deterministic assessment support is not active.