Loss of All Toes with Metatarsal Loss — VA Disability Rating (DC 5166)
Diagnostic Code 5166 · 38 CFR §4.71a
What Is It?
Amputation of all the toes together with metatarsal loss. 38 CFR 4.71a splits this at the half-metatarsal line: where more than half of the metatarsal is lost it is a forefoot amputation proximal to the metatarsal bones, DC 5166, at 40 percent; where up to half is lost it falls under the transmetatarsal branch of DC 5170, at 30 percent. The number 5165, kept in this page's URL, is the schedule's entry for a leg amputation at a lower level permitting a prosthesis.
Rating Criteria
| Rating | Criteria |
|---|---|
| 40% | Forefoot amputation proximal to the metatarsal bones, more than one-half of the metatarsal lost (DC 5166). Footnoted as also entitling the veteran to special monthly compensation. |
| 30% | Transmetatarsal amputation with up to half of the metatarsal lost (DC 5170). |
Evidence Needed
Service treatment records or VA medical records documenting the amputation. Operative reports if surgical. Documentation of the specific amputation level. Prosthetic evaluation records. For traumatic amputations, line of duty determination and incident documentation.
C&P Exam Tips
- Ensure the examiner documents the exact level of amputation
- Report any residual limb complications such as phantom pain, neuromas, or skin breakdown
- Describe prosthetic use limitations and fit problems if applicable
- Mention if dominant or non-dominant extremity is affected
How to File
File under DC 5166 with documentation of the amputation level. Include operative reports, prosthetic fitting records, and evidence of any residual limb complications. Ensure your claim specifies dominant vs non-dominant extremity when applicable. File secondary claims for phantom pain, mental health conditions, and compensatory musculoskeletal issues separately.
Common Mistakes
Not claiming Special Monthly Compensation (SMC) which is a separate entitlement on top of the disability rating. Failing to file for secondary conditions like phantom pain or depression. Not documenting prosthetic complications that may warrant additional ratings. Not specifying dominant vs non-dominant extremity when applicable.
Frequently Asked Questions
What is Special Monthly Compensation (SMC) for amputations?
SMC is additional monthly compensation paid on top of your regular disability rating. SMC(k) applies to anatomical loss or loss of use of a hand, foot, or creative organ. Higher SMC levels apply for combinations of losses or when aid and attendance is needed. SMC is not automatic — ensure it is specifically claimed.
Does the VA provide prosthetic devices?
Yes. Veterans with service-connected amputations are entitled to VA prosthetic services at no cost, including initial fitting, replacements, repairs, and upgrades to newer technology. This includes microprocessor knees, myoelectric upper extremity prosthetics, and specialized devices.
Can I get TDIU with an amputation rating?
Yes. If your amputation rating (alone or combined with other disabilities) prevents you from maintaining substantially gainful employment, you may qualify for Total Disability based on Individual Unemployability (TDIU), which pays at the 100% rate even if your combined rating is lower.