Plantar Fasciitis

38 CFR § 4.71a — Musculoskeletal System

Diagnostic Code

5269

Why your DC matters: In February 2021, the VA created DC 5269 specifically for Plantar Fasciitis. Before this, it was rated analogously (often under Flat Feet or Foot Injuries). This code determines how your foot pain and functional loss translate into a rating.

⚠️ Are You Potentially Under-Rated? Self-Check

If you are currently rated at 0% or 10% and any of these apply, you may have grounds for an increase:

☐ Your pain is unresponsive to treatment (shoes, inserts, physical therapy, injections).
☐ You have symptoms in both feet (bilateral). This is a 30% rating under the new DC 5269.
☐ You have undergone surgery for your plantar fasciitis that did not provide relief.
☐ Your foot pain forces you to limit walking, standing, or work activities significantly.

Note: If you were rated before 2021, you might be under an older (analogous) code. The new code is especially important for veterans with bilateral, treatment-resistant symptoms.

Official VA Rating Criteria — Plantar Fasciitis (DC 5269)

Rating	VA Criteria (38 CFR § 4.71a)	Key Evidence at This Level
40%	Loss of use of the foot (extreme case).	Documentation of total functional loss, often requiring mobility aids.
30%	Symptoms are bilateral (both feet) and unresponsive to treatment.	Treatment records (physical therapy, orthotics, injections) showing continued pain in both feet.
20%	Symptoms are unilateral (one foot) and unresponsive to treatment.	Physician notes confirming treatment failure in one foot.
10%	With otherwise (one or both feet) responsive to treatment.	Diagnosis of Plantar Fasciitis with current pain, even if orthotics provide some relief.
0%	Non-compensable (diagnosis without significant pain or limitation).	Service connection established but pain is minimal or manageable.

Source: 38 CFR § 4.71a, Diagnostic Code 5269

Key Terms Defined

Unresponsive to Treatment

This is a key phrase for the 20%/30% ratings. It means that despite following a doctor's plan (wearing inserts, doing stretches, taking meds, or getting injections), the pain and limitation persist.

Bilateral vs. Unilateral

Unilateral means one foot is affected. Bilateral means both feet are affected. The new DC 5269 includes the bilateral factor within the rating (30%), so you don't add the standard 10% bilateral factor on top of it.

Pyramiding

You cannot be rated for Plantar Fasciitis AND Flat Feet (Pes Planus) on the same foot at the same time. The VA must award the higher of the two ratings.

Service Connection Paths

🎯 Direct Service Connection

Foot pain/injury occurred during service (often from heavy rucking, running, or improper footwear). STRs should show complaints or treatment for heel/foot pain.

🔗 Secondary Service Connection

Plantar Fasciitis caused or aggravated by another condition, such as Flat Feet (Pes Planus), or an altered gait from a service-connected knee, hip, or back injury.

Secondary Conditions to Pursue if You Have Service-Connected Plantar Fasciitis

Foot pain changes how you walk (gait), which causes a chain reaction up your body.

Knee Pain / Patellofemoral Syndrome

DC 5260Strong

Compensating for heel pain leads to improper knee alignment.

Hip Strain / Tendonitis

DC 5252Strong

Altered gait puts excessive stress on the hip joint and labrum.

Lumbar Strain (Low Back Pain)

DC 5237Strong

Altered gait from chronic heel pain is a well-documented cause of secondary low-back pain.

Ankle Strain

DC 5271Strong

The ankle overworks to stabilize a painful heel/arch.

Achilles Tendonitis

DC 5271 analogousModerate

The plantar fascia and Achilles tendon are physically connected; inflammation often spreads.

Already Service-Connected for These? Plantar Fasciitis May Qualify as a Secondary

If you have service connection for any of the following, Plantar Fasciitis may be claimable as a secondary.

Flat Feet (Pes Planus)

DC 5276

Knee Condition

DC 5260

Hip Condition

DC 5252

Back Condition

DC 5237

Ankle Condition

DC 5271

Obesity (Secondary to Service Condition)

N/A (Intermediate Step)

Special Considerations

The "Unresponsive" Requirement

To get above 10%, you must prove that you've tried the standard medical treatments (inserts, physical therapy, weight loss, NSAIDs) and they haven't worked. Always mention treatment failures in your claim.

Custom Orthotics

If the VA provides you with custom-made orthotics but you still have pain while wearing them, that is strong evidence that your condition is "unresponsive to treatment."

Evidence Map — What Unlocks Each Rating

10%Diagnosis + Pain

• Current diagnosis from a Podiatrist or Doctor
• Records showing use of over-the-counter inserts or NSAIDs
• Statement describing pain while standing or walking

20% / 30%Unresponsive Treatment (Unilateral / Bilateral)

• Physical therapy records showing no improvement
• Documentation of corticosteroid injections
• Evidence of prescribed custom orthotics that don't eliminate pain
• Personal statement explaining why you can't stand for long periods despite treatment

What Leads to Lower Ratings or Denials

Failing to mention that the pain persists even when wearing prescribed inserts.
Rater missed that both feet are affected (Bilateral should be 30% if unresponsive).
Claiming Plantar Fasciitis and Pes Planus as two separate ratings on the same foot (Pyramiding).
No clear nexus link — if foot pain was not documented in service, the file usually needs a strong secondary or aggravation theory.

Next Steps

If your foot pain is persistent:

See a Podiatrist to get a formal diagnosis and a treatment plan
If treatment fails, ensure your doctor records that it failed
If you have flat feet, look into whether that or the plantar fasciitis results in a higher rating for you

This is general educational information only — not legal or medical advice.

Source: 38 CFR § 4.71a, Diagnostic Code 5269 • 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.