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View Full Enhanced Guide →38 CFR Part 4 — 38 CFR § 4.71a
Flatfoot Acquired
dc-5276-flatfoot-acquired
Musculoskeletal
Diagnostic code
5276
Why your DC matters: DC 5276 is the exact code the VA uses to rate this condition. It determines which symptoms unlock which percentage, what evidence the rater looks for, and which secondaries are most likely to be approved.
Last verified against 38 CFR (eCFR Part 4):
Rating criteria (38 CFR Part 4)
Diagnostic code 5276 — Flatfoot (Pes Planus), Acquired — covers fallen arches and related foot deformities, listed under 38 CFR § 4.71a.
Flatfoot can be rated at 0%, 10%, 20%, 30%, or 50% based on the severity of symptoms (pain, swelling, inability to bear weight) and whether the condition is unilateral or bilateral.
For a comprehensive guide with visual compensation breakdowns, secondary conditions, evidence strategies, and claim timelines, visit the detailed guide page for this condition.
Exact rating criteria: 0% for asymptomatic, 10% for mild symptoms (unilateral or bilateral), 20% for moderate symptoms (bilateral with weight-bearing pain), 30% for severe symptoms (pronounced bilateral deformity with marked inward displacement and severe weight-bearing pain), 50% for bilateral condition with marked pronation and objective evidence of swelling on use.
Effective dates & which schedule version applies
Which diagnostic code, percentage, and effective date apply depends on the facts of your claim and the version of the rating schedule in force for the period being decided. Generally, VA applies the schedule in effect at the specified time under 38 U.S.C. § 5110 and implementing rules, subject to exceptions (e.g., protected ratings, liberalizing law changes—see regulation and VA manual policy as applicable).
For older claims, the **current** eCFR may not match the text that applied years ago. If your decision references a prior percentage or code, compare against the Part 4 text **as of** your claim’s relevant dates; historical Federal Register / CFR snapshots may be needed for precise comparison.
The “Last verified” date on this page is when we last checked this educational summary against the electronic CFR—not the date of any VA policy or your personal claim decision.
Notes for your claim
Evidence: Show that your diagnosis and severity match the factors the schedule names for DC 5276 (e.g., measurements, frequency, treatment, functional loss), with medical and lay evidence as appropriate.
C&P exams: Results should reflect the schedule’s requirements (correct joints measured, correct formulas). If the exam omits required findings, consider submitting records or requesting clarification.
If you disagree with the DC, percentage, or effective date, review the Part 4 text for your period and consider a supplemental claim or appeal with a VA-accredited representative.
This site does not provide legal advice.
Official source
38 CFR Part 4 (eCFR) — locate diagnostic code 5276 in the subpart for your body system (use Find in Page if needed).
DC 5276 rewards bilaterality — bilateral severe pes planus is 30%, bilateral pronounced is 50%. Unilateral severe is only 20%. The single biggest issue: VA frequently denies pes planus claims by citing 'congenital condition' — but in-service AGGRAVATION (worsening of a pre-existing condition) under § 3.306 is fully compensable. The other trap: 'asymptomatic flat feet' is not ratable; you must document symptoms with weight-bearing and orthotic use.
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 50% | Pronounced bilateral — marked pronation, extreme tenderness of plantar surfaces, marked inward displacement and severe spasm of the tendo achillis on manipulation, NOT improved by orthopedic shoes or appliances. | Orthopedic exam documenting all four findings; failed orthotic trial; weight-bearing imaging showing severe pronation. |
| 30% | Pronounced unilateral — same severe criteria but one foot. OR Severe bilateral — objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, characteristic callosities. | Pronounced unilateral findings; or severe bilateral with marked deformity and callosities. |
| 20% | Severe unilateral — marked deformity, pain accentuated on use, swelling on use, characteristic callosities. | Exam documenting all four findings for one foot. |
| 10% | Moderate (unilateral or bilateral) — weight-bearing line over or medial to great toe, inward bowing of the tendo achillis, pain on manipulation and use of the feet. | Weight-bearing X-ray + orthopedic exam documenting altered weight-bearing line and tendo achillis bowing. |
| 0% | Mild — symptoms relieved by built-up shoe or arch support. | Diagnosis + orthotic use providing relief. |
What Qualifies as 'Acquired Flatfoot' Under DC 5276?
Documented symptomatic pes planus (NOT asymptomatic)
Weight-bearing X-ray showing arch collapse, plus orthopedic exam documenting altered weight-bearing line, tendo Achilles bowing, pain on manipulation/use, and (for higher tiers) characteristic callosities and treatment resistance.
CFR terms of art — laterality + severity
DC 5276 uses specific terms (mild/moderate/severe/pronounced) — not casual descriptions:
- • 0% (mild) — symptoms relieved by built-up shoe or arch support
- • 10% (moderate, uni or bi) — weight-bearing line over/medial to great toe + tendo Achilles bowing + pain
- • 20% (severe unilateral) — marked deformity + pain accentuated + swelling on use + callosities
- • 30% (severe bilateral OR pronounced unilateral)
- • 50% (pronounced bilateral) — marked pronation + extreme tenderness + tendo Achilles spasm + NOT improved by orthopedic shoes
Language Your Rater Needs to See
These are the exact (or near-exact) regulatory phrases that unlock specific tiers. If your DBQ or C&P report doesn't use this vocabulary, the rater may default to a lower percentage even when symptoms qualify.
“Weight-bearing line over or medial to great toe and inward bowing of the tendo achillis”
These are the two anatomical hallmarks for moderate pes planus. The DBQ must document weight-bearing line position and Achilles bowing — not just 'flat arches.' Without this specific language, the rater stays at 0%.
“Marked deformity, pain on manipulation AND on use, swelling on use, characteristic callosities”
Severe tier requires all four findings. 'Characteristic callosities' = thickened skin on plantar surface from abnormal weight-bearing. Make sure each is documented separately on the foot DBQ — checkbox-by-checkbox.
“Not improved by orthopedic shoes or appliances”
The 50% gate. You need documented failure of orthotic treatment — not just 'tried inserts.' Custom orthotics, supportive shoes, ankle braces — all tried, all failed, all in the chart.
Evidence Checklist — Specific to This Condition
Weight-bearing foot X-ray
CRITICALDocuments arch collapse, talar tilt, and weight-bearing line objectively. Non-weight-bearing X-rays understate severity.
Foot DBQ — both feet examined separately
CRITICALBilateral findings double your ceiling. Make sure each foot is graded individually. The DBQ should document weight-bearing line, tendo achillis position, pronation, callosities, swelling on use, and response to treatment for EACH foot.
Orthotic prescription history
CRITICALCustom orthotics, supportive shoes, ankle braces, PT referrals. The trail of failed conservative treatment is what unlocks 30%/50%.
STR documentation of in-service foot complaints
CRITICALSick call notes, profile changes, MOS strain (infantry, MP, drill instructor, recruiter). Critical for SC AND for showing aggravation if pre-existing.
Photographs of callosities and deformity
IMPORTANTMany examiners don't note 'characteristic callosities' even when present. Bring photos and have them attached to the DBQ.
C&P Exam Tips
Walk in your normal shoes — bring your orthotics
Show the examiner the worn orthotics, the supportive boots, the ankle braces. Visible evidence of accommodation.
Stand on both feet for the weight-bearing exam
Pes planus is most apparent under load. Don't lift the foot being examined — let it bear weight so the arch collapse and pronation are visible.
Don't say you have 'flat feet, no big deal'
Minimizing the impact reads as asymptomatic — which is 0%. Describe the pain, the callus formation, the gait changes, the missed activities.
Demonstrate pain on manipulation
When the examiner palpates your arch or rotates your foot, react honestly. 'Pain on manipulation' is a 10%/20% criterion — silent stoicism erases it.
Common Mistakes That Cost Veterans Points
Accepting denial for 'congenital condition'
Per § 3.306, a pre-existing condition AGGRAVATED by service is compensable. Pull STRs — if you had no foot complaints at entry and chronic complaints by EAS, that's aggravation. Don't accept congenital-condition denials without an aggravation appeal.
Letting examiner only document one foot
Bilateral severe = 30%; unilateral severe = 20%. Bilateral pronounced = 50%; unilateral pronounced = 30%. Always have both feet examined.
Filing without documented orthotic failure
The 30%/50% tiers require failed conservative treatment. Build the trail BEFORE filing for increase — at least 6–12 months of custom orthotics, PT, NSAIDs.
Not claiming secondary MSK conditions
Pes planus changes gait → loads back, knees, hips. File secondaries when imaging or exam supports.
Tactical Plays
⚡ Aggravation of pre-existing condition under § 3.306
If VA denies for 'congenital,' the appeal is aggravation. Pull STRs: any foot complaints during service + worsening by EAS = compensable aggravation, even if you had flat feet at entry. Most veterans don't know this and accept the denial.
⚡ Bilateral pronounced = 50%, but it's earned with paperwork
The jump from 30% to 50% requires documentation that orthotics, supportive shoes, and PT all failed. Build that record explicitly: custom orthotic Rx (failed), boot inserts (failed), ankle brace (failed), three rounds of PT (failed). Then file for increase.
⚡ Stack pes planus + plantar fasciitis when distinguishable
If both conditions are diagnosed and the pain locations / findings differ (arch deformity vs. plantar fascia tenderness), they can be rated separately under § 4.14 anti-pyramiding rules. Most veterans only file one. Audit your decision.
Secondary Conditions to File With This One
Plantar fasciitis
STRONGDC 5269
Pes planus strains the plantar fascia. Frequently co-occurs and can be rated separately when the fascial pain has its own findings.
Lumbar strain
MODERATEDC 5237
Altered gait shifts load to the lumbar spine. Well-accepted secondary if foot condition pre-dates the back.
Knee strain
MODERATEDC 5260
Hyperpronation stresses the medial knee. File when imaging shows medial-compartment changes.
Hip / sacroiliac dysfunction
SITUATIONALDC 5252
Less common but documented. Requires clear gait abnormality.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
0% — single, no dependents
TOTAL
$0.00/mo
Mild — relieved by inserts.
10% — single, no dependents
Base rating
$180.42
TOTAL
$180.42/mo
Moderate (uni or bi) — weight-bearing line + tendo Achilles bowing + pain.
20% — single, no dependents
Base rating
$356.66
TOTAL
$356.66/mo
Severe unilateral — marked deformity + callosities.
30% — single, no dependents
Base rating
$552.47
TOTAL
$552.47/mo
Severe bilateral OR pronounced unilateral.
50% — single, no dependents
Base rating
$1,132.90
TOTAL
$1,132.90/mo
Pronounced bilateral — orthotic-resistant, extreme tenderness.
30% pes planus + 10% lumbar strain + 10% knee strain (compensatory)
TOTAL
$1,132.90/mo
Combined ~43–46%, rounds to 50% with bilateral factor = $1,132.90/mo. Foot conditions chain into back/knee/hip secondaries.
Note: Amounts are approximations rounded to nearest dollar. Actual comp varies with effective date, dependents (spouse, children, parents — each adds), Aid & Attendance, and additional disabilities. Combined ratings use VA Math (§ 4.25), not simple addition.
Key Definitions
📐What is the 'Weight-Bearing Line'?
Imaginary line from the center of the heel to the second metatarsal head. In pes planus, this line falls OVER or MEDIAL to the great toe instead of through it. Documented by weight-bearing X-ray.
🦶What is 'Tendo Achilles Bowing'?
Inward bowing of the Achilles tendon visible when the foot is weight-bearing. Characteristic of moderate-to-severe pes planus. Examiner must document this specifically for the 10% tier.
🦴What are 'Characteristic Callosities'?
Thickened skin pads on the plantar (sole) surface from abnormal weight-bearing patterns. Required finding for the severe tier (20%/30%).
⚖️What is 'Aggravation' Under § 3.306?
Worsening of a pre-existing condition during service. Even congenital flat feet can be compensable if they WORSENED during service. STR foot complaints + current severity > entry condition = aggravation grant.
How to File Your Claim
Build a documented orthotic-failure trail BEFORE filing for increase
30%/50% tiers require documented failure of conservative treatment. At least 6–12 months of custom orthotics, PT, NSAIDs, and ankle bracing — all tried, all failed, all in the chart.
File VA Form 21-526EZ specifying 'pes planus, bilateral' if applicable
Bilateral doubles your ceiling: severe bilateral = 30%, pronounced bilateral = 50%. Single-foot ratings cap at 30%.
Submit weight-bearing foot X-ray + foot DBQ examining BOTH feet
Non-weight-bearing X-rays understate severity. Make sure each foot is graded individually with the specific CFR criteria (weight-bearing line, tendo Achilles position, pronation, callosities, swelling on use).
If denied as 'congenital,' appeal under § 3.306 aggravation
Per § 3.306, a pre-existing condition aggravated by service is compensable. STR foot complaints + current symptoms exceeding entry-condition severity = aggravation grant.
File secondary claims for compensatory MSK conditions
Pes planus changes gait → loads back, knees, hips. File secondaries when imaging or exam supports.
Typical Claim Timeline
File initial claim
Day 0–7: Submit VA Form 21-526EZ with all medical evidence on file
VA acknowledges claim
Week 1–2: Receive confirmation letter and claim tracking number
C&P examination scheduled
Month 1–3: VA contracts an exam vendor and sends you appointment notice
Attend C&P exam
Bring your full evidence package; describe symptoms on your worst days, not your best
Decision & rating notice
Month 3–6: Decision letter with rating percentage and effective date
First payment & retro back pay
Within 15 days of decision; retroactive to claim date (or effective date if earlier)
Timeline varies by case complexity and VA regional office workload. Some claims resolve faster; others take longer.
Important Considerations
Don't accept a 'congenital condition' denial without appealing
§ 3.306 makes aggravation of pre-existing conditions compensable. STRs showing foot complaints during service + current severity > entry condition = winnable on appeal.
Bilateral doubles your ceiling
Both feet must be on the DBQ with separate findings. Bilateral severe = 30%; unilateral severe = 20%. Bilateral pronounced = 50%; unilateral pronounced = 30%.
Photographs of callosities help
Many examiners don't document 'characteristic callosities' even when visible. Bring photos and have them attached to the DBQ. Callosities are required for the severe tier.
Pes planus + plantar fasciitis can sometimes both rate
Per § 4.14, can't double-rate the same disability. But if pain locations differ (arch deformity vs plantar fascia tenderness), distinct ratings may apply. Verify with VSO before filing.
Related Tools & Resources
Frequently Asked Questions
Can congenital flat feet be service-connected?
Yes — via § 3.306 aggravation if the condition WORSENED during service. STR foot complaints + current severity > entry condition is the path. VA often initially denies 'congenital' claims; appeals on aggravation grounds frequently win.
What's the difference between mild, moderate, severe, and pronounced?
CFR terms of art. Mild = relieved by inserts (0%). Moderate = weight-bearing line + tendo Achilles bowing + pain (10%). Severe = marked deformity + accentuated pain + swelling + callosities (20%/30%). Pronounced = severe findings + orthotic-resistant + Achilles spasm (30%/50%).
Do orthotics improve my rating chances?
Counter-intuitive answer: failed orthotics support 30%/50%. Successful orthotics keep you at 10%. The 50% tier explicitly requires 'NOT improved by orthopedic shoes or appliances.' Build the failure record.
Does pes planus cause back pain?
Hyperpronation alters gait, shifting load to the lumbar spine. If foot symptoms pre-date back symptoms by years, lumbar strain (DC 5237) is a strong secondary claim. Knee, hip, and ankle problems chain similarly.
Is pes planus rated under DC 5269 (plantar fasciitis)?
Different DCs. Pes planus = DC 5276 (arch deformity, weight-bearing line). Plantar fasciitis = DC 5269 (fascial inflammation, first-step pain). Both can co-exist; verify pyramiding rules before filing both.
Official Regulatory Source
Acquired flatfoot (pes planus) is rated under 38 CFR § 4.71a, Diagnostic Code 5276.
38 CFR § 4.71a — Musculoskeletal System (eCFR) →Scroll to DC 5276. The CFR terms mild/moderate/severe/pronounced have specific defined symptom clusters.
⚠️ Verify with a VSO
Pes planus rating tiers under § 4.71a use the specific terms 'mild / moderate / severe / pronounced' — these are CFR terms of art, not casual descriptions. Each has a defined symptom cluster. Verify that the C&P examiner's language matches the schedule's defined terms; vague descriptions like 'mild-to-moderate' can be challenged on HLR.
Next Steps
If your rating decision lists DC 5276, compare your current symptoms and documentation against the criteria above. Consider:
- Requesting a copy of your rating decision and C&P exam report from the VA
- Gathering all relevant medical records (VA and private providers)
- Documenting functional limitations and how they impact work and daily activities
- Obtaining a nexus letter if needed to establish or strengthen service connection
- Filing for secondary conditions that may be related to this primary condition
- Contacting a VA-accredited VSO, claims agent, or attorney to review your file
This is general educational information only — not legal or medical advice.
Also: DC code lookup (tools) lists the same index in a compact layout.
Source: 38 CFR Part 4, Diagnostic Code 5276 • va.gov
⚠️ Important Disclaimer
This page provides general educational information only based on public VA regulations (38 CFR) and va.gov resources. It is not legal, medical, or claims assistance. Ratings and service connections are decided case-by-case by the VA based on the individual veteran’s evidence. We do not prepare claims, generate documents, or provide personalized advice. Always consult a VA-accredited Veterans Service Organization (VSO), attorney, or your physician for help with your specific situation. Verify the latest rules on va.gov.