Flat Feet (Pes Planus) VA Rating

VA's fiscal year 2025 Annual Benefits Report counts 600,665 service-connected disabilities for acquired flatfoot. The claim has a structure most conditions do not. Flat feet are often written down on the entrance exam, which takes the ordinary direct path off the table and opens a different one: aggravation by service under 38 CFR § 3.306. And the rating code, DC 5276, pays more when both feet meet the severe or pronounced description, up to a 50 percent ceiling.

In my read, flat feet claims stall for three reasons. The veteran assumes a noted entrance exam ends the claim. The exam report skips the findings DC 5276 names. Or nobody explains how the feet changed the knees, hips or back. This page takes each in turn.

TL;DR

• DC 5276 rates acquired flatfoot at 0 percent (mild), 10 percent (moderate, one or both feet), 20 or 30 percent (severe, one foot or both) and 30 or 50 percent (pronounced, one foot or both).
• Under § 4.57, flat feet you were born with are not compensable when the arch is low but there are no abnormal calluses, pressure areas, strain or tenderness. VA rates the acquired condition by its anatomical changes and symptoms, not by how low the arch is.
• If flat feet were noted on your entrance exam, the claim is aggravation under § 3.306: an increase during service counts as aggravation unless clear and unmistakable evidence shows it was natural progress. If they were not noted, the presumption of soundness in § 3.304(b) applies.
• The higher levels depend on findings the foot DBQ asks for: pronation, calluses, swelling on use, plantar tenderness, Achilles tendon changes, and whether orthopedic shoes or appliances help.
• Flat feet can support secondary claims for the knees, hips, back and ankles when an opinion explains the mechanism and addresses aggravation.
• A ruling is one issue the Board decided in one decision; one decision often rules on several issues. Across 7,889 decided Board rulings on flat feet from 2021 to 2026, 25.5% were granted, 30.7% denied and 43.8% remanded, so remand is the most common outcome.

Flat feet VA rating criteria (DC 5276)

38 CFR § 4.71a, Diagnostic Code 5276 (Flatfoot, acquired), reads as follows.

Pronounced; marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement and severe spasm of the tendo achillis on manipulation, not improved by orthopedic shoes or appliances: Bilateral 50%, Unilateral 30%

Severe; objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, characteristic callosities: Bilateral 30%, Unilateral 20%

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

Mild; symptoms relieved by built-up shoe or arch support: 0%

In plain terms, the tendo achillis is the Achilles tendon, pronation is the foot rolling inward, callosities are calluses, and the plantar surface is the sole. The moderate level is the same 10 percent for one foot or both. At the severe and pronounced levels, both feet pay more than one: 30 instead of 20, and 50 instead of 30. The 50 percent bilateral pronounced level is the ceiling for flat feet alone.

For a veteran with no dependents, VA's rates effective December 1, 2025 are $180.42 a month at 10 percent, $356.66 at 20 percent, $552.47 at 30 percent and $1,132.90 at 50 percent.

Section 4.57 adds a rule that decides many claims before the levels come into play. "The congenital condition, with depression of the arch, but no evidence of abnormal callosities, areas of pressure, strain or demonstrable tenderness, is a congenital abnormality which is not compensable or pensionable." For the acquired condition, it says "depression of the longitudinal arch, or the degree of depression, is not the essential feature." What VA looks for is the change in how the foot and leg line up: the heel rotating inward, the Achilles tendon insertion shifting inward, the forefoot turned out, and a sole that is painful and tender.

Moving from 10 to 30 or 50 percent

A rating appeal for flat feet is usually a fight over whether the findings meet the severe or pronounced description, in one foot or both. Severe needs objective marked deformity, pain on manipulation and use that is accentuated, swelling on use and characteristic calluses. Pronounced needs marked pronation, extreme tenderness of the soles, marked inward displacement and severe spasm of the Achilles tendon on manipulation, and it has to be "not improved by orthopedic shoes or appliances." Keep records of every insert, custom orthotic and shoe change you tried and what it did, because that last phrase turns on them. The mild level works the other way: if arch supports relieve the symptoms, the rating is 0 percent.

Past 50 percent, more compensation comes from other ratings, not from DC 5276.

• Secondary conditions. Knees, hips, back and ankles, covered below.
• Plantar fasciitis and metatarsalgia. Neither adds a second rating on top of flat feet. VA's manual says that when pes planus and plantar fasciitis are both service connected, VA rates the symptoms of both together under whichever code gives the higher evaluation, because both sets of criteria pay for foot pain and § 4.14 bars paying for it twice (M21-1 V.iii.1.B.5.e). Pes planus and metatarsalgia also get one rating, under the predominant code (M21-1 V.iii.1.B.5.i). The exception: if either condition came from an injury to the foot, VA may rate the combined conditions under DC 5284, other foot injuries, when that pays more.
• Loss of use of a foot. Special monthly compensation under 38 CFR § 3.350(a) is payable for loss of use of one foot. Section 4.63 sets a high bar: no effective function remains other than what an amputation stump with a prosthesis would serve equally well, judged by balance and propulsion. That is a high bar for flat feet.
• TDIU. If your feet and the conditions they cause keep you from working, see TDIU.

How to get flat feet service connected

Start with your entrance exam, because it decides which path you are on.

Flat feet not noted at entry. Under 38 CFR § 3.304(b), you are presumed to have been in sound condition when you entered service, "except as to defects, infirmities, or disorders noted at entrance into service, or where clear and unmistakable (obvious or manifest) evidence demonstrates that an injury or disease existed prior thereto and was not aggravated by such service." VA has to prove both parts to rebut it. If it cannot, the claim proceeds as a direct claim.

A history is not a notation. Section 3.304(b) says "only such conditions as are recorded in examination reports are to be considered as noted," and § 3.304(b)(1) says a history of preservice existence recorded at the exam "does not constitute a notation." An entrance form that records "flat feet as a child" from your own answers is not the same as an examiner finding pes planus.

Flat feet noted at entry. The claim is aggravation under 38 CFR § 3.306(a): a preexisting condition "will be considered to have been aggravated" by service "where there is an increase in disability during such service, unless there is a specific finding that the increase in disability is due to the natural progress of the disease." Under § 3.306(b), once the record shows an increase in service, VA needs clear and unmistakable evidence to rebut aggravation. If the record shows no increase at all, aggravation is not conceded, so the in-service increase is the part you have to prove.

Two pieces of regulatory text help with that proof. Section 3.306(b)(2) says "due regard will be given the places, types, and circumstances of service." And § 4.57 says "exercise with undeveloped or unbalanced musculature, producing chronic irritation, can be an aggravating factor." Sick call visits for foot pain, profiles, issued orthotics, podiatry referrals and the separation exam are the records that show an increase.

The research on flat feet in training is mixed, which is why your own records matter more than general claims about boots and marching.

• Among 4,029 Finnish conscripts, flatfoot deformity was significantly related to foot and ankle disorders during service, and most visits for those disorders came in the first months (Parviainen and colleagues, 2019).
• In 449 Navy special warfare trainees, dynamic pes planus was one of the risk factors for lower extremity overuse injuries (Kaufman and colleagues, 1999).
• In 230 Royal Australian Air Force recruits, 22 of them flat-footed, foot shape was not related to injury over basic training, though the flat feet group reported poorer physical health on a questionnaire (Esterman and Pilotto, 2005).

When aggravation is granted, VA rates only the increase. Under 38 CFR § 3.322(a) and § 4.22, it deducts the degree of disability at entrance, in rating schedule terms, if that degree can be determined. If it cannot be determined, nothing is deducted.

The flat feet C&P exam

The exam follows the foot conditions DBQ, and its flatfoot section tracks DC 5276 almost word for word. The examiner records the following.

• Pain on use of the feet and pain on manipulation, and whether each is accentuated.
• Swelling on use and characteristic calluses.
• Whether arch supports or built-up shoes relieve the symptoms, foot by foot.
• Extreme tenderness of the soles.
• Objective marked deformity, marked pronation, and whether the weight-bearing line falls over or inside the great toe.
• Inward bowing of the Achilles tendon, and marked inward displacement and severe spasm of the Achilles tendon on manipulation, including whether orthopedic shoes or appliances improve it.

The form also asks about flare-ups and functional loss in your own words. Its testing section notes that X-rays are not required to diagnose flatfoot, while arthritis has to be confirmed by imaging.

An exam that says only "bilateral pes planus noted" cannot support the severe or pronounced levels. If yours reads that way, a private podiatry or orthopedic exam that records each DBQ finding can fill the gap. C&P exam prep walks through the questions.

Lay statements for flat feet

DC 5276 is written in descriptive terms: pain on use, swelling on use, calluses, tenderness, whether shoes help. An examiner sees your feet for a few minutes. Your statement is how the Board learns what they do the rest of the time, and the Board section below shows how its rulings lined up with its credibility findings on lay statements.

A strong personal statement gives specifics.

• Pain and its limits: "I can't stand more than 20 minutes without resting."
• Function: stairs, uneven ground, jobs or duties you changed.
• Treatment: custom orthotics, podiatry visits, injections, and whether they helped.
• Footwear: shoes you can no longer wear and what you buy instead.
• Dated episodes: a callus that needed treatment, a flare that kept you off your feet.

A weak statement says "my feet have bothered me since service" and stops. Statements from a spouse or someone you served with can add what they saw, and a buddy letter works best with dates and places.

Why VA denies flat feet claims

"Congenital, not acquired." VA calls the flat feet a birth defect under § 4.57. The fix is evidence of what § 4.57 says separates the acquired condition: abnormal calluses, pressure areas, strain, tenderness, and the anatomical changes in how the foot and leg line up.

"Noted at entry, no increase in service." The fix is the in-service record of foot complaints, orthotics, profiles or separation findings that shows an increase, then the § 3.306 standard that VA must rebut with clear and unmistakable evidence.

A notation that was really your history. The entrance form recorded what you said, not an examiner's finding. Point to § 3.304(b)(1).

Rated 0 percent because arch supports help. The fix is a description of the symptoms that remain with the supports in place, matched to the moderate description: pain on manipulation and use, inward bowing of the Achilles tendon and a weight-bearing line over or inside the great toe.

An exam that skipped the findings. The fix is a request for a new exam or a private exam that records each DBQ item.

A secondary claim with a one-line opinion. The fix is a nexus letter that explains the mechanism and addresses aggravation.

The Board section below shows how flat feet appeals were decided from 2021 to 2026, and how the Board ruled when a private medical opinion was in the record.

Flat feet and secondary claims

Secondary claims built on flat feet rest on one idea: that the feet changed how weight moves through the leg. Under 38 CFR § 3.310, a condition is service connected when your flat feet caused it (at least as likely as not), or when it is aggravated by your service-connected flat feet, meaning it would be less severe but for the flat feet (M21-1 V.ii.2.D). VA rates only the part above the baseline, which has to come from medical evidence, so the opinion should describe the baseline. This kind of aggravation is different from in-service aggravation under § 3.306: VA's manual no longer deducts natural progress here. An opinion that addresses only causation and not aggravation is inadequate (El-Amin v. Shinseki, 26 Vet. App. 136 (2013)).

The conditions most often claimed are the knees, the low back, the hips, the ankles and plantar fasciitis. The research supports some of these links and not others. Plantar fasciitis can be service connected this way, but it is then rated together with the flat feet, not separately, as the rating section above explains.

• Among 97,279 adolescents examined at military recruitment centers, before service, moderate and severe pes planus went with nearly double the rate of anterior knee pain (7% against 4%) and intermittent low back pain (10% against 5%), while mild pes planus did not (Kosashvili and colleagues, 2008).
• In 1,903 older adults in the Framingham studies, the flattest feet had 1.3 times the odds of knee pain on most days and 1.4 times the odds of cartilage damage on the inner side of the knee joint (Gross and colleagues, 2011).
• In 1,930 Framingham participants, foot posture was not associated with low back pain, but pronated foot function, measured while walking, was associated with it in women (Menz and colleagues, 2013).

These are associations at one point in time, not proof that flat feet caused anyone's knee or back problem, so the opinion has to explain your own gait and time line. The Board has granted on that reasoning. In decision A25008276 (January 30, 2025), it granted both knees and a hip secondary to service-connected flat feet after a private clinician explained that the foot condition and its pain altered the veteran's posture and gait, and it found the VA opinions inadequate because they used a proximate-cause standard and never addressed aggravation. That decision binds only that appeal. The Board section below shows which conditions veterans most often claimed secondary to flat feet and how those claims were decided.

Secondary ratings add up. Pes planus at 50 percent and a back at 20 percent combine to 60 percent under § 4.25; at 30 and 20 they combine to 44, which rounds to 40. Leg ratings can also bring in the bilateral factor, and § 4.26(a) uses pes planus in its own example: a compensable disability of one thigh and pes planus of the other foot.

Questions veterans ask about flat feet

What is the VA rating for flat feet?

DC 5276 rates flat feet at 0, 10, 20, 30 or 50 percent. Moderate flat feet rate 10 percent, severe rate 20 percent for one foot or 30 for both, and pronounced rate 30 percent for one foot or 50 for both.

Can I get service connection for flat feet if they were noted on my entrance exam?

Yes, through aggravation under § 3.306. If the record shows your flat feet got worse in service, VA treats that as aggravation unless clear and unmistakable evidence shows it was natural progress.

Are flat feet a VA disability if I was born with them?

Under § 4.57, congenital flat feet with a low arch but no abnormal calluses, pressure areas, strain or tenderness are not compensable. When those findings and the anatomical changes of acquired flatfoot are present, VA rates the condition under DC 5276.

Do I need an X-ray for a flat feet claim?

No. The foot DBQ says X-rays are not required to diagnose flatfoot, though arthritis in the foot has to be confirmed by imaging.

How do I get a higher VA rating for flat feet?

Show the severe or pronounced findings in each foot: marked deformity, accentuated pain, swelling on use, calluses, extreme tenderness, and Achilles tendon changes. For pronounced, show that orthopedic shoes or appliances did not improve them.

Can flat feet cause knee or back problems VA will rate?

Yes, if a medical opinion explains how your flat feet caused or worsened the knee or back condition. The back secondary to flat feet page covers that pair in detail.

Bottom Line

Flat feet are rated under DC 5276 from 0 to 50 percent, with more paid when both feet meet the severe or pronounced description. Whether flat feet were noted at entry decides the path: aggravation under § 3.306 if they were, the presumption of soundness under § 3.304(b) if they were not, and a recorded history is not a notation. The level depends on an exam that records each finding DC 5276 names and on a specific lay statement about pain, function, treatment and footwear. Past the 50 percent ceiling, additional compensation comes through the knees, hips, back and ankles, each with its own opinion.

Methodology and Limitations

• Data source: Board figures in this post come from Claim Raven's read of every Board decision from 2021 to 2026 that it holds: 511,036 decisions containing 1,378,030 rulings. Of 8,705 Board rulings on flat feet, 7,889 were decided (granted, denied or remanded); the rest were dismissed, withdrawn or closed another way. Rating criteria are quoted from 38 CFR § 4.71a, DC 5276, and § 4.57 as published in eCFR for October 1, 2026. Service connection rules are from 38 CFR §§ 3.304(b), 3.306, 3.310 and 3.322 and § 4.22. Exam items are from the Foot Conditions, Including Flatfoot (Pes Planus) DBQ. Every rule, case and study is listed under Sources.
• Sample size: Across 7,889 decided Board rulings on flat feet from 2021 to 2026, 25.5% were granted (2,008), 30.7% denied (2,422) and 43.8% remanded (3,459). Board-wide, the grant rate on decided rulings is 24.7%. By issue: service connection 5,045 rulings (23.1% grant rate), increased rating 2,018 (20.7%), other issues 826. Connection type on service connection rulings: secondary 778, all others (direct and in-service aggravation together) 4,267. The data does not separate aggravation from direct claims, record diagnostic codes, or record the tier assigned.
• Classification approach: A ruling counts toward flat feet when the issue the Board decided names it. A service connection ruling counts as secondary when the Board treated it as a secondary claim or its order says "secondary to." Lay evidence figures record whether the Board found the veteran's lay statements credible on the point at issue and, like the private opinion figure, count only rulings the Board granted or denied.
• Limitations:
• These rulings reached the Board. Claims granted at the regional office without appeal are not in this data.
• The data does not separate in-service aggravation claims from direct claims, so this page gives no aggravation grant rate, and it records the outcome of each ruling, not the level assigned.
• The lay evidence and private opinion figures in the Board section are associations, not causes. A credibility finding is part of how the Board decides, and those figures count only rulings the Board granted or denied.
• The research on flat feet comes from recruits and civilian cohorts. It does not decide an individual claim.
• These observations describe Board patterns. They are not predictions of individual outcomes.

Sources

• 38 CFR § 4.71a, DCs 5269 and 5276. eCFR (opens in a new tab)
• 38 CFR §§ 4.14, 4.22, 4.25, 4.26, 4.57 and 4.63.
• 38 CFR §§ 3.304(b) (authority 38 U.S.C. 1111), 3.306 (authority 38 U.S.C. 1153), 3.310, 3.322 and 3.350(a).
• M21-1, V.ii.2.D.
• El-Amin v. Shinseki, 26 Vet. App. 136 (2013).
• Board of Veterans' Appeals decision A25008276 (January 30, 2025).
• VA, Foot Conditions, Including Flatfoot (Pes Planus) Disability Benefits Questionnaire; VA Annual Benefits Report, fiscal year 2025, Compensation; VA compensation rates effective December 1, 2025.
• Parviainen M, Pihlajamäki H, Kautiainen H, Kiviranta I. Incidence and Risk Factors of Foot and Ankle Disorders in Male Finnish Conscripts. Mil Med. 2019. PMID 30423135.
• Kaufman KR, Brodine SK, Shaffer RA, Johnson CW, Cullison TR. The effect of foot structure and range of motion on musculoskeletal overuse injuries. Am J Sports Med. 1999. PMID 10496574.
• Esterman A, Pilotto L. Foot shape and its effect on functioning in Royal Australian Air Force recruits. Part 1: Prospective cohort study. Mil Med. 2005. PMID 16130646.
• Kosashvili Y, Fridman T, Backstein D, Safir O, Bar Ziv Y. The correlation between pes planus and anterior knee or intermittent low back pain. Foot Ankle Int. 2008. PMID 18778669.
• Gross KD, Felson DT, Niu J, et al. Association of flat feet with knee pain and cartilage damage in older adults. Arthritis Care Res (Hoboken). 2011. PMID 21717597.
• Menz HB, Dufour AB, Riskowski JL, Hillstrom HJ, Hannan MT. Foot posture, foot function and low back pain: the Framingham Foot Study. Rheumatology (Oxford). 2013. PMID 24049103.
• Board figures on this page: Claim Raven's read of every Board decision from 2021 to 2026 that it holds, and of every decision since 1992 for the longer view.