Reference: 38 CFR 4.71a, DC 5276

Sources & Related Guides

What is the VA rating for Pes Planus (Flat Feet)?

Evaluated based on weight-bearing alignment, tenderness, callosities, inward displacement of the Achilles tendon, and bilateral vs. unilateral involvement.

Condition Overview & Clinical Scope

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The published flatfoot schedule evaluates acquired pes planus under 38 CFR 4.71a, Diagnostic Code 5276. Ratings range from 0% to 50% based on whether symptoms affect one foot (unilateral) or both feet (bilateral), objective physical deformities such as the weight-bearing line falling over or medial to the great toe and inward bowing of the tendo achillis, pain on manipulation and use of the feet, swelling on use, characteristic callosities, tendo achillis spasm on manipulation, and whether symptoms are relieved by built-up shoes, arch supports, or orthopedic shoes and appliances.

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Explore Pes Planus (Flat Feet) Criteria & Tools

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Common Questions & FAQs

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Overview

About this condition

The published flatfoot schedule evaluates acquired pes planus under 38 CFR 4.71a, Diagnostic Code 5276. Ratings range from 0% to 50% based on whether symptoms affect one foot (unilateral) or both feet (bilateral), objective physical deformities such as the weight-bearing line falling over or medial to the great toe and inward bowing of the tendo achillis, pain on manipulation and use of the feet, swelling on use, characteristic callosities, tendo achillis spasm on manipulation, and whether symptoms are relieved by built-up shoes, arch supports, or orthopedic shoes and appliances.

Regulatory authority: 38 CFR 4.71a, DC 5276

IMPORTANT DISCLOSURE: DC 5276 evaluates acquired flatfoot on four severity tiers (mild, moderate, severe, and pronounced) across unilateral and bilateral presentations. DC 5276 is distinct from DC 5269 (plantar fasciitis) and DC 5271 (limitation of ankle motion). While flatfoot and plantar fasciitis frequently co-occur in the same foot, 38 CFR 4.14 strictly prohibits duplicate evaluations for the same disability manifestations. This guide is educational only. RatingScope does not diagnose flatfoot, does not infer missing clinical findings, does not determine service connection, and does not predict a VA decision.

Percentage Guides

Understanding Your Percentage

Select a pathway to see what the published criteria ask about, what records may clarify it, and what should not be assumed.

0%

Next: 10%

Mild flatfoot, whether affecting one foot (unilateral) or both feet (bilateral), where symptoms are relieved by a built-up shoe or arch support.

What separates the next level: Higher levels move into moderate flatfoot (10%) where the weight-bearing line falls over or medial to the great toe, inward bowing of the tendo achillis is present, and pain on manipulation and use is clinically documented.

Review CFR criteria, examples, and evidence

Official CFR language: DC 5276 rates mild flatfoot with symptoms relieved by built-up shoe or arch support at 0 percent for unilateral or bilateral involvement.
Qualification explanation: This level applies when acquired flatfoot is clinically documented, but symptoms are relieved by a built-up shoe or arch support.
Examples: A veteran has flat arches documented on examination, but pain is resolved when wearing a built-up shoe or arch support.; Clinical examination shows asymptomatic flatfoot with normal gait and no pain on manipulation.
Medical evidence: Foot Conditions DBQ documenting arch contour; Clinical notes showing symptomatic relief with built-up shoes or arch supports; Physical exam noting absence of pain on active manipulation
Functional impact examples: Mild fatigue after extended marching or standing, managed effectively with footwear inserts.; No continuous limitation of occupational standing or walking.
Common misconceptions: Having flat feet documented on an entrance exam does not guarantee a compensable rating without demonstrated functional impairment.; A 0% rating is still service-connected, allowing future claims for increase if the condition worsens.
Related topics: mild flatfoot; arch supports; built-up shoe; noncompensable foot rating
Source context: 38 CFR 4.71a; 5276; Current educational Pes Planus guide; deterministic assessment support is not active.

10%

Next: 20% (unilateral severe) / 30% (bilateral severe)

Moderate flatfoot affecting one or both feet (bilateral or unilateral), characterized by the weight-bearing line falling over or medial to the great toe, inward bowing of the tendo achillis, and pain on manipulation and use of the feet.

What separates the next level: Higher levels move to severe flatfoot (20% unilateral, 30% bilateral) which requires objective marked deformity, pain on manipulation and use accentuated, swelling on use, and characteristic callosities.

Review CFR criteria, examples, and evidence

Official CFR language: DC 5276 rates moderate flatfoot, with weight-bearing line over or medial to great toe, inward bowing of the tendo achillis, and pain on manipulation and use of the feet, at 10 percent for bilateral or unilateral involvement.
Qualification explanation: This level requires three clinical elements: the weight-bearing line over or medial to the great toe, visible inward bowing of the tendo achillis (Achilles tendon), and pain on manipulation and use of the feet.
Examples: Examination documents that the veteran's weight-bearing line shifts over or medial to the great toe with inward bowing of the tendo achillis and pain on manipulation and use of the feet.; Bilateral moderate flatfoot documented with persistent pain during manipulation and active weight-bearing use.
Medical evidence: Foot Conditions DBQ objective physical examination section; Clinical observation of tendo achillis alignment during standing; Documented pain on manipulation and use of the feet
Functional impact examples: Aching foot pain after 30 to 60 minutes of prolonged standing or walking.; Need to pause or sit during prolonged weight-bearing work.
Common misconceptions: Having moderate flatfoot in both feet does not result in two separate 10% ratings; DC 5276 provides a single 10% rating for either unilateral or bilateral moderate involvement.; Pain alone without the required anatomical signs (weight-bearing alignment, Achilles bowing) does not meet this specific rating tier.
Related topics: moderate flatfoot; weight-bearing line; tendo achillis bowing
Source context: 38 CFR 4.71a; 5276; Current educational Pes Planus guide; deterministic assessment support is not active.

20%

Next: 30%

Severe unilateral flatfoot with objective marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, swelling on use, and characteristic callosities.

What separates the next level: The bilateral version of this exact severe standard rates at 30%. Pronounced unilateral flatfoot with marked pronation, extreme tenderness, marked inward displacement, and severe tendo achillis spasm on manipulation not improved by orthopedic shoes or appliances also rates at 30%.

Review CFR criteria, examples, and evidence

Official CFR language: DC 5276 rates severe flatfoot, with objective marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, swelling on use, and characteristic callosities, at 20 percent for unilateral involvement.
Qualification explanation: This level applies when severe flatfoot affects only one foot and the medical record documents four objective elements: objective marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, swelling on use, and characteristic callosities.
Examples: One foot demonstrates objective marked deformity with pronation, pain on manipulation and use accentuated, noticeable swelling on use, and characteristic callosities under the midfoot.; Unilateral severe flatfoot documented following in-service trauma with marked pronation, accentuated pain on use, swelling on use, and plantar callosities.
Medical evidence: Foot Conditions DBQ detailing objective marked deformity, swelling on use, and characteristic callosities; Podiatry notes confirming pain on manipulation and use accentuated; Weight-bearing foot radiographs confirming structural collapse
Functional impact examples: Substantial difficulty walking more than brief distances without noticeable limp and localized swelling on use.; Inability to perform jobs requiring continuous standing or heavy load carrying.
Common misconceptions: Severe flatfoot requires objective clinical signs such as swelling on use and characteristic callosities, not merely patient-reported pain.; Bilateral involvement with these severe symptoms rates at 30%, not 20%.
Related topics: severe flatfoot; unilateral severe; callosities; swelling on use
Source context: 38 CFR 4.71a; 5276; Current educational Pes Planus guide; deterministic assessment support is not active.

30%

Next: 50%

Severe bilateral flatfoot (objective marked deformity, pain on manipulation and use accentuated, swelling on use, and characteristic callosities), or pronounced unilateral flatfoot (marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement, and severe spasm of the tendo achillis on manipulation, not improved by orthopedic shoes or appliances).

What separates the next level: Higher evaluation (50%) is reserved for pronounced bilateral flatfoot meeting the full marked pronation, extreme tenderness, marked inward displacement, tendo achillis spasm on manipulation, and appliance-resistant criteria across both feet.

Review CFR criteria, examples, and evidence

Official CFR language: DC 5276 rates severe bilateral flatfoot at 30 percent, and pronounced unilateral flatfoot at 30 percent.
Qualification explanation: This 30% tier covers two distinct clinical presentations under DC 5276: (1) severe bilateral flatfoot with objective marked deformity, pain on manipulation and use accentuated, swelling on use, and characteristic callosities on both feet; or (2) pronounced unilateral flatfoot with marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement, and severe spasm of the tendo achillis on manipulation, not improved by orthopedic shoes or appliances.
Examples: Both feet demonstrate objective marked deformity with pronation, bilateral swelling on use, pain on manipulation and use accentuated, and characteristic callosities.; One foot exhibits pronounced flatfoot with marked pronation, severe tendo achillis spasm on manipulation, extreme plantar tenderness, and complete failure of orthopedic shoes or appliances.
Medical evidence: Foot Conditions DBQ documenting bilateral severe findings or unilateral pronounced findings; Orthopedic or podiatric documentation confirming lack of improvement from orthopedic shoes or appliances; Physical therapy or exam notes documenting severe spasm of the tendo achillis on manipulation
Functional impact examples: Severe restriction in walking tolerance, requiring frequent breaks and reliance on specialized supportive footwear.; Inability to participate in recreational running, hiking, or sustained manual labor.
Common misconceptions: A 30% rating can be established either through bilateral severe flatfoot or unilateral pronounced flatfoot.; Pronounced flatfoot requires demonstrated lack of improvement from orthopedic shoes or appliances.
Related topics: severe bilateral flatfoot; pronounced unilateral flatfoot; tendo achillis spasm
Source context: 38 CFR 4.71a; 5276; Current educational Pes Planus guide; deterministic assessment support is not active.

50%

Highest listed pathway

Pronounced bilateral flatfoot with marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement, and severe spasm of the tendo achillis on manipulation, not improved by orthopedic shoes or appliances.

What separates the next level: This is the highest rating available under DC 5276. Unilateral pronounced flatfoot is evaluated at 30% instead.

Review CFR criteria, examples, and evidence

Official CFR language: DC 5276 rates pronounced bilateral flatfoot, with marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement and severe spasm of the tendo achillis on manipulation, not improved by orthopedic shoes or appliances, at 50 percent.
Qualification explanation: This is the maximum schedular evaluation for acquired flatfoot under DC 5276. It requires that both feet exhibit marked pronation, extreme tenderness of the plantar surfaces of the feet, marked inward displacement, severe spasm of the tendo achillis on manipulation, and no improvement from orthopedic shoes or appliances.
Examples: Both feet demonstrate pronounced flatfoot with marked pronation, extreme plantar tenderness, marked inward displacement, severe bilateral tendo achillis spasm on manipulation, and lack of improvement from orthopedic shoes or appliances.; A veteran with service-connected bilateral flatfoot who cannot bear weight without severe bilateral pain and muscle spasms despite specialized orthopedic footwear and appliances.
Medical evidence: Foot Conditions DBQ confirming bilateral pronounced deformities; Podiatric records verifying chronic lack of improvement from orthopedic shoes or appliances in both feet; Clinical documentation of active bilateral tendo achillis spasm on manipulation and extreme plantar tenderness
Functional impact examples: Profound functional limitation of ambulation, requiring assistive devices like canes or crutches for daily mobility.; Severe barrier to occupations requiring standing, walking, or physical exertion.
Common misconceptions: The 50% tier cannot be awarded for a single foot; unilateral pronounced flatfoot is evaluated at 30%.; Tendo achillis spasm on manipulation and lack of improvement from orthopedic shoes or appliances must be objectively documented.
Related topics: pronounced bilateral flatfoot; maximum flatfoot rating; tendo achillis spasm
Source context: 38 CFR 4.71a; 5276; Current educational Pes Planus guide; deterministic assessment support is not active.

Evidence

Evidence that may clarify the published criteria

Clinical diagnosis of acquired flatfoot

A formal diagnosis of pes planus or flatfoot established by a physician or podiatrist.

A diagnosis alone without anatomical measurements or functional findings does not establish a compensable rating tier.

Weight-bearing and alignment examination

Examination records evaluating the medial weight-bearing line, arch height, and Achilles tendon alignment.

Physical examination must be conducted under weight-bearing conditions to evaluate functional arch collapse.

Orthotic and appliance trial history

Documentation of prescribed arch supports, custom orthotics, or orthopedic shoes and whether they provided symptomatic relief.

Documentation of conservative treatment failure is mandatory for the severe and pronounced rating tiers.

Objective functional-loss evidence

Records detailing pain on manipulation, active swelling, callosities, and Achilles tendon spasm during use.

Subjective statements of pain must be corroborated by objective examination findings under 38 CFR 4.40, 4.45, and 4.59.

Official VA Forms & DBQs

Downloadable DBQs & Supporting Claim Forms

Take the public DBQ to your private physician or review it prior to your C&P examination.

Terminology

Plain-English terms

Pes planus

Flat feet, where the natural arch on the inside of the foot collapses.

Evaluated under 38 CFR 4.71a, DC 5276, based on deformity, pain, swelling, callosities, and response to appliances.

Foot Conditions DBQ diagnosis section

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Weight-bearing line medial to great toe

The body weight pushes down inside the big toe instead of through the center of the foot.

A key objective criterion for the 10% moderate flatfoot rating under DC 5276.

Physical examination alignment notes

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Inward bowing of the tendo achillis

The heel cord tilts inward toward the inside of the ankle when standing.

Required along with weight-bearing line displacement for the 10% moderate flatfoot tier.

DBQ physical exam findings

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Pronated foot

The ankle rolls inward and the arch flattens out during walking.

Marked pronation is an objective deformity required for severe and pronounced flatfoot ratings.

DBQ objective deformity findings

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Severe spasm of the tendo achillis

Severe, involuntary muscle tightens and locks the heel cord during clinical examination.

A mandatory finding for the 30% unilateral and 50% bilateral pronounced flatfoot rating under DC 5276.

Specialist podiatry and DBQ exam notes

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Characteristic callosities

Thick calluses that develop under the midfoot or inside edge because the arch hits the ground.

An objective finding required for severe (20% unilateral / 30% bilateral) flatfoot ratings under DC 5276.

Dermatological and podiatric physical exam notes

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Common Questions

Questions veterans commonly ask

How does the VA differentiate flatfoot (DC 5276) from plantar fasciitis (DC 5269)?

Flatfoot (DC 5276) evaluates structural arch collapse, alignment deformity, Achilles tendon bowing, callosities, and response to arch supports. Plantar fasciitis (DC 5269) evaluates inflammation of the plantar fascia ligament based on unilateral vs. bilateral presentation and responsiveness to nonsurgical and surgical treatment.

Can I receive separate ratings for flatfoot and plantar fasciitis in the same foot?

Under 38 CFR 4.14 (anti-pyramiding), the VA prohibits duplicate ratings for the same physical impairment. While veterans can be diagnosed with both conditions, separate ratings require distinct, non-overlapping symptomatology that is documented in the medical evidence.

What is required to receive the maximum 50% flatfoot rating?

The 50% rating requires pronounced bilateral flatfoot with marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement, severe spasm of the tendo achillis on manipulation, and no improvement from orthopedic shoes or appliances.

What if my flat feet existed before military service?

If flatfoot was noted at your military entrance physical, service connection can still be established under 38 CFR 3.306 if military service aggravated the condition beyond its natural progression, such as developing marked deformity or persistent pain following combat training.

What separates the 0% rating from adjacent levels?

Higher levels move into moderate flatfoot (10%) where the weight-bearing line falls over or medial to the great toe, inward bowing of the tendo achillis is present, and pain on manipulation and use is clinically documented.

What separates the 10% rating from adjacent levels?

Higher levels move to severe flatfoot (20% unilateral, 30% bilateral) which requires objective marked deformity, pain on manipulation and use accentuated, swelling on use, and characteristic callosities.

What separates the 20% rating from adjacent levels?

The bilateral version of this exact severe standard rates at 30%. Pronounced unilateral flatfoot with marked pronation, extreme tenderness, marked inward displacement, and severe tendo achillis spasm on manipulation not improved by orthopedic shoes or appliances also rates at 30%.

What separates the 30% rating from adjacent levels?

Higher evaluation (50%) is reserved for pronounced bilateral flatfoot meeting the full marked pronation, extreme tenderness, marked inward displacement, tendo achillis spasm on manipulation, and appliance-resistant criteria across both feet.

What separates the 50% rating from adjacent levels?

This is the highest rating available under DC 5276. Unilateral pronounced flatfoot is evaluated at 30% instead.

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External source/reference

38 CFR 4.71a: Schedule of ratings, musculoskeletal system

Open 38 CFR 4.71a: Schedule of ratings, musculoskeletal system

Secondary conditions

Conditions commonly connected to Pes Planus (Flat Feet)

No commonly documented secondary connections are tracked for Pes Planus (Flat Feet) yet.

Educational Guides & Evidence Resources

In-depth analysis of DBQ forms, medical evidence thresholds, and rating schedules for Pes Planus (Flat Feet).

How VA Rates Flatfoot (Pes Planus): DC 5276 Severity and Arch Support Criteria

Learn how the VA evaluates flatfoot (pes planus) under 38 CFR 4.71a (DC 5276) across mild, moderate, severe, and pronounced deformity tiers.

Plantar Fasciitis vs. Flatfoot VA Disability Rating: DC 5269 vs. DC 5276

Compare VA disability rating criteria for plantar fasciitis (DC 5269) and flatfoot / pes planus (DC 5276), anti-pyramiding rules, and separate rating requirements.

Plantar Fasciitis and Flatfoot Evidence Guide: Podiatry Records and DBQs

Learn what medical evidence, podiatry records, conservative treatment histories, and DBQ findings are needed for VA plantar fasciitis and flatfoot claims.

How VA Rates Plantar Fasciitis: DC 5269 Treatment and Surgery Criteria

Understand how the VA evaluates plantar fasciitis under 38 CFR 4.71a (DC 5269) based on conservative care, surgical treatment, and bilateral symptoms.

How VA Rates Ankle Pain: DC 5270-5274 Motion and Instability Criteria

Learn how the VA evaluates ankle pain, limited motion, and joint instability under 38 CFR 4.71a using Diagnostic Codes 5270 through 5274.

Foot and Ankle C&P Exam Guide: DBQs, Range of Motion, and Functional Loss

Prepare for your VA foot and ankle C&P exam with this complete guide to Foot and Ankle DBQs, goniometer range of motion, and functional loss standards.

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Evidence Center

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