Pes Planus (Flat Feet)

1. What This Condition Is

Pes planus is the medical term for flat feet, a condition where the arch of the foot partially or completely collapses so that the sole makes full or near-full contact with the ground. In mild cases it causes foot fatigue and aching. In severe cases it produces constant pain across the plantar surface of the foot, tendon strain, and an altered gait that stresses the ankle, knee, hip, and spine. The condition is rated by VA because it limits your ability to stand, march, and perform sustained physical activity.

Most veterans develop symptomatic pes planus from prolonged standing, heavy load-bearing, marching in boots, or repetitive stress during service. A pre-existing condition that worsened in service can also be service-connected under 38 CFR 3.306 (aggravation). If your flat feet were asymptomatic before service but became symptomatic due to military demands, you still have a valid claim.

2. VA Rating Criteria

Pes planus is rated under 38 CFR Part 4, Section 4.71a, Diagnostic Code 5276. The rating scale distinguishes between unilateral (one foot) and bilateral (both feet) and grades severity from mild to pronounced.

Bilateral cases are subject to the bilateral factor under 38 CFR 4.26, which adds a small additional percentage to the combined rating.

If your flat feet also produce painful limitation of ankle motion, VA may also apply DC 5271 in addition to DC 5276. The rating that most favors you applies.

3. What to Expect at Your C&P Exam

The examiner will assess the severity and functional impact of your flat feet. Specific tests and questions include:

• Observation of arch structure in standing and non-weight-bearing positions
• Assessment of the tendo Achillis for inward bowing or displacement
• Palpation of plantar surfaces for tenderness and callosities
• Range of motion of the ankle and subtalar joint (inversion, eversion, dorsiflexion, plantar flexion)
• Observation of your gait for pronation pattern and antalgic changes
• Questions about footwear, orthotics, and whether they provide relief

Be direct about whether your orthotic devices, custom insoles, or arch supports provide adequate relief. If they do not, say so. The transition from 10% to 20%/30%/50% hinges partly on whether conservative treatment has failed.

Tell the examiner about your worst days, not just your average. Describe how long you can stand, how far you can walk, what surfaces make your pain worse, and whether you limp. Functional loss under DeLuca v. Brown must be captured, not just structural measurements.

4. Evidence You Need to Win

The foundation of your claim is a current diagnosis confirmed by a qualified provider. Flat feet are often visible on physical examination, but imaging strengthens the record.

Key evidence to assemble:

• Service treatment records showing in-service foot complaints, sick call visits, or physical exam notations of flat feet
• A current diagnosis from a physician, podiatrist, or orthopedic specialist
• Weight-bearing X-rays, which measure arch height and confirm the degree of deformity; the lateral weight-bearing X-ray is the standard view
• Records of orthotics, custom footwear, and any surgical interventions, with documentation of their outcomes
• A nexus letter connecting your current pes planus to your military service (38 CFR 3.102 standard: "at least as likely as not")
• A personal statement documenting your daily functional limitations and whether treatment provides adequate relief

The VA DBQ is titled "Foot Conditions (Including Flatfoot, Pes Planus) DBQ." Having a private podiatrist or orthopedic surgeon complete this form before your C&P exam allows you to enter the exam with a documented severity baseline.

Buddy statements (VA Form 21-10210) can corroborate in-service observations of foot problems and current limitations.

5. Secondary Conditions to Consider

Flat feet force the entire lower kinetic chain into misalignment. The inward roll of the foot (overpronation) transmits abnormal torque to every joint above it. Secondary conditions worth evaluating include:

• Plantar fasciitis: The collapsed arch places constant stress on the plantar fascia, producing inflammation and heel pain (DC 5269). This is one of the most common secondary conditions to pes planus.
• Ankle instability and limited motion: Chronic pronation strains the lateral ankle ligaments and can alter ankle mechanics over time (DC 5271, 5272).
• Patellofemoral syndrome: Tibial internal rotation from overpronation creates a lateral pull on the patella, contributing to kneecap pain and cartilage breakdown (DC 5260, 5261, 5257).
• Hip bursitis and strain: Gait compensation shifts load to the hip, producing trochanteric bursitis or iliotibial band syndrome.
• Lumbar spine strain: An asymmetric gait pattern from painful flat feet places uneven load on the lumbar spine, which can cause or aggravate degenerative disc disease and muscle strain (DC 5237, 5242, 5243).

File secondary claims under 38 CFR 3.310 with medical evidence linking each secondary condition to your service-connected pes planus.

6. Common Mistakes That Kill Claims

Claiming pes planus was pre-existing without addressing aggravation. Many veterans had flat feet before service. VA may deny direct service connection on that basis. But if your service significantly worsened the condition beyond its natural progression, you are entitled to a rating for the aggravated portion under 38 CFR 3.306. Always address aggravation if a pre-existing condition is an issue.

Not getting weight-bearing X-rays. Non-weight-bearing X-rays can appear near-normal even in symptomatic flat feet. Weight-bearing lateral foot X-rays show the actual arch collapse under load. Insist on proper imaging when seeking your diagnosis.

Failing to document treatment failure. Moving from 10% to 20% or above requires objective evidence of marked deformity and inadequate response to conservative treatment. Keep records of every orthotic device, injection, and any surgical referral.

Describing only bilateral symptoms and missing the unilateral distinction. The rating schedule assigns different maximum ratings to unilateral and bilateral cases. If one foot is significantly more affected, document that asymmetry. If both feet are severe, make sure your records explicitly address both.

Ignoring secondary conditions. Veterans rate pes planus and stop there. Every downstream joint condition that flows from gait compensation is a separate ratable disability. File those claims.

7. FWD Assist Resources

The following FWD Assist books are relevant to your pes planus claim:

• "C&P Exam Secrets" covers musculoskeletal exam preparation, how to communicate functional loss, and what examiners assess for foot and ankle conditions.
• "Nexus Letters" explains the standard a physician must meet to establish service connection and how to find a provider willing to write a credible letter.
• "Secondary Conditions" walks through the 38 CFR 3.310 framework and how to build and stack claims for conditions caused by flat feet.
• "Back and Joint Conditions" addresses the full lower extremity rating picture, including how foot, ankle, knee, and spine conditions interact and how to maximize each.
• "VA Appeals" explains all three AMA lanes so you can challenge a rating that understates the severity of your condition.

Visit fwdassisthq.com for the full catalog.

8. Get Help Without a Claim Shark

Free accredited help is available through Veterans Service Organizations including the Disabled American Veterans (DAV), Veterans of Foreign Wars (VFW), American Legion, and AMVETS. County Veterans Service Officers (CVSOs) also provide free claims assistance at no cost.

VA-accredited attorneys and claims agents may charge fees, but only after an initial VA decision and only on past-due benefits. The fee is capped at 20 percent of retroactive benefits under 38 U.S.C. 5904. Charging upfront fees for VA claims assistance violates 38 U.S.C. 5905.

Verify accreditation at va.gov/ogc/accreditation.asp before working with any paid representative.