EDUCATIONAL TOOL ONLY. Not legal or medical advice. Not affiliated with the VA.
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Sesamoiditis
✓ VERIFIED AGAINST 38 C.F.R.§ 4.71a (Musculoskeletal system) · reviewed 2026-05-27 · ClaimRecon Editorial Team
Sesamoiditis is rated by the U.S. Department of Veterans Affairs under DC 5283 of 38 CFR § 4.71a, DC 5283 across 4 severity tiers (30% / 20% / 10% / 0%). 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
Chronic inflammation or stress fracture of the sesamoid bones beneath the first metatarsophalangeal joint causing forefoot pain with push-off
RATING CRITERIA (4 LEVELS)
30%
Severe — sesamoid nonunion/malunion with marked pain on weight-bearing, antalgic gait, callosity formation at plantar first metatarsal head.
20%
Moderately severe — documented sesamoid malunion/nonunion with pain on push-off, weight-bearing limitation.
10%
Moderate — documented sesamoid pathology (MRI/bone scan) with intermittent pain on use.
0%
Slight — sesamoid inflammation without measurable functional impairment; consider DC 5279 (Morton's metatarsalgia, 10%) as alternative pathway for symptomatic non-fracture sesamoiditis.
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.
SOURCES & EDITORIAL
Rating criteria text quoted verbatim from 38 C.F.R. § 4.71a (Musculoskeletal system). Source verified 2026-05-27 by ClaimRecon Editorial Team during a regulation-text comparison against the Cornell Law CFR mirror; eCFR.gov is the authoritative government source.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026