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

Pes planus (flat feet) is evaluated under DC 5276 in four distinct categories: mild, moderate, severe, and pronounced. Each category specifies anatomical findings and functional limitations, distinguishing whether one foot (unilateral) or both feet (bilateral) are affected.

A 0% rating is assigned under DC 5276 for mild flatfoot (bilateral or unilateral) when symptoms are relieved by a built-up shoe or arch support. A 10% rating is assigned for moderate flatfoot (bilateral or unilateral) when objective examination demonstrates that the weight-bearing line falls over or medial to the great toe, inward bowing of the tendo achillis is present, and there is pain on manipulation and use of the feet.

Severe flatfoot under DC 5276 is rated at 20% for unilateral involvement and 30% for bilateral involvement when objective evidence demonstrates marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, swelling on use, and characteristic callosities. Pronounced flatfoot is rated at 30% for unilateral involvement and 50% for bilateral involvement when marked pronation is accompanied by 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.

Many service members enter the military with asymptomatic mild flat feet noted on their entrance physical (MEPS). Under 38 CFR 3.306, if military service aggravated flat feet beyond natural progression, the condition is compensable. Military records documenting intense rucking, marching in combat boots, or stress fractures establish the service connection link.

Veterans with chronic flatfoot may experience altered gait patterns that contribute to secondary conditions in the ankles, knees, hips, or lumbar spine. However, association between conditions does not by itself establish secondary service connection. The evidence must support causation or aggravation in the individual claim, requiring a competent medical nexus linking the downstream musculoskeletal disability directly to the service-connected flatfoot.