Flat Feet VA Rating: Why the VA Denies This More Than Almost Any Other Condition
Pes planus (flat feet) is one of the most denied VA disability claims. The reason is not that flat feet are hard to rate. The VA denies them because most veterans had some degree of flat feet before service, and the VA treats it as a pre-existing condition under 38 C.F.R. § 3.306 unless you can show aggravation.
Here is the rating criteria, how to overcome the pre-existing condition problem, and what the C&P examiner actually measures.
DC 5276 Rating Criteria (Bilateral)
The critical distinction between 30% and 50% is whether orthopedic shoes or appliances improve the condition. If custom orthotics do not help, that supports 50%. If they provide some relief, the rater stays at 30%. Document this clearly with your provider.
The Pre-Existing Condition Problem
Many veterans had flat feet noted on their entrance physical. Under the presumption of soundness at 38 U.S.C. § 1111, a veteran is presumed sound at entry unless the condition was noted on the entrance examination. If flat feet were noted, the VA treats them as pre-existing.
However, pre-existing does not mean not ratable. Under 38 U.S.C. § 1153 and 38 C.F.R. § 3.306, if the condition was aggravated by service beyond its natural progression, it is service-connected for the degree of aggravation. Years of running, rucking, and standing on concrete in military boots aggravates flat feet. The evidence you need is a comparison between your entrance exam findings and your current condition, showing worsening.
Plantar Fasciitis by Analogy
Many veterans are diagnosed with plantar fasciitis rather than pes planus. Plantar fasciitis does not have its own diagnostic code in the VASRD. The VA rates it by analogy under DC 5276 (pes planus) or DC 5284 (other foot injuries). Under 38 C.F.R. § 4.20, when a condition is not specifically listed, it is rated by analogy to a closely related condition.
The advantage of being rated under DC 5276 is the higher bilateral rating (up to 50%). Under DC 5284, the maximum for moderately severe is 20% per foot, but each foot is rated separately. The rating path that produces the highest combined rating depends on your specific situation.
What the C&P Examiner Measures
The examiner uses the Foot Conditions DBQ. They will check weight-bearing line position relative to the great toe, Achilles tendon alignment (inward bowing), tenderness on manipulation of the plantar surface, presence of calluses, whether you have marked pronation, and whether orthotics improve the condition. They also order weight-bearing X-rays if not already in your records.
Report your worst days. If your feet are worse after standing for extended periods or first thing in the morning, say so. Per Sharp v. Shulkin (2017), the examiner must document functional limitations during flare-ups even if you are not flaring at the time of the exam.
Secondary Conditions from Flat Feet
Flat feet cause a biomechanical chain of secondary conditions. Altered gait from flat feet stresses the ankles, knees, hips, and lumbar spine. Each secondary condition is rated separately. Common secondaries include knee conditions (DC 5260-5261), hip conditions (DC 5250-5255), lumbar spine strain (DC 5237), Achilles tendinitis (DC 5271), bunions/hallux valgus (DC 5280), and hammertoes (DC 5282).
If you have flat feet and knee or back problems, the nexus letter should explain how altered foot mechanics caused compensatory stress on the upstream joints. This is established biomechanical science.
Dollar Impact
Bilateral flat feet at 30% alone is $552.47/month at the 2026 rates for a single veteran. Add bilateral knee conditions at 10% each (with bilateral factor), radiculopathy at 10% each leg (with bilateral factor), and lumbar spine at 20%, and you are looking at a combined rating of 60-70% from a single foot condition and its secondaries. That is $1,432.71 to $1,808.45 per month.