Plantar Fasciitis — VA Disability Rating Criteria (DC 5269)
Diagnostic Code 5269 · 38 CFR §4.71a
What Is It?
Plantar fasciitis is inflammation of the plantar fascia — the thick band of tissue running along the bottom of the foot connecting the heel bone to the toes. It causes stabbing heel pain that is typically worst with the first steps in the morning or after periods of rest. Marching, running, and long hours standing on hard surfaces during service are a common part of the history veterans give for it. Plantar fasciitis has its own code in the foot section of 38 CFR 4.71a, DC 5269, and the code is scored on treatment, not on how severe the pain is. It pays 10 percent "Otherwise, unilateral or bilateral" — one foot or both. It pays 20 percent for "No relief from both non-surgical and surgical treatment, unilateral" and 30 percent for the same finding, bilateral. Two Notes follow. Note (1): "With actual loss of use of the foot, rate 40 percent." Note (2): "If a veteran has been recommended for surgical intervention, but is not a surgical candidate, evaluate under the 20 percent or 30 percent criteria, whichever is applicable." Because the code writes both feet into its own levels, it is applied once for the condition, not once per foot: 10 percent is the figure for one foot or both, and bilateral involvement is what separates 30 percent from 20 percent at the higher level.
Rating Criteria
| Rating | Criteria |
|---|---|
| 40% | With actual loss of use of the foot (Note (1) to DC 5269). |
| 30% | No relief from both non-surgical and surgical treatment, bilateral. Under Note (2), a veteran who has been recommended for surgical intervention but is not a surgical candidate is evaluated under the 20 percent or 30 percent criteria, whichever is applicable. |
| 20% | No relief from both non-surgical and surgical treatment, unilateral. Note (2) applies here as well. |
| 10% | Otherwise, unilateral or bilateral. |
Evidence Needed
A complete, dated record of treatment, split into non-surgical and surgical — the 20 and 30 percent levels turn on no relief from both. Non-surgical treatment includes orthotics and arch supports, night splints, physical therapy, stretching programs, and steroid injections; surgical treatment is any procedure on the plantar fascia. If a surgeon has recommended surgery but you are not a surgical candidate, get both the recommendation and the reason in writing, since Note (2) to DC 5269 then sends the claim to the 20 or 30 percent criteria. Podiatry or orthopedic evaluations stating whether one foot or both are affected. MRI or ultrasound showing plantar fascia thickening or tears supports the diagnosis. Service treatment records showing foot complaints during active duty, and buddy statements about limping and activity limits, support service connection.
C&P Exam Tips
- Schedule your exam for a time when symptoms are typically worse — usually morning
- Do NOT take pain medication before the exam
- Walk normally — do not try to hide your limp or pain
- Describe your worst flare-up days in detail
- Mention all activities you can no longer do (running, prolonged standing, hiking)
- Bring worn-out orthotics or shoe inserts as evidence of chronic use
- Report it if both feet are affected — bilateral involvement is the difference between the 20 and 30 percent levels
- Walk the examiner through every treatment you have tried, non-surgical and surgical, and whether any of it brought relief
- If surgery was recommended but you are not a surgical candidate, say so and bring the record
- Describe the morning pain and how long it takes to become mobile
How to File
File a claim for plantar fasciitis citing your foot condition and providing evidence of in-service onset or aggravation. If both feet are affected, claim both; DC 5269 rates the condition once, and bilateral involvement is what the 30 percent level requires. Include your full treatment history — non-surgical and surgical — imaging results, and a nexus statement connecting the condition to military service activities like running, rucking, and prolonged standing on hard surfaces.
Common Mistakes
Only claiming one foot when both are affected — at the higher level, bilateral involvement is the difference between 20 and 30 percent. Describing pain severity without documenting treatment: DC 5269 is scored on whether both non-surgical and surgical treatment have failed to bring relief, so an incomplete treatment record holds the claim at 10 percent. Not getting a surgeon's recommendation in writing when surgery has been advised but is not an option, which Note (2) sends to the 20 or 30 percent criteria. Taking pain medication before the C&P exam which masks symptoms. Not claiming secondary conditions caused by altered gait such as knee, hip, or back pain.
Frequently Asked Questions
Can I get separate ratings for each foot?
Not under DC 5269. The code prints its levels for one foot and both feet together: 10 percent "Otherwise, unilateral or bilateral"; 20 percent for no relief from both non-surgical and surgical treatment in one foot; 30 percent for the same finding in both feet. So bilateral plantar fasciitis is one evaluation, and both feet being affected is what raises the higher level from 20 to 30 percent.
What if my plantar fasciitis developed after service?
If your plantar fasciitis developed after service but was caused by another service-connected condition (like flat feet, knee problems causing gait changes, or weight gain from limited mobility), you can file it as a secondary condition. You will need a medical nexus opinion linking it to your primary service-connected disability.
Does the VA consider plantar fasciitis a presumptive condition?
Plantar fasciitis is not a presumptive condition. Direct service connection can be established with documented foot complaints during service, or with a medical opinion that military activities (prolonged marching, running, standing) caused the condition.
What does it take to be rated above 10 percent?
No relief from both non-surgical and surgical treatment: 20 percent if one foot, 30 percent if both. Failed orthotics, injections and therapy alone do not meet that standard, because surgical treatment is part of it. Note (2) to DC 5269 covers the veteran who has been recommended for surgical intervention but is not a surgical candidate: that veteran is evaluated under the 20 or 30 percent criteria, whichever is applicable. Document every treatment and its result.
Is there a rating higher than 30 percent?
Yes, in one circumstance. Note (1) to DC 5269 reads: "With actual loss of use of the foot, rate 40 percent." Actual loss of use is a high bar, well beyond pain. For special monthly compensation, 38 CFR 4.63 and 3.350(a)(2) define loss of use of a foot as no effective function remaining other than that which would be equally well served by an amputation stump at the site of election below the knee with a suitable prosthetic appliance.