Flat Feet (Pes Planus) VA Rating 2026: DC 5276 Criteria

What is flat feet (pes planus) and how does it affect veterans?

Flat feet, medically known as pes planus, is a condition where the arches of the feet collapse so that the entire sole contacts the ground during standing. Acquired flatfoot develops over time due to stress, injury, or weakening of the posterior tibial tendon that supports the arch. This is distinct from congenital flatfoot, which is present from birth.

Military service is a well-established cause of acquired flat feet. Years of marching, running, and standing in military boots — often on hard surfaces and with heavy loads — progressively break down the arch support structures. The posterior tibial tendon, which is primarily responsible for maintaining the arch, degrades under repetitive stress. Paratrooper landings, prolonged field exercises, and the cumulative impact of physical training over a military career all contribute to arch collapse.

Flat feet affect far more than just the feet. When the arches collapse, the entire biomechanical chain from the ankles through the knees, hips, and spine is disrupted. The feet pronate inward excessively, placing abnormal stress on the ankles and knees. Gait changes from flat feet alter hip and spinal mechanics, frequently causing pain and degeneration in those joints. Many veterans with service-connected flat feet eventually develop a cascade of secondary musculoskeletal conditions.

Daily life with flat feet means dealing with chronic foot pain, difficulty standing or walking for extended periods, inability to run or engage in high-impact activities, and the need for custom orthotics or specialized footwear that may provide only partial relief.

VA diagnostic code for flat feet

Acquired flatfoot is rated under Diagnostic Code (DC) 5276 per 38 CFR § 4.71a, Schedule of Ratings — Musculoskeletal System.

DC 5276 provides explicit criteria at four severity levels (mild, moderate, severe, pronounced) with separate ratings for unilateral and bilateral conditions at the higher levels. This is one of the few diagnostic codes that specifically distinguishes between one-foot and both-feet involvement in its rating criteria.

Rating criteria for flat feet (DC 5276)

0% rating — Mild

Criteria: Symptoms relieved by built-up shoe or arch support.

Monthly payment: $0 (but establishes service connection)

What this looks like: Your flat feet cause some discomfort, but over-the-counter or custom arch supports effectively manage your symptoms. You can perform normal activities with appropriate footwear. The condition is documented and service-connected, which protects you if symptoms worsen over time.

10% rating — Moderate — $180.42/month

Criteria: Weight-bearing line over or medial to the great toe, inward bowing of the tendo achillis, pain on manipulation and use of the feet (bilateral or unilateral).

What this looks like: Your flat feet cause observable structural changes. When you stand, your weight-bearing line falls over or toward the inside of your big toe instead of centered over the foot. The achilles tendon bows inward (valgus alignment). You experience pain when your feet are manipulated by a clinician and when using your feet for walking and standing. Orthotics help but don’t fully control symptoms.

20% rating — Severe, unilateral — $356.66/month

Criteria: Objective evidence of marked deformity (pronation, abduction), pain on manipulation and use accentuated, indication of swelling on use, characteristic callosities.

What this looks like (one foot): One foot shows significant structural deformity — marked inward rolling (pronation) and outward turning of the forefoot (abduction). Pain is more than moderate — it is accentuated with any manipulation or use. The foot swells after periods of standing or walking. You’ve developed calluses in characteristic locations from the altered weight distribution. Conservative treatments provide limited relief.

30% rating — Severe, bilateral or Pronounced, unilateral

Severe bilateral — $552.47/month: Same criteria as severe (marked deformity, accentuated pain, swelling, callosities) but affecting both feet. Both feet show objective evidence of significant structural changes and functional impairment.

Pronounced unilateral — $552.47/month: Marked pronation, extreme tenderness of the plantar surface of one foot, marked inward displacement and severe spasm of the tendo achillis on manipulation, not improved by orthopedic shoes or appliances.

What this looks like: Either both feet have severe deformity with significant pain and swelling, or one foot has extreme, treatment-resistant symptoms. At this level, walking is substantially impaired. You may require assistive devices, and your condition limits employment options.

50% rating — Pronounced, bilateral — $1,132.90/month

Criteria: Marked pronation, extreme tenderness of plantar surfaces of both feet, marked inward displacement and severe spasm of the tendo achillis on manipulation, not improved by orthopedic shoes or appliances (bilateral).

What this looks like: Both feet have extreme symptoms. The arches are completely collapsed with marked pronation. The bottoms of both feet are extremely tender to touch. The achilles tendons show marked inward displacement with severe spasm when manipulated. No orthopedic intervention — custom shoes, orthotics, braces — provides meaningful improvement. This is the maximum schedular rating for flat feet and represents a severely disabling bilateral foot condition.

What evidence do you need?

Service records

• Entrance physical examination (documenting normal arches at entry strengthens an acquired flatfoot claim)
• Service treatment records showing foot complaints, arch pain, or flatfoot diagnosis during service
• Records of in-service orthotic prescriptions or specialized footwear
• DD-214 showing MOS involving heavy physical demands — infantry, airborne, combat engineer, military police
• Separation physical examination documenting flatfoot or foot problems
• Physical profiles or duty limitations for foot conditions

Medical evidence

• Current diagnosis of acquired pes planus from a treating physician
• Weight-bearing X-rays showing arch collapse, talar head uncovering, and alignment changes
• MRI showing posterior tibial tendon degeneration if applicable
• Treatment records documenting progression of the condition over time
• Records of all treatments attempted: orthotics, physical therapy, injections, surgery
• Documentation of objective findings: pronation, achilles alignment, tenderness, swelling, calluses

Nexus letter

A medical opinion connecting your flat feet to military service. The letter should explain how the specific physical demands of your service — prolonged weight-bearing, marching with heavy loads, running on hard surfaces, inadequate footwear support — caused progressive arch collapse. If your entrance exam showed normal arches, the nexus letter should reference this baseline and explain how service caused the acquired condition.

Buddy statements

Statements from fellow service members describing the shared physical demands — long marches, runs, extended standing formations, field exercises. Statements from family members describing how your foot condition limits daily activities: inability to stand for long periods, difficulty walking, need for special shoes, avoidance of activities requiring prolonged time on your feet.

Personal statement

A detailed personal statement describing when you first noticed arch collapse or foot pain, how the condition progressed during and after service, what treatments you’ve tried, and how flat feet affect your daily life. Include specifics about how far you can walk, how long you can stand, what footwear you require, and what activities you can no longer do.

C&P exam tips for flat feet

What the examiner evaluates

• Arch height (or absence) under weight-bearing and non-weight-bearing conditions
• Weight-bearing line position relative to the great toe
• Achilles tendon alignment — inward bowing (valgus)
• Pronation and abduction of the forefoot
• Tenderness on palpation of the plantar surface
• Swelling after weight-bearing
• Presence of characteristic callosities
• Whether orthopedic shoes or appliances improve the condition
• Whether the condition is unilateral or bilateral
• Functional impact on standing and walking

How to prepare

1. Follow your clinician’s medication instructions. Do not stop, skip, or change prescribed medication for an exam without talking to your healthcare provider. Tell the examiner what you take, how much it helps, any side effects, and which symptoms remain. See VA’s medication-safety guidance.
2. Bring your orthotics and specialized footwear. Show the examiner what you use and explain honestly how much (or how little) they help. If your symptoms persist despite orthopedic intervention, this supports a pronounced rating.
3. Stand for the examiner. The key findings are observed during weight-bearing. Make sure the examiner evaluates your feet while standing, not just while seated or lying down.
4. Point out calluses. If you have calluses from altered weight distribution, show them to the examiner. These are objective findings that support a severe rating.
5. Describe both feet. If both feet are affected, ensure the examiner documents findings for each foot separately. Bilateral involvement leads to significantly higher ratings.
6. Report pain honestly. When the examiner palpates (presses on) the bottom of your feet, don’t minimize the pain. Extreme tenderness of the plantar surface is a criterion for the pronounced rating level.

Common mistakes

• Not having weight-bearing X-rays in your medical file before the exam
• Failing to ensure the examiner evaluates both feet when both are affected
• Minimizing pain during the examination
• Not mentioning that orthotics don’t fully resolve symptoms
• Failing to describe how the condition affects daily activities and employment
• Not requesting a standing evaluation of the feet

Common secondary conditions linked to flat feet

Flat feet frequently cause or worsen other conditions through altered biomechanics:

• Back pain — Collapsed arches change your gait, which alters spinal mechanics. The abnormal forces transmitted up the kinetic chain from flat feet frequently cause chronic lower back pain. This is one of the most well-established secondary connections.
• Knee pain — Excessive pronation from flat feet places abnormal rotational stress on the knees, contributing to patellofemoral syndrome, meniscal wear, and degenerative changes.
• Hip conditions — The same biomechanical changes that affect the knees also stress the hips. Altered gait from flat feet can cause hip pain and accelerate hip degeneration.
• Plantar fasciitis — Flat feet increase strain on the plantar fascia, making plantar fasciitis a common co-occurring condition.
• Ankle conditions — The excessive inward rolling of flat feet stresses the ankle joints and tendons, contributing to chronic ankle instability and pain.

How to calculate your monthly payment

Your total VA disability payment depends on your combined rating across all service-connected conditions. Flat feet rated at the bilateral severe or pronounced level already provide a substantial base rating, and when combined with secondary conditions like back pain and knee problems, your combined rating can increase significantly.

Use our VA disability calculator to:

• Calculate your combined rating including flat feet and secondary conditions
• Use VA math to review separately ratable extremity disabilities and whether the bilateral factor applies to your facts
• Estimate your monthly payment including dependents

For the full breakdown of payment amounts at every rating level, see our 2026 VA disability pay rates page.

Correction — October 21, 2026: Corrected the FAQs to distinguish congenital defects from congenital diseases and pre-existing acquired flatfoot. Replaced the claim that both feet always get a 10% bilateral factor with the claims manual’s rule. Replaced advice to skip pain medication before the exam with guidance to follow your clinician’s instructions.

Disclaimer: This content is for informational purposes only and does not constitute legal or medical advice. For personalized guidance on your VA disability claim, consult a VA-accredited Veterans Service Organization (VSO), attorney, or claims agent. You can find accredited representatives at VA.gov.