Pes Planus Under 38 CFR: Flat Feet VA Disability Ratings

The VA disability rating for flat feet runs from 0% to 50% under Diagnostic Code 5276, with the exact percentage set by how severe the condition is and whether one or both feet are affected. A moderate case earns 10%, a severe case earns 20% for one foot or 30% for both, and a pronounced case earns 30% for one foot or 50% for both. The difference between the top two tiers is worth more than $580 a month in 2026, which is why the clinical findings in your file matter so much.¹

The Five Rating Levels for Pes Planus

DC 5276 sets out four severity categories, and severe and pronounced each split into unilateral and bilateral ratings.¹

Mild (0%): Symptoms relieved by built-up shoes or arch supports. The condition is recognized but not compensable.
Moderate (10%, one or both feet): Weight-bearing line over or medial to the great toe, inward bowing of the Achilles tendon, pain on use of the feet or on manipulation. This is the first level that pays.
Severe, one foot (20%) or both (30%): Objective evidence of marked deformity such as pronounced pronation or abduction, accentuated pain on use and manipulation, swelling on use, and characteristic callosities.
Pronounced, one foot (30%) or both (50%): Marked pronation, extreme tenderness of the plantar surfaces, marked inward displacement, and severe spasm of the Achilles tendon on manipulation, not improved by orthopedic shoes or appliances.

Most disputes happen at the line between severe and pronounced. The examiner is looking, in particular, at whether corrective footwear gives any relief. If shoes and inserts still leave you in significant pain with visible deformity, that points to pronounced. If they help even partially, severe is the more likely outcome. Bilateral severe and unilateral pronounced share the same 30% rating even though the clinical pictures differ, so veterans with symptoms in both feet should look closely at whether their exam meets the pronounced criteria, because that is the only path to the 50% maximum.¹

What the C&P Exam Documents

The Compensation and Pension exam drives your rating more than almost anything else in the file. The examiner uses a foot-specific Disability Benefits Questionnaire and records findings for each foot separately.²

Pain on use during normal activity, and whether it is accentuated.
Pain on manipulation, and whether it is accentuated.
Swelling after weight-bearing activity.
Characteristic calluses consistent with abnormal weight distribution.
Whether arch supports or built-up shoes give complete, partial, or no relief.

Preparation matters. If your feet are worse after standing or walking, an appointment later in the day or after normal activity gives the examiner a chance to see the symptoms as you actually live with them, rather than after a full rest.

Pain and Functional Loss Can Raise the Rating

Even when your structural findings sit at one level, VA regulations require examiners to account for functional loss caused by pain. Under 38 CFR § 4.40, disability of the musculoskeletal system reflects the inability to perform normal movements with normal strength, speed, and endurance, and a body part that becomes painful on use is to be regarded as seriously disabled.³

Section 4.59 backs this up by requiring at least the minimum compensable rating for actually painful, unstable, or misaligned joints, and directs testing for pain in both active and passive motion and in both weight-bearing and non-weight-bearing positions.⁴

In practice, a veteran whose exam shows moderate deformity but severe pain and an inability to walk normally has grounds to argue for a higher rating than structure alone would suggest. If the C&P report leaves out your flare-ups and how they limit you, that gap is worth challenging.

Evidence That Supports a Higher Rating

Start with a formal diagnosis from a podiatrist or orthopedic specialist. Weight-bearing X-rays are the standard imaging because they show alignment under load and reveal arch collapse that non-weight-bearing images can miss.

Beyond the diagnosis, the VA looks at the full treatment history. Records showing you tried orthotics, physical therapy, or specialized footwear and still had significant pain carry more weight than a diagnosis alone. Failure of conservative treatment lines up directly with the severe and pronounced criteria, both of which turn on whether corrective measures help.¹

Collect records from military treatment facilities, VA medical centers, and private providers. A timeline showing worsening symptoms over the years is harder for a rater to dismiss than a single snapshot.

If Your Flat Feet Existed Before Service

Many veterans had some degree of flat feet before enlistment, and that alone does not disqualify a claim. Under 38 CFR § 3.306, a pre-existing condition is considered aggravated by service if it worsened during active duty, unless the VA can show the worsening was the natural progression of the condition.⁵

The burden favors the veteran. Once you show worsening during service, the VA needs clear and unmistakable evidence that the change was natural progression to deny the claim. Combat veterans get additional consideration, with the regulation directing evaluators to weigh the hardships and circumstances of combat service.⁵

The key piece of evidence is a medical opinion stating that military service permanently worsened your flat feet beyond natural progression, tying specific service demands (prolonged marching, heavy load-bearing, rigid boots) to the documented change. Entrance and separation physicals are particularly useful because they bracket your service.

Secondary Conditions Linked to Flat Feet

Flat feet change how you walk, and that altered gait can stress your knees, hips, and lower back over time. Under 38 CFR § 3.310, a disability that develops because of an already service-connected condition qualifies for service connection in its own right.⁶

Common secondaries include lower back pain, knee problems, hip conditions, and plantar fasciitis. Each is rated under its own diagnostic code and combines with your pes planus rating to raise your overall percentage. To establish a secondary, you need a medical opinion that explains the biomechanical link, not just one that notes both conditions exist. Where flat feet made an otherwise non-service-connected condition worse rather than causing it, § 3.310(b) allows compensation for the degree of aggravation, measured against a baseline.⁶

You Can’t Be Rated Twice for the Same Symptoms

Under 38 CFR § 4.14, the VA cannot compensate twice for the same functional loss. This anti-pyramiding rule matters for flat feet because pes planus often coexists with plantar fasciitis, metatarsalgia, or other foot problems that share symptoms like heel pain and difficulty walking. Where the symptoms overlap, the VA rates you under the single diagnostic code that produces the highest rating rather than stacking codes.⁷

The rule cuts both ways. If a foot condition produces symptoms genuinely distinct from your flat feet, such as neurological numbness unrelated to arch collapse, a separate rating for that distinct impairment may be appropriate. The question is whether the symptoms overlap, not whether the diagnoses do.

2026 Monthly Compensation by Rating

Rates effective December 1, 2025, for a veteran with no dependents:⁸

10% (moderate): $175.51.
20% (severe, one foot): $347.83.
30% (severe bilateral or pronounced unilateral): $552.47, or $617.47 with a spouse.
50% (pronounced bilateral): $1,132.90, or $1,241.90 with a spouse.

At 30% and above, additional amounts apply for children and dependent parents. The step from 30% to 50% is worth over $580 a month for a single veteran, which is where the severe-versus-pronounced distinction pays off in real money.⁸

How to File

You can file for pes planus on VA Form 21-526EZ online at va.gov, by mail, in person at a regional office, or through a Veterans Service Organization. Filing online preserves your effective date from the moment you start the form, which protects back pay if the claim is approved. Submitting an intent-to-file first is worth considering if you need time to gather records.⁹

Send in your evidence with the initial claim whenever possible: diagnosis, treatment records, weight-bearing imaging, and any private medical opinions linking your condition to service. The VA reports an average processing time of about 77 days as of early 2026.⁹

If You’re Denied or Underrated

A denial or a low rating is not the end. You have one year from the decision letter to choose one of three review paths:¹⁰

Supplemental Claim: submit new and relevant evidence the VA did not have, such as a stronger medical opinion or updated records showing worsening.
Higher-Level Review: a senior reviewer re-examines the same evidence. No new evidence is allowed, but this option fits when the original rater misapplied the criteria or overlooked findings already in the file.¹¹
Board Appeal: a Veterans Law Judge reviews your case, and you can submit new evidence and request a hearing.

For flat-feet claims, the most common winning move on appeal is a stronger medical opinion that ties your specific exam findings to the criteria for the next higher tier. If your C&P didn’t adequately document pain, swelling, or the failure of orthotics, a private evaluation addressing those gaps can be the evidence that flips the decision.

1
eCFR. 38 CFR 4.71a – Musculoskeletal System
2
U.S. Department of Veterans Affairs. Foot Conditions Including Flatfoot Disability Benefits Questionnaire
3
eCFR. 38 CFR 4.40 – Functional Loss
4
eCFR. 38 CFR 4.59 – Painful Motion
5
eCFR. 38 CFR 3.306 – Aggravation of Preservice Disability
6
eCFR. 38 CFR 3.310 – Disabilities Proximately Due to Service-Connected Disease or Injury
7
eCFR. 38 CFR 4.14 – Avoidance of Pyramiding
8
Veterans Affairs. Veterans Disability Compensation Rates
9
Veterans Affairs. How to File a VA Disability Claim
10
Veterans Affairs. VA Decision Reviews and Appeals
11
Veterans Affairs. Higher-Level Reviews