Flat feet — medically called pes planus — are one of the most commonly underrated conditions in the VA disability system. Veterans who spent years marching, running in boots, and carrying heavy loads often develop painful fallen arches, yet many receive a 0% rating or miss out on additional compensation for secondary conditions. This guide breaks down exactly how VA evaluates flat feet under 38 CFR Part 4, Diagnostic Code 5276, explains the bilateral factor, and shows you how to claim the chain of secondary conditions that flat feet frequently cause.
Ratings governed by 38 CFR § 4.71a — Foot Ratings. See also: DC 5276 — Flatfoot, Acquired.
VA rates flat feet under 38 CFR Part 4, Diagnostic Code 5276 — Flatfoot, Acquired. The regulation assigns ratings based on the severity of structural deformity and the degree of functional impairment. There are five possible rating levels: 0%, 10%, 20%, 30%, and 50%. Here is what each one requires:
Weight-bearing line: The line drawn from the center of the knee straight down through the ankle. In a healthy arch, it passes through the center of the foot. In moderate pes planus, it shifts medially — falling over or past the great toe. A VA examiner checks this during the standing portion of your exam.
Inward bowing of the Achilles tendon: When viewed from behind, a normal Achilles tendon is straight. As the arch collapses, the heel tilts outward (valgus), causing the tendon to bow inward. This is a hallmark of moderate-to-severe pes planus and is documented by the examiner with the veteran standing.
Marked pronation: Excessive rolling inward of the foot during weight-bearing. It is typically measured by calcaneal pitch angle on x-ray — a lower pitch angle signals more severe pronation.
Extreme tenderness of the plantar surfaces: Significant pain to palpation across the bottom of the foot, particularly along the plantar fascia and the medial longitudinal arch. This is assessed by the examiner applying direct pressure during your C&P exam.
Cannot reasonably walk without severe pain (50%): This is the highest threshold under DC 5276. To reach a 50% rating, you must demonstrate through medical evidence, functional statements, and examiner findings that walking is severely limited by pain — not merely uncomfortable, but genuinely disabling.
The 20% and 30% ratings for bilateral flat feet differ by one element: objective imaging evidence. If your VA examiner or treating physician has ordered weight-bearing foot x-rays or an MRI that documents arch collapse, you should be at 30%, not 20%. Always request imaging before your C&P exam.
This distinction matters enormously to your claim — and it catches veterans off guard. Diagnostic Code 5276 covers only acquired flat feet, meaning flat feet that developed or worsened over time due to external forces such as physical stress, injury, or overuse. Congenital flat feet — present from birth due to bone structure — are not ratable under DC 5276.
If a VA examiner or rating officer concludes your flat feet are entirely congenital, your claim will likely be denied. However, many veterans who were born with a mild predisposition to flat arches had their condition significantly worsened by military service. This is where the argument of aggravation beyond natural progression comes in: even if you had some degree of flat feet before service, if military duties demonstrably worsened the condition, VA must rate the additional impairment caused by that aggravation.
Your service records are critical here. Enlistment physical findings, sick call visits for foot pain, physical training records, and any duty assignments involving prolonged marching, standing, or heavy load-bearing all support the argument that service caused or aggravated your flat feet. A well-written nexus letter from a physician explicitly distinguishing acquired aggravation from natural progression can be the difference between a grant and a denial.
When a veteran has a service-connected disability in both extremities — both feet, both knees, both shoulders — VA applies what is called the bilateral factor under 38 CFR § 4.26. For bilateral flat feet, the bilateral factor adds 10% to the combined value of the two separate foot ratings before that sum is folded into your overall combined rating.
Let's say you have 20% for the right foot and 20% for the left foot. Without the bilateral factor, VA would simply combine them using the standard whole-person formula:
With the bilateral factor, VA first adds the two ratings together (20 + 20 = 40), multiplies by 10% (40 × 0.10 = 4), and adds that back (40 + 4 = 44%) before plugging into the combined disability formula. That combined bilateral value of 44% is then used in the whole-person calculation alongside your other service-connected conditions.
In practice, the bilateral factor adds a few percentage points to your combined rating and can push you across a rating threshold — which has a real dollar impact on your monthly compensation.
If you have flat feet in both feet but only claimed one, file to add the second foot immediately. You are leaving bilateral factor compensation on the table every month you wait. Use our Rating Estimator to see how the bilateral factor changes your combined rating.
To establish service connection for acquired flat feet, you need three elements: a current diagnosis, an in-service incurrence or aggravation, and a medical nexus connecting the two. Here is what each looks like in practice.
You need a physician's diagnosis of pes planus — ideally documented on weight-bearing x-rays showing loss of the medial longitudinal arch. The diagnosis should specify whether the condition is unilateral or bilateral and whether it is acquired or congenital.
Pull your service treatment records (STRs) and look for any of the following: sick call visits for foot, ankle, or arch pain; referrals to podiatry or orthopedics; documentation of march fractures or stress reactions in the foot; Physical Training (PT) test exemptions due to foot pain; or profile limitations on foot activity. If your STRs are thin — which is common — your own lay statement describing foot pain during service carries weight under Jandreau v. Nicholson (2007). Describe specific events: the 12-mile ruck march in boot camp, the hours of standing post, the running program that aggravated your arches.
A nexus letter from a physician, physician's assistant, or nurse practitioner must state — at minimum — that it is "at least as likely as not" that your current flat feet are a result of or were permanently aggravated beyond natural progression by your military service. The letter should reference your specific MOS or duties (infantry, logistics, military police), the biomechanical stress those duties place on the arch, and your current clinical findings.
Flat feet don't just hurt your feet. When the arch collapses, the entire kinetic chain from ankle to hip is thrown out of alignment. This altered biomechanics places abnormal stress on joints and soft tissue up the leg and into the lower back — creating a cascade of secondary conditions that are each independently ratable under 38 CFR § 3.310.
Each of the following conditions can be claimed as secondary to your service-connected flat feet — and each receives its own separate disability rating added to your combined total.
Overpronation caused by flat feet forces the tibia to rotate inward during the gait cycle, pulling the kneecap (patella) off its normal tracking groove. This is the direct mechanism for patellofemoral pain syndrome — characterized by dull, aching pain around or behind the kneecap that worsens with stairs, squatting, or prolonged sitting. VA rates knee conditions under DC 5260 (limitation of flexion) and DC 5261 (limitation of extension), among others.
Inward rotation of the femur — again, driven by overpronation — places repetitive friction on the iliotibial band and the greater trochanteric bursa, the fluid-filled sac on the outer hip. Hip bursitis and hip pain from altered gait mechanics are well-documented secondary effects of pes planus and can be rated under DC 5251 (limitation of hip extension) or other relevant hip codes.
Flat feet reduce the shock-absorbing capacity of the foot's arch, transmitting greater impact forces up through the ankle, knee, and hip into the lumbar spine. Over years of service and post-service activity, this contributes to lumbar muscle strain and degenerative disc changes. If you already have a service-connected back condition, the nexus to flat feet strengthens both claims. If your back pain has no current rating, claiming it secondary to flat feet under the DC 5237 (lumbosacral strain) criteria can add significant compensation.
The plantar fascia — the thick band of tissue running along the bottom of the foot from heel to toes — is under constant stress in a flat foot because it must compensate for the absent arch. Plantar fasciitis (heel and arch pain worst in the morning or after rest) is one of the most direct and common sequelae of pes planus. It can be rated separately under DC 5284 (other foot injuries) based on functional impairment.
Overpronation stretches and strains the Achilles tendon with every step. Achilles tendinitis produces pain, stiffness, and swelling along the back of the heel. The condition can be separately rated and, if chronic, may involve evidence of tendinosis on MRI.
Veterans with flat feet often experienced shin splints during service — particularly during basic training — because overpronation overloads the medial edge of the tibia. Chronic shin splints can be documented in STRs and claimed as a secondary condition, particularly if they contributed to stress fractures or ongoing pain.
Use our free disability calculator to estimate your combined rating — including flat feet, secondary conditions, and the bilateral factor.
Calculate My Rating →Your Compensation & Pension (C&P) exam for flat feet is where ratings are made or lost. A DBQ (Disability Benefits Questionnaire) for pes planus will guide the examiner through a structured assessment. Here is what they are measuring — and what you must communicate clearly.
Do not minimize your symptoms. The exam is not a physical fitness test — it is an assessment of impairment. Be specific and honest:
If the C&P examiner does not order weight-bearing foot x-rays during the exam, request them explicitly. The difference between a 20% and a 30% rating under DC 5276 is objective imaging evidence. Without it, you cannot reach 30% even if your clinical findings support it.
The following are the 2025 VA disability compensation rates for a veteran with no dependents. These are monthly tax-free payments:
Veterans with dependents (spouse, children, or dependent parents) receive higher monthly amounts at 30% and above. Use the VA Disability Calculator to calculate your exact amount with dependents factored in.
Remember: these rates apply to your combined disability rating — not just your flat feet rating in isolation. If you have multiple service-connected conditions, flat feet at 20% bilateral might push your combined rating from, say, 40% to 50%, representing a substantial monthly increase across all conditions.
Secondary conditions add further: a veteran with 20% bilateral flat feet, 10% plantar fasciitis (secondary), and 10% lumbar strain (secondary) might have a combined rating that qualifies for significantly more than any single condition alone. See the Rating Estimator for a full combined-rating breakdown.
These are the errors that result in denied claims, underrated conditions, and thousands of dollars in lost compensation every year.
This is the single most common mistake. Many veterans file for one foot — often the one that hurts more — and forget that VA rates each foot separately AND applies the bilateral factor. If both feet are symptomatic, claim both. You will receive a rating for each foot and the bilateral factor on top of that. Filing for only one foot when both are affected leaves real money on the table each month.
Flat feet are a gateway condition. Every secondary diagnosis — plantar fasciitis, knee pain, hip pain, low back pain, Achilles tendinitis — represents a separate rating that adds to your combined total. VA will not automatically look for these connections. You must proactively claim each secondary condition with a clear nexus statement linking it to your service-connected flat feet.
A 0% rating means VA has acknowledged your condition is service-connected but has determined it does not currently warrant compensation. This is not a dead end — it is the starting point. If you have symptoms: pain on use, difficulty with prolonged standing, need for orthotics, tenderness — you should not be at 0%. File for an increased rating with updated medical evidence, C&P exam results, and a buddy or lay statement describing the functional impact of your flat feet.
Showing up without documentation, minimizing symptoms because you want to seem tough, or failing to mention secondary complaints are classic exam mistakes. The examiner's DBQ is the primary document that drives your rating decision. Prepare for it the same way you would prepare for any important appointment.
Weight-bearing x-rays are the objective evidence required to reach a 30% rating under DC 5276. Without them, even severe flat feet will likely be rated at 20% or lower. Request imaging through your VA primary care provider or ask your C&P examiner to order foot x-rays at the time of your exam.
claim.vet walks you through every step — from gathering evidence to submitting your claim for flat feet and all secondary conditions.
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