Plantar Fasciitis VA Rating and Diagnostic Code 5269 Criteria

Diagnostic Code 5269 rating table and criteria

Under 38 CFR 4.71a (The Foot), Diagnostic Code 5269 establishes three primary schedular tiers at 10%, 20%, and 30%, along with a 40% evaluation under Note (1) when the condition causes actual loss of use of the foot.

Diagnostic Code 5269 includes two binding regulatory notes in 38 CFR 4.71a:

• 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.

Under the VA compensation schedule effective 2025-12-01, a standalone 10% rating pays $180.42 per month for a veteran with no dependents, a 20% rating pays $356.66 per month, a 30% rating pays $552.47 per month, and a 40% rating pays $795.84 per month.

How the 10%, 20%, 30%, and 40% thresholds work in practice

Because Diagnostic Code 5269 ties disability percentages to treatment history and surgical status rather than range-of-motion degrees alone, understanding what adjudicators look for at each tier is important before filing a claim.

The 10% baseline evaluation (“Otherwise, unilateral or bilateral”)

The 10% evaluation is the standard rating assigned under Diagnostic Code 5269. Unlike codes that separate unilateral and bilateral impairments at the lowest compensable level, DC 5269 groups unilateral (one foot) and bilateral (both feet) plantar fasciitis together at 10% whenever the 20% or 30% criteria are not met.

If you have chronic heel and arch pain in one or both feet and manage the condition through conservative measures—such as custom orthotic inserts, night splints, stretching, physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), shock wave therapy, or corticosteroid injections—your claim falls under “Otherwise, unilateral or bilateral” at 10%. Even if conservative therapies do not resolve your foot pain, the rating remains at 10% unless surgery has also been performed without relief or recommended and ruled out under Note (2).

The 20% and 30% evaluations: Unrelieved by non-surgical and surgical treatment

To qualify for a 20% rating (one foot) or a 30% rating (both feet), medical evidence must show that you underwent both non-surgical and surgical treatments, and that neither relieved your plantar fasciitis symptoms.

Surgical intervention for refractory plantar fasciitis typically involves an endoscopic or open plantar fasciotomy (partial release of the tight plantar fascia) or gastrocnemius recession. If a veteran undergoes surgery after failed conservative care and still experiences persistent heel pain, plantar tenderness, and functional limitation on standing or walking, the VA assigns 20% for one affected foot or 30% if both feet meet this standard.

Note (2): Recommended for surgery, but not a surgical candidate

Many veterans have treatment-resistant plantar fasciitis that fails conservative care, yet they never undergo surgery because a podiatrist or orthopedic surgeon determines that operating is medically contraindicated. Under Note (2) to Diagnostic Code 5269, the VA treats a documented surgical recommendation paired with surgical ineligibility as equivalent to failed surgery.

To qualify for a 20% (unilateral) or 30% (bilateral) rating under Note (2), your medical records or C&P exam report must establish two clinical facts:

1. A recommendation for surgical intervention: A treating physician, podiatrist, or orthopedic specialist must state that non-surgical treatments failed to relieve your plantar fasciitis and that surgery is recommended.
2. Determination that you are not a surgical candidate: The provider must document why you cannot undergo the operation—such as peripheral arterial disease, diabetes with impaired wound healing, severe neuropathy, cardiopulmonary risks, or structural foot instability.

Declining elective surgery out of personal preference does not satisfy Note (2); the record must reflect a medical determination that you are not a surgical candidate.

Note (1): The 40% rating for actual loss of use of the foot

Under Note (1) to Diagnostic Code 5269, if plantar fasciitis results in the actual loss of use of a foot, the VA assigns a 40% evaluation for that foot. Under 38 CFR 4.63 and 38 CFR 3.350(a)(2), loss of use of a foot exists when no effective function remains other than that which would be equally well served by a below-knee amputation stump with a suitable prosthesis. Adjudicators evaluate whether essential acts of balance and propulsion can still be accomplished. When actual loss of use of a foot is established, the veteran also qualifies for Special Monthly Compensation at the (k) rate (SMC-K) under 38 U.S.C. 1114(k).

Interaction with pes planus (flatfoot) and anti-pyramiding rules

Veterans claiming plantar fasciitis frequently also have acquired flatfoot (pes planus), evaluated under Diagnostic Code 5276. Under 38 CFR 4.14 (Avoidance of pyramiding), evaluating the same disability or manifestation under different diagnoses is prohibited. Both Diagnostic Code 5269 (plantar fasciitis) and Diagnostic Code 5276 (acquired flatfoot) involve plantar surface tenderness and pain on weight-bearing use. Under 38 CFR 4.71a, DC 5276 rates acquired flatfoot at 0% (mild), 10% (moderate, unilateral or bilateral), 20% unilateral or 30% bilateral (severe), and 30% unilateral or 50% bilateral (pronounced, involving marked pronation and extreme tenderness of the plantar surfaces not improved by orthopedic shoes or appliances).

Because tenderness of the plantar surfaces and pain on manipulation and use of the feet are built into DC 5276, VA adjudicators generally cannot stack separate ratings for plantar fasciitis and pes planus on the same foot when the symptoms overlap. Instead, the VA evaluates both conditions together under whichever diagnostic code provides the higher disability rating. Separate evaluations are only assigned if medical evidence establishes distinct, non-overlapping functional impairments.

Proving service connection for plantar fasciitis

To receive a disability evaluation under Diagnostic Code 5269, you must establish service connection under 38 CFR 3.303 or 38 CFR 3.310:

• Direct service connection (38 CFR 3.303): Requires a current diagnosis of plantar fasciitis, evidence of an in-service foot injury, strain, or repetitive weight-bearing onset (such as sick call records during basic training or ruck marches), and a medical nexus linking the condition to service. Continuity of symptomatology since discharge under 38 CFR 3.303(b) can also support the claim.
• Aggravation (38 CFR 3.306): If a preexisting foot condition noted on your entrance exam permanently worsened beyond its natural progression during active duty, service connection may be established through aggravation.
• Secondary service connection (38 CFR 3.310): Under 38 CFR 3.310(a), a disability proximately caused or aggravated by an existing service-connected condition is granted service connection. Common primary conditions that may cause or aggravate plantar fasciitis include service-connected pes planus (flatfoot), which places continuous traction on the plantar fascia during arch collapse, as well as service-connected ankle, knee pain, hip, or back pain disabilities that cause an antalgic gait and shift abnormal mechanical loads onto the feet.

Secondary conditions that plantar fasciitis may cause

Chronic plantar fasciitis alters how a veteran stands and walks. When heel pain forces you to walk on the outer border of your foot, shorten your stride, or shift weight onto the opposite leg, that altered gait may contribute to secondary musculoskeletal disabilities under 38 CFR 3.310(a):

• Ankle disabilities (limited ankle motion, Diagnostic Code 5271) and Achilles tendon problems: Guarding the heel and walking with an altered foot strike may strain the ankle joint and Achilles tendon, potentially restricting ankle motion.
• Knee conditions (Diagnostic Codes 5257, 5260, 5261): Compensatory gait changes from chronic heel pain may alter alignment at the knee joint, which may cause or aggravate patellofemoral pain or degenerative arthritis of the knee.
• Hip and lumbar spine conditions: Chronic changes in posture and stride length from bilateral foot pain may transmit uneven mechanical loads into the hips and thoracolumbar spine, potentially causing or aggravating lower back pain.

Every secondary claim requires a current diagnosis of the secondary condition and a medical nexus opinion explaining how the altered gait or mechanical strain from service-connected plantar fasciitis caused or aggravated the secondary joint disorder.

How the C&P exam and Foot Conditions DBQ measure plantar fasciitis

When you file a claim for plantar fasciitis, the VA typically schedules a Compensation and Pension (C&P) examination. During this evaluation, the clinician completes the official Foot Conditions, Including Flatfoot (Pes Planus) Disability Benefits Questionnaire (DBQ), available on the VA Public DBQs portal.

On the Foot Conditions DBQ, the examiner records clinical findings that map directly to Diagnostic Code 5269:

1. Diagnosis and laterality: Confirms the diagnosis of plantar fasciitis and specifies whether it affects the right foot, left foot, or both feet.
2. Treatment history and symptom relief: Documents whether you received non-surgical treatment (orthotics, shoe inserts, medications, injections, or physical therapy) and surgical treatment, and whether those treatments provided relief.
3. Surgical candidacy (Note 2): Records whether a provider recommended surgical intervention for your plantar fasciitis and whether you are a surgical candidate. Bring written records from your podiatrist or orthopedist to the exam if relying on Note (2).
4. Physical examination and functional loss: Notes tenderness on palpation of the plantar fascia, painful motion under 38 CFR 4.59, swelling, callosities, arch alignment, and how pain or flare-ups limit weight-bearing, standing, and walking under 38 CFR 4.40 and 4.45.
5. Diagnostic imaging and loss of use: Logs X-ray or MRI findings (such as calcaneal heel spurs or fascial thickening) and states whether the condition causes actual loss of use of the foot.

How plantar fasciitis combines with other ratings and the bilateral factor

When plantar fasciitis is rated alongside other service-connected disabilities, the VA combines your percentages using the Combined Ratings Table in 38 CFR 4.25. You can model how a 10%, 20%, 30%, or 40% foot rating affects your overall compensation using the VA combined rating calculator.

Under 38 CFR 4.26, the bilateral factor adds 10% of the combined value of compensable disabilities affecting both lower extremities before combining with other ratings. Because Diagnostic Code 5269 already provides single combined evaluations for bilateral plantar fasciitis (10% under “Otherwise, unilateral or bilateral” and 30% for unrelieved bilateral plantar fasciitis), a standalone bilateral rating under DC 5269 does not receive a separate bilateral factor addition by itself. However, under 38 CFR 4.26(a), if you have a compensable rating on one foot (such as 20% for right plantar fasciitis) and a separate compensable disability on the opposite lower extremity (such as a left knee or left ankle rating), the bilateral factor applies when combining those right and left lower-extremity ratings.

When to get help from a VA-accredited representative

Disputes over plantar fasciitis claims frequently involve proving failed conservative and surgical care for a 20% or 30% rating, documenting surgical ineligibility under Note (2), or addressing anti-pyramiding issues alongside pes planus (DC 5276).

If you need assistance developing medical nexus evidence or appealing a rating decision, consider working with a VA-accredited representative:

• Veterans Service Organizations (VSOs): Accredited representatives from organizations such as Disabled American Veterans (DAV), the Veterans of Foreign Wars (VFW), and the American Legion assist with claims free of charge.
• VA-Accredited Claims Agents and Attorneys: Accredited attorneys and claims agents certified by the VA Office of General Counsel represent veterans on Supplemental Claims, Higher-Level Reviews, and Board appeals under federal fee rules.

No representative can promise a specific rating or guarantee an outcome. You can find free VSO assistance or verify accreditation through the official VA Office of General Counsel Accreditation Search.