What happens during a C&P exam for Forefoot Amputation (Transmetatarsal)?

Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation. Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.

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Forefoot Amputation (Transmetatarsal)

Q: What are the VA rating percentages for Forefoot Amputation (Transmetatarsal)?

Forefoot Amputation (Transmetatarsal) (DC 5166) is rated at 40% under 38 CFR § 4.71a, DC 5166. DC 5166 verbatim — Forefoot, amputation proximal to metatarsal bones (more than one-half of metatarsal loss): 40 percent. Footnote 2: also entitled to SMC under 38 CFR § 3.350. Includes transmetatarsal amputations (Lisfranc / Chopart variants) where more than half of each affected metatarsal is removed.

Q: What rates 40% for Forefoot Amputation (Transmetatarsal) under 38 CFR § 4.71a, DC 5166?

Under 38 CFR § 4.71a, DC 5166 (DC 5166), a 40% rating for Forefoot Amputation (Transmetatarsal) requires: DC 5166 verbatim — Forefoot, amputation proximal to metatarsal bones (more than one-half of metatarsal loss): 40 percent. Footnote 2: also entitled to SMC under 38 CFR § 3.350. Includes transmetatarsal amputations (Lisfranc / Chopart variants) where more than half of each affected metatarsal is removed.

Q: What evidence do I need for a Forefoot Amputation (Transmetatarsal) VA claim?

Key evidence for a Forefoot Amputation (Transmetatarsal) claim includes: Service treatment records showing injury or complaints; Imaging (X-ray, MRI, CT); Range of motion measurements; Flare-up documentation per Sharp v. Shulkin; Buddy statements describing limitations. All evidence should document both the condition and its impact on daily functioning.

DC 5166 | 38 CFR § 4.71a, DC 5166 | 

Forefoot Amputation (Transmetatarsal) is rated by the U.S. Department of Veterans Affairs under DC 5166 of 38 CFR § 4.71a, DC 5166 across 1 severity tier (40%). Service connection requires (1) a current diagnosis, (2) an in-service event, injury, or exposure, and (3) a medical nexus opinion linking the two under 38 C.F.R. § 3.303.

OVERVIEW

Amputation through the metatarsal bones of the forefoot, requiring specialized footwear and causing significant gait impairment

RATING CRITERIA (1 LEVELS)

40%

DC 5166 verbatim — Forefoot, amputation proximal to metatarsal bones (more than one-half of metatarsal loss): 40 percent. Footnote 2: also entitled to SMC under 38 CFR § 3.350. Includes transmetatarsal amputations (Lisfranc / Chopart variants) where more than half of each affected metatarsal is removed.

KEY EVIDENCE TO GATHER

-Service treatment records showing injury or complaints

-Imaging (X-ray, MRI, CT)

-Range of motion measurements

-Flare-up documentation per Sharp v. Shulkin

-Buddy statements describing limitations

-Prescription history

-Physical therapy records

-Employment impact documentation

C&P EXAM TIPS (6)

1.Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation.

2.Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.

3.Tell the examiner about flare-ups: frequency, duration, estimated ROM loss. Sharp v. Shulkin (2017) requires estimates.

4.Request active, passive, weight-bearing, and non-weight-bearing ROM testing per Correia v. McDonald (2016).

5.If you use assistive devices (brace, cane), bring them.

6.Describe daily activity impact: work, sleep, household tasks.

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SOURCES & EDITORIAL

Rating criteria reference 38 C.F.R. Part 4 (Schedule for Rating Disabilities). This entry has not yet undergone editorial review against the live regulation text — consult the authoritative source directly before relying on the criteria shown.

→ View 38 C.F.R. Part 4 on eCFR → Editorial Standards → Suggest a correction

EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
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