Understanding VA Disability Ratings for Plantar Fasciitis and Pes Planus
Veterans who suffer from foot conditions like plantar fasciitis and pes planus (commonly known as flat feet) know how debilitating these conditions can be. They can lead to chronic pain, difficulty walking, and a diminished quality of life. Fortunately, the Department of Veterans Affairs (VA) provides disability compensation for veterans whose foot conditions are connected to their military service. However, securing these benefits often requires navigating complex VA disability ratings, understanding the relationship between different conditions, and proving the connection between your service and your current disability.
In this comprehensive guide, we'll explore the VA disability ratings for plantar fasciitis and pes planus, discuss the importance of a Nexus Letter in establishing service connection, and explain how Xterra Health can help strengthen your claim by providing expert medical opinions.
What Is Plantar Fasciitis?
Plantar fasciitis is a painful condition of the foot in which the plantar fascia—a thick band of tissue that runs across the bottom of the foot from the heel to the toes—becomes inflamed. This inflammation often results in sharp, stabbing pain, particularly with the first steps taken in the morning or after periods of rest. The plantar fascia acts as a shock absorber and supports the arch of the foot, but repetitive strain, overstretching, or overuse can cause micro-tears in the tissue, leading to inflammation and pain.
While many cases of plantar fasciitis can resolve with proper treatment, such as rest, physical therapy, and orthotic devices, some cases become chronic and significantly impact a veteran’s ability to perform daily activities.
Common Causes and Risk Factors
Several factors can contribute to the development of plantar fasciitis, including:
Tight Achilles Tendon: A tight Achilles tendon can place additional stress on the plantar fascia, leading to inflammation.
Running or Walking on Uneven Surfaces: High-impact activities, especially on uneven surfaces, can strain the plantar fascia.
Sudden Weight Gain: Extra weight can increase the load on the plantar fascia, leading to injury.
Improper Footwear: Shoes that lack proper arch support can exacerbate or cause plantar fasciitis.
Drastic Changes in Activity Level: Suddenly increasing physical activity can strain the plantar fascia.
Veterans who have pes planus, or flat feet, are at an increased risk of developing plantar fasciitis due to the altered biomechanics of their feet.
What Is Pes Planus (Flat Feet)?
Pes planus, or flat feet, is a common condition where the arch of the foot is flattened, often causing the entire sole to touch the ground when standing. This condition can be congenital (present from birth) or acquired due to various factors such as injury, wear and tear, or specific health conditions.
The severity of pes planus can vary widely. While some individuals with flat feet experience no symptoms and require no treatment, others may suffer from significant pain, swelling, and difficulty with foot movements, such as standing on their toes. The lack of an arch can lead to improper weight distribution, which can cause or exacerbate other conditions like plantar fasciitis.
Causes and Risk Factors for Pes Planus
Pes planus can result from a variety of causes, including:
Congenital Abnormalities: Some individuals are born with flat feet, where the arches never fully develop.
Injury: Torn or stretched tendons, dislocated bones, or fractures in the legs or feet can lead to the collapse of the arch.
Health Conditions: Conditions like rheumatoid arthritis and diabetes can contribute to the weakening of the foot’s tendons and ligaments, leading to flat feet.
Nerve Damage: Peripheral neuropathy and other nerve-related conditions can result in flat feet.
Obesity: Excessive weight can strain the tendons and ligaments of the foot, leading to flattening of the arch over time.
For veterans, the physical demands of military service, including prolonged standing, marching, and carrying heavy loads, can contribute to the development or worsening of flat feet.
The Relationship Between Plantar Fasciitis and Pes Planus
There is a significant relationship between plantar fasciitis and pes planus. Veterans with flat feet are at a higher risk of developing plantar fasciitis due to the increased strain placed on the plantar fascia. When the arch of the foot collapses, the plantar fascia is overstretched, leading to inflammation and pain. This connection between the two conditions is crucial when filing for VA disability benefits, as veterans may need to establish a secondary service connection for plantar fasciitis if it arises as a result of their service-connected pes planus.
VA Disability Ratings for Plantar Fasciitis and Pes Planus
The VA rates both plantar fasciitis and pes planus under 38 CFR § 4.71a, the Schedule of Ratings for the Musculoskeletal System. The ratings are determined based on the severity of the condition and how it impacts the veteran’s ability to function.
VA Disability Rating for Plantar Fasciitis
Plantar fasciitis is rated under Diagnostic Code 5269. The ratings range from 10 to 40 percent, depending on the severity and treatment response:
30 Percent (Bilateral): This rating is given if the veteran has no relief from both non-surgical and surgical treatment, and the condition affects both feet.
20 Percent (Unilateral): This rating is assigned if the veteran has no relief from both non-surgical and surgical treatment, but the condition affects only one foot.
10 Percent (Unilateral or Bilateral): This rating applies to all other cases of plantar fasciitis, regardless of whether one or both feet are affected.
40 Percent: This rating is awarded if the veteran’s plantar fasciitis results in the loss of use of the foot.
VA Disability Rating for Pes Planus (Flat Feet)
Pes planus is rated under Diagnostic Code 5276, with ratings ranging from 0 to 50 percent based on the severity:
50 Percent (Bilateral Pronounced): Veterans with marked pronation, extreme tenderness of plantar surfaces, marked inward displacement, and severe Achilles tendon spasm that is not improved by orthopedic shoes or appliances.
30 Percent (Unilateral Pronounced): The same criteria as above, but affecting only one foot.
30 Percent (Bilateral Severe): Clear deformity, pain on manipulation, and swelling, along with characteristic callosities.
20 Percent (Unilateral Severe): The same criteria as above, but affecting only one foot.
10 Percent (Moderate): Weight-bearing line over the big toe, inward bowing of the Achilles tendon, and pain on manipulation or use of the foot, whether unilateral or bilateral.
0 Percent (Mild): Non-compensable rating for veterans whose flat feet are relieved by arch supports or do not cause significant symptoms.
Establishing Service Connection for Pes Planus and Plantar Fasciitis
To receive VA disability benefits for pes planus or plantar fasciitis, veterans must establish a service connection. This requires demonstrating that the condition was caused or aggravated by military service. The process involves three key elements:
A Current Diagnosis: Veterans must have a current diagnosis of the condition. For plantar fasciitis, this may involve medical records showing persistent foot pain and inflammation, while for pes planus, it may require documentation of flat feet.
In-Service Event, Injury, or Illness: There must be evidence of an in-service event that could have caused or aggravated the condition. This could include medical records showing foot injuries during service, records of high-impact physical activities, or documentation of other factors like long periods of standing or marching.
A Medical Nexus: A medical nexus is a crucial component of the claim, providing a link between the current diagnosis and the in-service event. A Nexus Letter from a qualified medical professional is often necessary to establish this connection.
How to Prove Plantar Fasciitis as Secondary to Pes Planus
If you are already service-connected for pes planus and later develop plantar fasciitis, you may be eligible to file a claim for plantar fasciitis on a secondary basis. To do this, you must provide medical evidence showing that the plantar fasciitis is a result of the service-connected pes planus.
Key Evidence for Secondary Service Connection
Nexus Letter: A Nexus Letter from a medical professional is critical in proving secondary service connection. The letter should clearly state that the plantar fasciitis is "at least as likely as not" caused by the pes planus.
Relevant Medical Records: Medical records documenting the development of plantar fasciitis after the diagnosis of pes planus can help establish the connection between the two conditions.
Lay Evidence: Personal statements, or lay evidence, from the veteran or individuals familiar with their situation can support the claim by providing additional context about the onset and impact of the conditions.
The Importance of a Nexus Letter
A Nexus Letter can be the cornerstone of a successful VA disability claim for some. It serves as a medical opinion that connects your current condition to your military service. For conditions like plantar fasciitis and pes planus, a well-crafted Nexus Letter can make the difference between a denied claim and receiving the benefits you deserve.
At Xterra Health, we specialize in providing veterans with expert Nexus Letters that are tailored to their specific circumstances. Our team of medical professionals understands the intricacies of VA disability claims and works diligently to ensure that your Nexus Letter is comprehensive, clear, and compelling.
How Xterra Health Can Help Strengthen Your VA Disability Claim
Navigating the VA disability claims process can be overwhelming, especially when dealing with complex conditions like plantar fasciitis and pes planus. Xterra Health is here to help. Our services are designed to provide
