Claim Raven explanation
What this means
This rule distinguishes acquired flatfoot from the congenital condition described in its text. For acquired flatfoot, the depth of the arch alone is not the whole disability picture.
VA should consider the relevant anatomical changes, pressure, strain, tenderness, and other findings discussed in the section. A clinician's explanation helps distinguish those findings from a label in a problem list.
How this helps your claim
This helps you understand what the foot examination is addressing and why the type of condition matters. Compare the medical explanation with the actual foot findings and history.
What to check in your records
Use your decision, examination reports, and relevant records to check the following points.
- Find the diagnosis and any explanation of acquired or congenital origin.
- Look for findings about alignment, tenderness, pressure, and strain.
- Compare the foot examination with the symptoms and limitations recorded over time.
Describe the foot findings beyond arch appearance
An arch that looks low does not by itself explain acquired flatfoot disability. The clinical findings about alignment, tenderness, pressure and strain help distinguish the actual condition and its effects. Footwear and treatment history may also provide context without replacing the examination.
Read the clinician's characterization of congenital or acquired findings carefully. The classification should not be inferred from photographs alone. When the decision relies on a particular finding, compare it with the documented anatomy and functional description rather than the everyday label flat feet.
Does every low arch establish acquired flatfoot for compensation?
No. This section distinguishes conditions and emphasizes more than arch depth. The diagnosis, relevant service-connection requirements and rating criteria must be considered separately. A visual observation can prompt a medical question, but it does not establish the entire legal or diagnostic analysis.
Official regulatory text
38 CFR § 4.57
eCFR snapshot: September 3, 2026. Layout and spacing are adapted for reading. The full section and its tables are included below.
§ 4.57 Static foot deformities.
It is essential to make an initial distinction between bilateral flatfoot as a congenital or as an acquired condition. 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. In the acquired condition, it is to be remembered that depression of the longitudinal arch, or the degree of depression, is not the essential feature. The attention should be given to anatomical changes, as compared to normal, in the relationship of the foot and leg, particularly to the inward rotation of the superior portion of the os calcis, medial deviation of the insertion of the Achilles tendon, the medial tilting of the upper border of the astragalus. This is an unfavorable mechanical relationship of the parts. A plumb line dropped from the middle of the patella falls inside of the normal point. The forepart of the foot is abducted, and the foot everted. The plantar surface of the foot is painful and shows demonstrable tenderness, and manipulation of the foot produces spasm of the Achilles tendon, peroneal spasm due to adhesion about the peroneal sheaths, and other evidence of pain and limited motion. The symptoms should be apparent without regard to exercise. In severe cases there is gaping of bones on the inner border of the foot, and rigid valgus position with loss of the power of inversion and adduction. Exercise with undeveloped or unbalanced musculature, producing chronic irritation, can be an aggravating factor. In the absence of trauma or other definite evidence of aggravation, service connection is not in order for pes cavus which is a typically congenital or juvenile disease.
Related references
- 38 CFR § 4.1: What a VA disability rating measures
- 38 CFR § 3.159: VA duty to assist: records and examinations
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