Flatfoot (Pes Planus) — VA Disability Rating Criteria (DC 5276)
Diagnostic Code 5276 · 38 CFR §4.71a
What Is It?
Flatfoot (pes planus) is a condition where the arch of the foot collapses, causing the entire sole to contact the ground when standing. Veterans commonly develop or worsen flatfoot from prolonged marching, running, standing, and carrying heavy loads during military service. DC 5276 rates flatfoot based on severity — mild, moderate, severe, or pronounced — and provides different ratings for bilateral (both feet) versus unilateral (one foot) involvement. The condition can cause pain in the feet, ankles, knees, and even the lower back due to altered biomechanics.
Rating Criteria
| Rating | Criteria |
|---|---|
| 50% | Pronounced bilateral flatfoot. Marked pronation, extreme tenderness of plantar surfaces, marked inward displacement and severe spasm of the Achilles tendon on manipulation, not improved by orthopedic shoes or appliances. |
| 30% | Severe bilateral flatfoot. Same symptoms as the 20% unilateral criteria but affecting both feet. |
| 20% | Severe unilateral flatfoot. Objective evidence of marked deformity (pronation, abduction), pain on manipulation and use accentuated, indication of swelling on use, characteristic callosities. |
| 10% | Moderate flatfoot, bilateral or unilateral. Weight-bearing line falls over or medial to the great toe, inward bowing of the Achilles tendon, pain on manipulation and use of the feet. |
| 0% | Mild flatfoot. Symptoms relieved by built-up shoe or arch support. |
Evidence Needed
Physical examination findings showing the degree of arch collapse, Achilles tendon alignment, callosity formation, and swelling. X-rays of the feet showing the degree of deformity. Service treatment records showing foot complaints during service or documenting the progression of flatfoot. Current treatment records showing use of orthotics, arch supports, or specialty footwear. A comparison between entrance and separation physical exams showing worsening of a pre-existing flat foot condition is strong evidence for aggravation claims.
C&P Exam Tips
The examiner will inspect your feet while standing and bearing weight, check the alignment of the Achilles tendon, look for callosities, and manipulate the feet to assess pain and deformity. Wear your regular shoes (not new ones) so the examiner can see any abnormal wear patterns. Bring your orthotics or arch supports. If your feet swell after prolonged standing or walking, schedule the exam for a time when symptoms are representative. Describe the impact on your daily life — how far you can walk, whether you can stand for extended periods, and what activities you have had to stop.
How to File
File on VA Form 21-526EZ specifying flatfoot and whether it is bilateral or unilateral. If your flatfoot was noted at entrance to service but worsened during service, you can claim it as aggravation of a pre-existing condition. Include treatment records, imaging, and information about orthotic use.
Common Mistakes
The most common mistake is not claiming flatfoot because it was noted on the entrance physical. If the condition worsened during service, you can claim aggravation — the VA compares your condition at entry to your condition at separation or currently. Another mistake is not claiming bilateral flatfoot when both feet are affected, as bilateral ratings are higher at the severe and pronounced levels.
Frequently Asked Questions
Can I claim flatfoot if it was noted on my entrance exam?
Yes. If your flatfoot worsened during military service (aggravation), you can claim it. The VA will compare your condition at entry to your current condition. Evidence of worsening — increased pain, greater arch collapse, new symptoms — supports an aggravation claim.
Are bilateral and unilateral flatfoot rated differently?
Yes. At the severe and pronounced levels, bilateral flatfoot receives a higher rating than unilateral. Pronounced bilateral flatfoot is rated at 50%, while severe unilateral is 20% and severe bilateral is 30%.