Subastragalar (Subtalar) Ankylosis VA Disability Rating
Diagnostic Code 5272 · 38 CFR §4.71a
What Is It?
The subtalar joint sits below the ankle joint between the talus and calcaneus bones. It controls the side-to-side rocking motion of the foot that allows you to walk on uneven surfaces. When this joint becomes fixed and immobile, your foot cannot adapt to different terrain, making walking on anything other than flat ground difficult and increasing the risk of ankle sprains. Subtalar ankylosis commonly results from severe fractures of the heel bone (calcaneus) or talus, which are injuries frequently seen in veterans who sustained falls or blast injuries.
Rating Criteria
| Rating | Criteria |
|---|---|
| 20% | Ankylosis in a poor weight-bearing position. |
| 10% | Ankylosis of the subastragalar or tarsal joint in a good weight-bearing position. |
Evidence Needed
- Orthopedic records confirming loss of subtalar joint motion
- Imaging showing joint fusion or destruction
- Documentation of whether the foot is fixed in a favorable or unfavorable position
- Records of the original injury or condition that caused the ankylosis
- Functional assessment of walking ability on different surfaces
C&P Exam Tips
- Make sure the examiner specifically tests subtalar joint motion, not just ankle motion — they are different joints
- Describe difficulty walking on uneven ground, slopes, or stairs
- Report increased ankle sprains or instability on rough terrain
- Mention any orthotics or shoe modifications prescribed for the condition
- Ask the examiner to document whether the fixation is in a good or poor weight-bearing position
How to File
File under DC 5272 with evidence showing the subtalar joint is completely immobile. Make sure your examiner distinguishes between the ankle joint and the subtalar joint as they are rated under different codes.
Common Mistakes
Examiners testing only the ankle joint and missing the subtalar joint entirely Not understanding the difference between ankle ankylosis and subtalar ankylosis — they are different joints with different codes Failing to document whether the position is favorable or unfavorable for weight bearing Not reporting difficulty on uneven terrain which is the hallmark limitation of this condition
Frequently Asked Questions
What is the difference between the ankle joint and the subtalar joint?
The ankle joint allows up and down movement of the foot. The subtalar joint sits below it and allows the side-to-side tilting that helps your foot adapt to uneven ground. They are separate joints with separate diagnostic codes, and both can be affected independently.
What does good versus poor weight-bearing position mean?
Good weight-bearing position means the foot is fixed in a way that still allows you to stand and walk with the sole flat on the ground. Poor weight-bearing position means the foot is fixed at an angle that makes normal standing or walking difficult, such as being tilted inward or outward.