Foot Conditions: VA Rating Criteria

Plain-language guide

What this rating actually turns on

The hard truth about the forefoot and toes is that most of their diagnostic codes are capped low; the real ratings live in a handful of deformity and injury codes. These conditions sit in 38 CFR 4.71a, “The Foot” table. The codes in play: weak foot (DC 5277), claw foot or pes cavus (DC 5278), anterior metatarsalgia, i.e. Morton’s disease (DC 5279), hallux valgus, i.e. a bunion (DC 5280), hallux rigidus (DC 5281), hammer toe (DC 5282), malunion or nonunion of the tarsal or metatarsal bones (DC 5283), and “other” foot injuries (DC 5284).

Most of these are capped low. Metatarsalgia and Morton’s disease (DC 5279) is a flat 10 percent, unilateral or bilateral. Hallux valgus (DC 5280) tops out at 10 percent, granted only when it is operated with resection of the metatarsal head or is severe, equivalent to amputation of the great toe; there is no higher bunion rating, so anything short of that rates 0. Hallux rigidus (DC 5281) is rated as severe hallux valgus, so also 10 percent maximum, and by its note is not combined with claw-foot ratings. Hammer toe (DC 5282): all toes on one foot without claw foot is 10 percent, a single toe is 0. Weak foot (DC 5277) tells the rater to rate the underlying condition, with a 10 percent minimum.

The codes that actually reach higher are the deformity and injury codes. Claw foot or pes cavus (DC 5278) scales with the deformity, unilateral 0/10/20/30 and bilateral 0/10/30/50; the top bilateral 50 percent requires marked contraction of the plantar fascia with dropped forefoot, all toes hammer toes, very painful callosities, and marked varus deformity. Malunion or nonunion of the tarsal or metatarsal bones (DC 5283) and other foot injuries (DC 5284) both run moderate 10 percent, moderately severe 20, severe 30, and both carry the same note: with actual loss of use of the foot, rate 40 percent.

Two rules matter. Painful motion: 38 CFR 4.59 entitles an actually painful joint to at least the minimum compensable rating even where the deformity itself would rate 0. Bilateral factor: because the feet are a paired set, 38 CFR 4.26 adds 10 percent of the combined value when both feet are compensable, the calculator on this site handles that.

A worked example

Consider a veteran who fractured two metatarsals when a loaded pallet dropped on his foot in service. The bones healed, but out of alignment, and x-rays at C&P confirm malunion of the metatarsal bones, which is DC 5283. The examiner records a foot that aches and swells after standing, an antalgic gait, and tenderness over the old fracture sites, but he can still bear weight and the foot is not useless. That picture reads as moderately severe residuals, above the moderate grade but below severe and well short of loss of use, so DC 5283 rates it at 20 percent. Worth noting: had the injury destroyed the foot’s usefulness for standing and walking, the note under DC 5283 would push it to 40 percent and open special monthly compensation, so it pays to make the examiner address loss of use head-on rather than let it be written up as merely “severe.” See the pay table on this page for what 20 percent pays.

What the C&P exam measures

The examiner completes the Foot Conditions DBQ (including flatfoot, pes planus). It asks for the specific diagnosis, since each foot code has different criteria, then the presence and degree of deformity (varus, dropped forefoot, hammer-toeing, callosities), tenderness under the metatarsal heads, pain on use and on manipulation, and whether symptoms are relieved by orthotics or surgery. For DC 5283 and 5284 it captures injury severity and, critically, whether the functional loss rises to loss of use of the foot, the trigger for the 40 percent note. It records your description of flare-ups and the effect on standing and walking.

What to have in your file

Per VA’s evidence requirements: service treatment records tying the deformity or injury to service, operative reports (a resected metatarsal head is the express trigger for the 10 percent under DC 5280; fusion or fixation hardware bears on DC 5283), imaging showing malunion, nonunion, or the varus or cavus deformity, and podiatry notes on callosities and orthotic response. Lay statements (VA Form 21-10210) about pain with standing and walking and about flare-ups feed the DBQ.

Common mistakes

• Expecting a big rating for a bunion. DC 5280 is capped at 10 percent, and only for a bunion operated with a resected metatarsal head or one that is amputation-equivalent; everything short of that rates 0. Painful motion under 4.59 is often the better route to that 10 percent.
• Letting “loss of use” go unclaimed. DC 5283 and 5284 pay 40 percent with actual loss of use of the foot, which also opens special monthly compensation, do not let it be written up as merely “severe.”
• Stacking codes for one deformity. Hallux rigidus is rated as hallux valgus and is not combined with claw foot; the amputation rule (38 CFR 4.68) also caps the combined rating for the extremity at the below-the-knee amputation level, 40 percent under DC 5165.

Worth knowing

VA rewrote the musculoskeletal schedule effective February 7, 2021 (85 FR 76453), but it left these classic forefoot and toe codes (DC 5277 to 5284) with their long-standing descriptive criteria. The main foot change was a dedicated plantar fasciitis code, DC 5269, rated up to 30 percent and placed in “The Foot,” so plantar fasciitis is no longer forced into “other foot injuries.” If an injury reaches loss of use, the 40 percent note under DC 5283 or 5284 and possible special monthly compensation are on the table. When both feet are compensable, the bilateral factor adds to the combined value, which the calculator handles.

If your rating came back lower than this

A decision that ignores the criteria above is a frequent reason veterans are underpaid. Line your decision up against the levels on this page. If the evidence supports a higher level than VA assigned, you have three ways to challenge it, and the right one depends on why it went wrong:

• Something was missing from the record (an exam finding, a prescription, a flare-up statement, a nexus letter): add it with a Supplemental Claim.
• The evidence was already there and VA misread it: ask for a Higher-Level Review by a more senior rater, with no new evidence needed.
• A legal or judgment error: take it to the Board of Veterans' Appeals.

Before you file, recombine this rating with your others (VA math does not add ratings), check how long each lane is taking right now, and remember a VA-accredited representative or VSO will help you for free. You can also browse every other condition's criteria to make sure you are claiming everything you are owed.