Os Calcis (Calcaneus) Malunion VA Disability Rating
Diagnostic Code 5273 · 38 CFR §4.71a
What Is It?
Os calcis is the medical term for the calcaneus or heel bone. A malunion of the calcaneus means the bone fractured and healed in an improper position. Calcaneal fractures are high-energy injuries typically caused by falls from height, parachute landing injuries, or blast events. When the heel bone heals crooked, it changes the alignment of the entire foot, alters how weight is distributed, and often leads to chronic pain with every step. The subtalar joint sitting on top of the calcaneus is frequently affected as well.
Rating Criteria
| Rating | Criteria |
|---|---|
| 20% | Malunion with marked deformity. |
| 10% | Malunion of the os calcis or astragalus with moderate deformity. |
Evidence Needed
- Imaging showing the malunion and degree of deformity
- Medical records documenting the original fracture and treatment
- Functional assessment of walking and weight-bearing ability
- Records of orthotic devices or shoe modifications prescribed
- Statements describing daily pain and limitations with standing and walking
C&P Exam Tips
- Bring imaging that clearly shows the heel bone alignment compared to normal
- Report pain with standing and walking, especially on hard surfaces
- Describe how long you can stand or walk before pain forces you to stop
- Mention any custom orthotics or shoe modifications you require
- Show the examiner any visible deformity in heel shape or foot alignment
How to File
File under DC 5273 with imaging showing the malunion and medical evidence of the deformity severity. If the malunion has caused subtalar arthritis or other foot conditions, file those as secondary claims.
Common Mistakes
Not getting updated imaging that shows the current state of the healed fracture Failing to describe the deformity as moderate or marked, which determines the rating Missing secondary claims for subtalar arthritis which almost always develops after calcaneal malunion Not documenting the need for specialized footwear or orthotics
Frequently Asked Questions
What is the difference between moderate and marked deformity?
Moderate deformity means visible malalignment that causes noticeable functional problems but still allows you to walk without major assistive devices. Marked deformity means severe malalignment causing significant disability in walking and weight bearing. Imaging measurements and clinical examination both factor into this determination.
Are calcaneal fractures common in veterans?
Yes, particularly among paratroopers, infantry personnel, and anyone exposed to blast events or falls from height. The calcaneus absorbs the impact of axial loading, making it vulnerable during hard landings.