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

In 2021, the VA established Diagnostic Code 5269 as a dedicated rating code for plantar fasciitis. Previously rated analogously under flatfoot or general foot injuries, plantar fasciitis is now evaluated specifically on responsiveness to treatment and whether one or both feet are affected.

A baseline 10% rating is assigned for otherwise unilateral or bilateral plantar fasciitis that responds to treatment or does not meet higher criteria. A 20% rating is awarded for unilateral plantar fasciitis with no relief from both conservative and surgical treatment. A 30% rating is assigned for bilateral plantar fasciitis with no relief from both conservative and surgical treatment.

Note (2) of DC 5269 states that if surgery has been recommended by a physician but the veteran is not a candidate for surgery due to medical contraindications, the condition is evaluated as though surgical treatment was attempted without relief. Actual loss of use of the foot resulting from extreme foot conditions is rated at 40%.

Under 38 CFR 4.14, the VA prevents pyramiding by prohibiting duplicate ratings for the same physical impairment. While plantar fasciitis and flatfoot (pes planus) frequently occur together, they can only be rated separately if each condition produces distinct symptoms and functional impairment that do not overlap.

Critical evidence includes a Foot Conditions DBQ detailing heel pain and morning stiffness, podiatry records showing the failure of conservative therapies (such as custom orthotics, night splints, physical therapy, and cortisone injections), and operative reports or surgical consultation notes.