Morton's Neuroma / Metatarsalgia

Morton's neuroma is a thickened, irritated nerve between the metatarsal heads, usually between the third and fourth toes. Metatarsalgia is pain across the ball of the foot. Veterans file them as two conditions, and the rating schedule treats them as one: DC 5279 in 38 CFR § 4.71a, "metatarsalgia, anterior (Morton's disease)," rated at 10 percent whether one foot or both feet are affected. Ten is the entire schedule. There is no severity ladder.

A flat-10 code sounds like a dead end, and this is where most content stops. The live questions are elsewhere. Why is a nerve condition not on the nerve schedule? Can the 10 stack with flat feet, plantar fasciitis, claw toes, or bunions on the same foot, or does the anti-pyramiding rule kill the combination? And since the maximum is fixed, what does a strong 5279 claim actually need to prove? This page answers those three, then walks the service-connection lanes and the failure modes.

TL;DR

• Morton's neuroma and anterior metatarsalgia are rated under DC 5279 (38 CFR § 4.71a): a single 10 percent, unilateral or bilateral. It is the schedular maximum and the only level.
• Despite the nerve involvement, 5279 is structural foot-schedule territory, not the peripheral nerve schedule; it is not graded mild to severe like median or sciatic nerve codes.
• Whether DC 5279 can be combined with another foot code depends on whether the evaluations use distinct manifestations. Section 4.14 bars double-counting; the current schedule does not create a blanket flatfoot-plus-metatarsalgia prohibition or a special plantar-fasciitis exception.
• Neighbor codes contain express limits: hallux rigidus (5281) is not combined with claw-foot ratings, and DC 5282 compensates hammer toes only when there is no claw foot.
• The win condition at a flat 10 is simple: a current diagnosis (forefoot pain with the characteristic squeeze-test findings, imaging to exclude mimics), plus an in-service onset story or a service-connected condition that changes gait.
• Secondary lanes run through altered gait from service-connected knee, ankle, hip, or spine conditions, and through service-connected flat feet, under 38 CFR § 3.310.
• This page does not publish a Board outcome statistic for neuroma- or metatarsalgia-specific claims.

One Code, Three Names

The naming mess is the first thing to get straight, because veterans file claims on all three names and sometimes think they are three disabilities. "Metatarsalgia, anterior (Morton's disease)" is the schedule's label. Morton's neuroma is the interdigital nerve thickening at the same location. Anterior metatarsalgia is the pain pattern across the metatarsal heads with or without a confirmed neuroma. Under DC 5279, all of it is one code with one level: 10 percent, unilateral or bilateral. Both feet involved does not change the number.

The criteria have no severity words at all. No mild, moderate, severe; no treatment-response test; no obstruction-style threshold. Current diagnosis, 10 percent. That makes 5279 one of the simplest rating provisions in the schedule, and it means the claim's real work is entirely in diagnosis and service connection, not in grading.

Why It Is Not on the Nerve Schedule

Veterans reasonably ask why a neuroma is not rated like carpal tunnel (median nerve, DC 8515) or another peripheral nerve, with grades up to severe or complete. The answer is structural: the rating schedule organizes by system, and the foot codes (5276 through 5284) are the musculoskeletal home for acquired foot pathology, which is where the schedule's authors put metatarsalgia and Morton's disease. The peripheral nerve schedule in § 4.124a covers named nerves with their own codes, and the small interdigital nerves are not among them.

The practical consequence: there is no mild-moderate-severe negotiation here and no sensory-only ceiling argument to make. If a forefoot condition is genuinely something else, tarsal tunnel syndrome (a true nerve entrapment proximal to the foot) or peripheral neuropathy, it belongs to those frameworks instead, and the diagnosis should be re-examined. But for the interdigital neuroma itself, 5279's flat 10 is the home the schedule built.

Same-Foot Ratings: Apply § 4.14 to the Actual Findings

The value question for a flat-10 code is combination math. 38 CFR § 4.14 bars using the same manifestation to support more than one evaluation, while the foot schedule contains a few code-specific limits.

Flatfoot (5276) plus 5279: fact specific. Flatfoot criteria can include pain on manipulation and use, tenderness, and callosities, which may overlap with a metatarsalgia evaluation. If the same forefoot pain supports both codes, § 4.14 bars the duplicate evaluation. If the medical evidence identifies distinct manifestations, separate evaluations may be considered. The current text of § 4.71a does not state a blanket rule or a special plantar-fasciitis exception, so this analysis should not be presented as automatic.

Claw foot (5278) and its neighbors. DC 5281 expressly says hallux rigidus is not combined with claw-foot ratings, and DC 5282 compensates hammer toes only "without claw foot." A metatarsalgia evaluation alongside pes cavus still requires distinct manifestations under § 4.14; it is not guaranteed merely because the diagnoses differ.

Plantar fasciitis (5269). Plantar fasciitis often centers on the heel or plantar fascia while metatarsalgia centers on the forefoot, but labels alone do not establish separate ratings. The medical evidence must separate the manifestations used for each evaluation.

The theme is always the same: one manifestation, one rating. Distinct findings can stack; the same findings cannot be counted twice.

Service-Connection Lanes

Direct service connection from load: ruck marches, running in boots, jump and impact activities, prolonged standing under load. The forefoot takes the repetitive compression, and the interdigital nerve or metatarsal heads take the damage. The file needs in-service foot complaints, profiles, or podiatry visits (or credible lay evidence of them), the current diagnosis, and continuity or a nexus opinion. The classic denial is a silent service record plus an examiner who attributes the condition to post-service footwear or work, which is why the in-service complaint trail matters more here than in most foot claims.

Secondary service connection under 38 CFR § 3.310 runs through gait. A service-connected knee, ankle, hip, or spine condition that changes how you walk shifts load onto the forefoot, and metatarsalgia follows. The file needs the service-connected primary, a documented gait abnormality, and an opinion that explicitly addresses the weight-bearing change; "speculative chain" is the standard denial when the gait change is asserted but never documented. Service-connected flat feet are the other common primary: collapsed arches alter forefoot loading, a recognized contributor, with the same-foot pyramiding bar in mind when both ratings are claimed on one foot.

No lane is automatic. The 5279 criteria may be simple, but the service-connection half of the claim is where these are actually decided.

What a Strong 5279 File Contains

Because the rating is binary, the file's job is diagnosis plus nexus:

• The clinical picture, written down: burning or sharp forefoot pain, the pebble-or-bunched-sock sensation, numbness or tingling into the third and fourth toes, worse in boots and tight footwear, relieved by removing the shoe and rubbing the forefoot.
• The examination: forefoot squeeze test (the Mulder's click), tenderness localized to the interspace rather than diffusely across the ball, gait observation.
• Imaging to exclude mimics: X-ray or ultrasound excluding stress fracture, arthritis, or bursitis; the mimics have their own codes and their own claims, and a stress fracture is a different disability entirely.
• The service story: in-service complaints or profiles, or the gait-chain documentation for a secondary claim.

Podiatry notes carry unusual weight here because this is a podiatry-condition in practice: veterans who treat consistently have better files than veterans who white-knuckle it.

Common Failure Modes

The empty service record. No in-service foot complaints, no profiles, no lay statements, and the examiner blames post-service life. Direct lane dies.

The undocumented gait chain. A secondary claim asserted on a limp that appears nowhere in the medical record.

Pyramiding surprise. Two foot diagnoses are claimed separately, but the medical evidence attributes the same pain, tenderness, or functional loss to both.

Wrong-condition filing. Heel pain filed as metatarsalgia (that is plantar fasciitis territory), or whole-foot numbness filed as neuroma (that is peripheral neuropathy territory).

Mimics undiagnosed. A stress fracture or bursitis treated as "just neuroma," leaving a different, sometimes higher, evaluation unclaimed.

Secondary Conditions and Neighbors

Morton's neuroma sits in the forefoot with plantar fasciitis (DC 5269), pes cavus (DC 5278), flat feet (DC 5276), and bunions (DC 5280). Code references: /va-codes/5276 and /va-codes/5284 for the neighbors; for DC 5279 itself, the current eCFR text of § 4.71a controls. The secondary conditions tool maps gait-related theories, and the combined rating calculator shows the math after the permissible evaluations are established.

Bottom Line

Morton's neuroma and anterior metatarsalgia share one code with one number: DC 5279, 10 percent whether unilateral or bilateral. There is no severity ladder, so the core issues are diagnosis and service connection. For other conditions in the same foot, read the medical findings and the existing rating decision: separate evaluations require distinct manifestations, and § 4.14 bars using the same pain or functional loss twice.

Methodology and Limitations

• Data source: Rating criteria paraphrased from the current eCFR text of 38 CFR § 4.71a, DC 5279, with neighbor codes 5276, 5278, 5280, 5281, 5282, and 5269 for the same-foot analysis; pyramiding from 38 CFR § 4.14; secondary service connection from 38 CFR § 3.310. Criteria checked against the eCFR current text on 2026-08-06.
• Board statistics: This page publishes no Board outcome statistic for Morton's neuroma or metatarsalgia claims, because no verified count specific to these conditions was available.
• Limitations:
• The current schedule does not state a blanket flatfoot-plus-5279 bar or a plantar-fasciitis exception; combinations are evaluated under § 4.14 and any express code-specific notes.
• Gait-based secondary theories are evaluated case by case; this page describes the recognized mechanism, not a determination for any claim.
• These observations reflect the regulatory text and claim patterns, not legal or medical advice for a specific case.