Flat Feet (Pes Planus)
38 CFR § 4.71a — Musculoskeletal System
Diagnostic Code
5276
Why your DC matters: DC 5276 is used by the VA to rate Flat Feet (Pes Planus). It includes four levels of severity: Mild, Moderate, Severe, and Pronounced. Each level requires specific clinical findings like arch collapse, bowing of the Achilles, and symptoms being "relieved" or "not relieved" by orthotics.
⚠️ Are You Potentially Under-Rated? Self-Check
If you are currently rated at 10% and any of these apply, you may have grounds for an increase:
- ☐ Your arch collapse is so severe that it is visible when standing.
- ☐ Your pain is not relieved by arch supports or custom orthotics.
- ☐ You have callosities (calluses) on the bottom of your feet due to abnormal weight-bearing.
- ☐ Your Achilles tendon is bowing inward when viewed from behind.
If rated at 30% (Bilateral) and any of these apply, you may have grounds to reach 50%:
- ☐ Your feet are "pronounced" (deformity is extreme, with marked displacement and swelling).
- ☐ Your condition is not relieved by any orthotic or surgical treatment.
This is general educational information only — not legal or medical advice.
Official VA Rating Criteria — DC 5276
| Rating | VA Criteria (38 CFR § 4.71a) | Key Evidence at This Level |
|---|---|---|
| 50% | Pronounced: Marked deformity (pronation, abduction, etc.), swelling on use, characteristic callosities, and not relieved by arch support. (Bilateral only) | X-rays, Podiatry notes confirming "pronounced" deformity, documentation of treatment failure with orthotics. |
| 30% | Severe: Objective evidence of marked deformity, pain on manipulation and use, and not relieved by arch support. (Bilateral rating; 20% if Unilateral) | Weight-bearing X-rays, evidence of bowing Achilles, documented failure of arch supports. |
| 10% | Moderate: Weight-bearing line over or medial to the great toe, inward bowing of the Achilles tendon, and relieved by arch support. | Diagnosis of moderate pes planus with use of orthotics. |
| 0% | Mild: Symptoms relieved by built-up shoes or arch support. | Asymptomatic flat feet or symptoms easily managed by footwear. |
Source: 38 CFR § 4.71a, Diagnostic Code 5276
Key Terms Defined
Pronation / Abduction
Refers to the foot rolling inward and the front of the foot turning outward — common signs of arch collapse.
Marked Deformity
Visually obvious collapse of the arch and structural misalignment of the foot when standing (weight-bearing).
Relieved by Arch Support
A key differentiator between 10% and 30%/50%. If you still have pain while wearing orthotics, your condition is not relieved.
Service Connection Paths
🎯 Direct Service Connection
Flat feet began during service (often from boots, rucking, or standing on hard surfaces). Must show a current diagnosis and link (nexus) to service.
🔗 Aggravation of Pre-existing
If you entered service with flat feet and they became permanently worse during service (e.g., became painful or more deformed), you can be rated for the aggravation.
Secondary Conditions to Pursue if You Have Service-Connected Flat Feet
Flat feet destroy your body's foundation, leading to "kinetic chain" issues up the legs and spine.
Plantar Fasciitis
DC 5269StrongThe collapse of the arch puts extreme tension on the plantar fascia ligament.
Knee Pain / Arthritis
DC 5260StrongFlat feet cause internal rotation of the leg, putting stress on the knee joint.
Hip Pain / Strain
DC 5252StrongMisalignment of the foot leads to pelvic tilt and hip joint wear.
Lumbosacral Strain (Back)
DC 5237StrongWalking with flat feet causes an abnormal gait that strains the lower back.
Shin Splints
DC 5262ModerateExcessive pronation is a primary cause of medial tibial stress syndrome.
Ankle Strain
DC 5271ModerateThe ankle collapses inward to compensate for the missing arch.
Already Service-Connected for These? Flat Feet May Qualify as a Secondary
If you have service connection for any of the following, flat feet may be claimable as a secondary condition.
Knee Condition
DC 5260Hip Condition
DC 5252Back Condition
DC 5237Ankle Condition
DC 5271Obesity (Secondary to Service Condition)
N/A (Intermediate Step)Special Considerations
The "Relief" Factor
If your C&P exam says you wear orthotics, the rater will often assume you are "relieved" (10% max). You MUST clarify if you still have pain while wearing them to reach 30% or 50%.
Pyramiding with Plantar Fasciitis
You cannot be rated for both Flat Feet and Plantar Fasciitis on the same foot. The VA must choose the code that gives you the highest rating.
Evidence Map — What Unlocks Each Rating
- • Podiatry diagnosis showing arch flattening
- • Prescription for built-up shoes or custom inserts
- • Weight-bearing X-rays showing arch collapse
- • Podiatry notes documenting marked deformity and pain despite orthotics
- • Evidence of bowing Achilles tendons
- • Everything above, plus:
- • Clinical documentation of swelling on use and extreme deformity
- • Callosities on weight-bearing areas of the foot
What Leads to Lower Ratings or Denials
- C&P examiner did not perform a weight-bearing exam (arch status changes when standing).
- Failing to mention that pain persists while wearing orthotics.
- X-rays not taken in a weight-bearing position.
- Rater missed that symptoms are present in both feet (bilateral).
Next Steps
If your arches are flat and painful:
- See a Podiatrist and ask for weight-bearing X-rays
- Explicitly tell your doctor if your orthotics are not stopping the pain
- Check for secondary conditions like Knee or Back pain and link them to your foot gait
This is general educational information only — not legal or medical advice.
Source: 38 CFR § 4.71a, 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.