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Plantar fasciitis used to be rated by analogy, squeezed into codes for flat feet or generic foot injuries. That ended with the 2021 musculoskeletal revision, which gave the condition its own diagnostic code: DC 5269 under 38 CFR § 4.71a. If you read an older page that rates plantar fasciitis under DC 5276 or DC 5284, you are reading stale criteria.
The current code prices exactly one variable: response to treatment. Rated at 10 percent, plantar fasciitis is compensable whether it affects one foot or both. At 20 percent, it affects one foot and has not responded to surgical or non-surgical treatment. At 30 percent, it affects both feet and has not responded. There is also a 40 percent path, but it is not really about plantar fasciitis anymore: Note 1 to DC 5269 rates 40 percent when there is actual loss of use of the foot. Everything between 10 and 30 is decided by what the treatment record shows, which makes this condition a documentation fight more than a diagnosis fight.
This page walks through the 2021 code change, the rating ladder in plain language, what "no relief from treatment" actually requires, the surgery-recommended-but-not-a-candidate clause, the bilateral mechanics, the service-connection lanes, and the evidence that moves these ratings.
TL;DR
- Plantar fasciitis is rated under DC 5269 (38 CFR § 4.71a), a dedicated code added in the 2021 revision. Pre-2021 pages rating it under 5276 or 5284 are outdated.
- The ladder: 10% if the condition responds to treatment (one foot or both), 20% if one foot gets no relief from non-surgical and surgical treatment, 30% if both feet get no relief.
- A veteran recommended for surgery who is not a surgical candidate is evaluated under the 20 or 30 percent criteria, whichever applies (Note 2 to the code).
- Actual loss of use of the foot rates 40 percent (Note 1).
- The code prices one-foot versus both-feet inside itself; there is no separate bilateral-factor add-on built on top of the 20/30 tiers.
- Common lanes: direct service connection from in-service repetitive impact (marching, running, standing), and secondary service connection to service-connected lower-extremity conditions that alter gait, under 38 CFR § 3.310.
- No verified Board-outcome statistic specific to plantar fasciitis claims is available, so this page publishes none.
DC 5269 and the 2021 Code Change
Before the 2021 musculoskeletal revision took effect, plantar fasciitis had no code of its own. Raters reached for analogies: DC 5276 (flatfoot) when arch mechanics dominated, DC 5284 (other foot injuries) as the catch-all. Ratings were inconsistent because the analog codes price deformity and general injury, not a treatment-response condition.
The 2021 revision added DC 5269 with criteria built around the condition's actual clinical course. The full current text:
5269 Plantar fasciitis: No relief from both non-surgical and surgical treatment, bilateral, 30% No relief from both non-surgical and surgical treatment, unilateral, 20% Otherwise, unilateral or bilateral, 10% Note (1): With actual loss of use of the foot, rate 40 percent Note (2): If a veteran has been recommended for surgical intervention, but is not a surgical candidate, evaluate under the 20 percent or 30 percent criteria, whichever is applicable
Two things to notice. First, the 10 percent tier is the default: "otherwise" means diagnosed plantar fasciitis that responds to treatment is still a compensable 10 percent, one foot or both. Second, everything above 10 percent is gated on failed treatment, and both kinds: non-surgical AND surgical, unless the surgical door is closed by the Note 2 clause.
"No Relief From Treatment": Where the Rating Is Decided
The phrase doing all the work in DC 5269 is "no relief from both non-surgical and surgical treatment." In practice, the fight is over what counts as an adequate treatment trial and what "no relief" looks like on paper.
Non-surgical treatment means the conservative stack: orthotics and arch supports, night splints, stretching protocols, physical therapy, anti-inflammatory medication, activity modification, sometimes injections. A file that shows diagnosis plus one round of orthotics that half-worked is a 10 percent file. A file that shows a documented sequence, multiple conservative modalities tried and failed over months, with the pain and functional limits persisting, is the beginning of a 20 or 30 percent argument.
The surgical half of the phrase is where Note 2 matters. Most plantar fasciitis never goes to surgery, and plantar fascia release is a last-line procedure. A literal reading of the criteria would cap almost everyone at 10 percent for lack of failed surgery. Note 2 closes that gap: when a surgeon recommends intervention but the veteran cannot have it (comorbidities, anesthesia risk, other contraindication), the rater evaluates under the 20 or 30 percent criteria as if the surgical arm were satisfied. The recommendation itself becomes the key document, and it has to actually be in the record.
What does not work: no treatment trial at all (the file reads as responsive by default, because there is no evidence of failure), self-treatment with no medical trail, and gaps where treatment stopped for years. The criteria price documented medical management, not self-reported struggle.
Bilateral Mechanics and the 40 Percent Route
DC 5269 prices laterality internally. Twenty percent is unilateral, thirty percent is bilateral, at the same failed-treatment standard. Because the code already accounts for one foot versus two, there is no bilateral-factor calculation stacked on top of those tiers; the 30 percent IS the bilateral price.
The 40 percent route is different in kind. Note 1 requires actual loss of use of the foot, the same "loss of use" standard used across the schedule: the foot functions as poorly as if it were gone, not merely painful. That is an amputation-equivalent standard, and plantar fasciitis almost never reaches it. When a file claims loss of use, the evidence looks like complete failure of ambulation mechanics attributable to the condition, documented over time, not a bad limp on exam day.
Service-Connection Lanes
Direct service connection from in-service repetitive impact is the classic lane. Road marches, running in boots, jump and impact training, prolonged standing under load: the infantry, airborne, and field-MOS pattern. The file needs in-service foot or heel complaints (or strong lay evidence of them), a current diagnosis, and continuity or a nexus opinion tying the pattern to service demands.
Secondary service connection runs through gait mechanics. A service-connected knee, ankle, hip, or opposite-foot condition that changes how you walk shifts load onto the plantar fascia, and the condition develops or worsens as a consequence, claimed under 38 CFR § 3.310. Flat feet are the most cited primary: collapsed arches increase fascial strain, and pes planus is itself a common service-connected condition. Weight gain driven by service-connected mobility limits or medications appears in these claims too, as a load mechanism.
Aggravation covers pre-existing fasciitis made permanently worse by service. As with every lane here, none of these relationships is automatic: each needs a record and a medical opinion behind it.
The C&P Exam and the Records That Matter
The foot DBQ drives the exam. What decides the tier is less the exam itself than the treatment file behind it. The examiner will document the diagnosis (clinical exam, tenderness at the fascial insertion, sometimes imaging showing fascial thickening or a heel spur, which is a separate radiographic finding, not the condition), the laterality, the functional impact on standing and walking, and the treatment history summary.
The records that move the rating: podiatry notes showing serial failed conservative care, orthotics prescriptions, physical therapy discharge summaries documenting persistence, injection records, and any surgical recommendation with the contraindication noted. Imaging rules out the mimics: calcaneal stress fracture (acute, positive imaging), tarsal tunnel syndrome (nerve entrapment with tingling into the toes, a different claim), and gout (inflammatory, metabolic).
Common Failure Modes
No documented treatment trial. The file shows diagnosis and complaints but no conservative-care sequence, so the criteria's default ("otherwise") caps the rating at 10 percent.
The missing surgical note. Surgery was discussed and declined for medical reasons, but the recommendation and contraindication never made it into the record, so Note 2 cannot be applied.
Stale criteria. A claim or a page argues under pre-2021 analog codes (5276, 5284) and confuses the criteria the rater must actually apply.
Heel spur confusion. The X-ray shows a spur, the veteran claims the spur, and the fascial condition, which is the rateable disability, goes undocumented.
Unilateral documentation, bilateral condition. Both feet hurt, but only one was ever examined, so the 30 percent tier is unreachable on the record.
Secondary Conditions and Neighbors
Plantar fasciitis sits in the middle of the foot cluster. Flat feet are the most common primary or co-claim, rated under DC 5276 with their own deformity criteria. Morton's neuroma and metatarsalgia share the forefoot but are a different code (5279) with a flat 10 percent. Pes cavus, the high-arch mirror of flat feet, loads the fascia from the other direction. Gait-chain partners live at the knee and ankle pages. Code references: /va-codes/5276 and /va-codes/5284 for the neighbors. The secondary conditions tool maps the gait chain, and the combined rating calculator shows what a foot rating adds.
Bottom Line
Plantar fasciitis has its own code now, and the code cares about one thing: whether treatment worked. Ten percent is the diagnosed-and-managed default. Twenty and thirty require documented failure of conservative care plus the surgical arm, either actual failed surgery or a recommendation you cannot safely undergo, and the difference between them is one foot versus two. The 40 percent loss-of-use level is an amputation-equivalent standard almost no fasciitis claim reaches. The rating lives in the treatment file: serial podiatry records, failed modalities, and the surgical note if there is one. Diagnosis gets you in the door. The treatment record sets the percentage.
Methodology and Limitations
- Data source: Rating criteria paraphrased and quoted from the current eCFR text of 38 CFR § 4.71a, DC 5269 (including Notes 1 and 2), with neighbor codes 5276 and 5284 for the pre-2021 frame; secondary service connection from 38 CFR § 3.310. Criteria checked against the eCFR current text on 2026-08-06.
- Board statistics: No verified Board-outcome statistic specific to plantar fasciitis claims is available, and a figure from a different condition would not describe these claims, so this page publishes no outcome statistic.
- Limitations:
- "No relief from treatment" is applied by raters to individual treatment records; descriptions here reflect the criteria's structure, not a determination for any claim.
- Whether a particular veteran is a surgical candidate is a medical determination; Note 2's application depends on documentation in the record.
- Worked examples of treatment sequences are illustrative, not a protocol or a prediction.
- These observations reflect the regulatory text and claim patterns, not legal or medical advice for a specific case.