DBQ · DC 5276 · 38 CFR § 4.71a

Flat Feet (Pes Planus) DBQ Field Guide

9 min read · CFR-cited · 2026 schedule

The Flat Feet DBQ is driven by objective foot mechanics. The examiner must document weight-bearing alignment, degree of pronation, pain on manipulation, callosities, and whether symptoms improve with orthotics. Ratings hinge on these findings plus whether the condition is unilateral or bilateral. Get the deformity and functional impact recorded accurately and the tier follows.

What the examiner is filling out

The Foot Conditions DBQ (or Flatfoot/Pes Planus section) requires the examiner to record:

  1. Diagnosis — acquired flatfoot (pes planus) confirmed by weight-bearing X-ray or clinical exam.
  2. Alignment and deformity — weight-bearing line position, inward bowing of Achilles, degree of pronation or abduction.
  3. Pain on manipulation and use — whether pain is present, accentuated on use, and any swelling or tenderness.
  4. Callosities and skin changes — characteristic calluses from abnormal weight bearing.
  5. Response to orthotics — whether symptoms improve with built-up shoes or arch supports.
  6. Unilateral vs bilateral — critical for 20% and 30% tiers.

The DC 5276 schedule

0%Mild

Symptoms relieved by built-up shoe or arch support. No significant deformity or pain on manipulation.

10%Moderate; weight-bearing line over or medial to great toe, inward bowing of the tendo achillis, pain on manipulation and use of the feet

Applies to unilateral or bilateral. Pain on use and moderate alignment shift.

20%Severe unilateral

Objective evidence of marked deformity, pain on manipulation accentuated, swelling on use, characteristic callosities. Unilateral only.

30%Severe bilateral OR Pronounced unilateral

Two routes to 30%: (a) Severe criteria (marked deformity, accentuated pain, swelling, callosities) present in BOTH feet, OR (b) Pronounced criteria (marked pronation, extreme plantar tenderness, marked inward displacement, severe tendo achillis spasm on manipulation, not improved by orthotics) present in ONE foot.

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.

50% is the schedular maximum. If flat feet plus other service-connected conditions prevent substantially gainful employment, consider TDIU under 38 CFR § 4.16.

The phrases that map to each tier

Magic words for this tier

To establish moderate (10%):

  • “My arches collapse inward when I stand. The weight-bearing line sits over my big toe.”
  • “I have pain on the inside of my feet when I walk or stand for more than 20 minutes.”

Magic words for this tier

To establish severe (20% or 30%):

  • “My feet roll inward severely. My Achilles tendons bow inward when I stand.”
  • “I get swelling and thick calluses on the inside edges of my feet from the way I walk.”
  • “Pain is much worse after standing or walking; I have to sit and elevate my feet.”

Magic words for this tier

To establish pronounced (50%):

  • “My feet are extremely flat with marked pronation. The bottoms are so tender I can barely walk barefoot.”
  • “Even with custom orthotics my feet still collapse and the Achilles goes into severe spasm.”
  • “I cannot stand or walk for work without constant pain despite orthopedic appliances.”

What NOT to say

What NOT to say

  • “My feet are just a little flat.” (Defaults to 0% or 10%.)
  • “Arch supports help a lot.” (Kills the 50% “not improved” element.)
  • “I only have pain at the end of a long day.” (Sounds mild.)
  • “It doesn’t really slow me down.” (Undercuts all higher tiers.)
  • “My feet look normal when I sit.” (Ignores weight-bearing requirement.)

Bring weight-bearing X-rays and photos

Recent weight-bearing radiographs showing collapse and any buddy or spouse statements describing your gait and daily limitations strengthen the objective findings the examiner must record.

Use this with the rest of the site

Educational content only. DBQ structures are public knowledge from M21-1 and archived sources; VA discontinued public DBQ distribution in 2020 but the rating criteria these forms map to remain in 38 CFR Part 4. Not legal or medical advice. Always consult a VA-accredited VSO or attorney for claim-specific guidance. CFR citations: 38 CFR § 4.71a Diagnostic Code 5276 (flatfoot, acquired), § 4.71a Note (measurement of joint motion), § 4.40 and § 4.45 (functional loss and pain), § 4.16 (TDIU)..