C&P Exam for Plantar Fasciitis: What to Expect and How to Prepare

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Today, VA disability expert Brian Reese explains what to expect and how to prepare for a C&P exam for plantar fasciitis.

After you’ve filed a VA claim for plantar fasciitis, you’ll likely be scheduled for a Compensation and Pension (C&P) exam by a private company contracted by the VA.

Plantar fasciitis, one of the main causes of heel pain, is very common among military veterans.

According to our data, plantar fasciitis is the #26 most claimed VA disability of the top 50 most common VA claims.

Pro Tip: The VA rates plantar fasciitis from 10% to 30% with a break at 20%, depending on unilateral (one foot) versus bilateral (both feet) as well as your severity of symptoms. A 30% disability rating is assigned when a veteran receives no relief from plantar fasciitis in both feet despite trying all types of non-surgical and surgical treatments; a 20% rating applies when treatments fail to alleviate the condition in just one foot; and a 10% rating is given for cases where the condition persists in one or both feet under less specified circumstances.

Summary of Key Points

• Plantar fasciitis can be rated at 10%, 20%, or 30%, depending upon unilateral (one foot) versus bilateral (both feet) and the severity of your symptoms. If you have pain in your foot and heel, the VA is required to at least award the minimum compensable rating of 10%.

• The C&P exam for plantar fasciitis evaluates if you have the condition diagnosed, determines if there’s a “nexus” to your military service or other service connected disabilities, and assesses your severity of symptoms including frequency, severity, and duration, as well as negative impacts to your work, life, and social functioning.

• It’s important to discuss your experiences before, during, and after military service, including when your plantar fasciitis symptoms began. Risk factors for veterans developing plantar fasciitis may include prolonged standing, running, or strenuous physical activities during their service.

What to Expect at a C&P Exam for Plantar Fasciitis

A C&P exam for plantar fasciitis is designed to assess whether (#1) you have the condition diagnosed, (#2) if there is a “nexus” for service connection (meaning your plantar fasciitis was caused or made worse by your military service or by another service connected disability for secondary service connection), and (#3) the severity of your symptoms in terms of frequency, severity, and duration along with any negative impacts to your work, life, and social functioning.

Here’s what you can expect during a VA Compensation and Pension (C&P) exam for plantar fasciitis:

• Review of Medical History: The examiner will begin by reviewing your medical records related to any foot conditions, specifically focusing on plantar fasciitis. This review will include past diagnoses, treatments you have received, and the outcomes of those treatments. It’s important that the VA has access to all relevant medical records prior to the exam, but you can bring additional documents if you think they are necessary.

• History and Onset: During the exam, there will be a discussion about your military service history and any incidents or physical activities during your service that might have contributed to the development of plantar fasciitis. Factors like prolonged standing, carrying heavy loads, or engaging in extensive running or marching, which are common in military training and duties, will be considered.

• Discussion of Heel Pain and Symptoms: You will be asked to describe the symptoms of your plantar fasciitis, including the onset, frequency, severity, and any triggers of pain such as specific activities or times of day. Common symptoms include sharp pain in the heel or the bottom of the foot, especially after periods of rest or during the first steps in the morning.

• Negative Impacts on Work, Life, and Social Functioning: The examiner will need to understand how your plantar fasciitis affects your ability to work, perform daily activities, and engage in social activities. Issues such as pain when standing, difficulty walking, or limitations on physical activities can impact your job performance, personal life, and social interactions.

• Physical Examination of Your Feet: The physical examination will focus on the foot. The examiner will check for tenderness on the heel and the bottom of the foot, examine the arch and the way you walk, and may perform tests to evaluate the stiffness or tightness of the plantar fascia. The walking test allows the examiner to observe how your plantar fasciitis symptoms present during movement. This includes evaluating the location and severity of pain, any limping or altered gait patterns, assessment of your arches for flat feet, and how symptoms change with activity.

• X-Rays or Other Imaging: The C&P examiner might order X-rays to rule out other possible causes of heel pain, such as a stress fracture or a heel spur. Plantar fasciitis is usually diagnosed based on medical history, physical examination, and sometimes imaging studies like ultrasound or MRI, which can provide detailed images of the soft tissues. The diagnosis is often confirmed through symptoms such as pain in the heel or bottom of the foot, particularly during the first steps in the morning or after prolonged periods of rest.

• Completion of the Disability Benefits Questionnaire (DBQ) for Foot Conditions: After assessing your condition, the examiner will fill out a DBQ for foot conditions including flat feet and plantar fasciitis, noting the findings, the severity of your condition, and its impact on your life. This questionnaire will be submitted to the VA Rater who will use it to determine the eligibility and rate of your disability claim.

Questions You Might Get Asked at a Plantar Fasciitis C&P Exam

Here’s a list of questions from the DBQ for foot conditions, including flat feet and plantar fasciitis, that veterans can expect to be asked during their C&P exam:

SECTION I – DIAGNOSIS

• What is your current diagnosis for your foot condition?

• On which side is your plantar fasciitis located?

• When was your plantar fasciitis first diagnosed?

SECTION II – MEDICAL HISTORY

• Can you describe the history of your plantar fasciitis, including how and when it started?

• Do you experience pain in your foot due to plantar fasciitis? If yes, how would you describe it?

• How do flare-ups affect your foot’s functionality? Can you describe the frequency and intensity of these flare-ups?

• Do you have any functional loss or impairment due to plantar fasciitis? If yes, list examples.

SECTION III – FLATFOOT (PES PLANUS)

• Do you have flat feet in one or both feet? If yes, indicate the severity.

SECTION IV – PLANTAR FASCIITIS

• Have you received any non-surgical treatments for plantar fasciitis? Were they effective?

• Have you undergone surgical treatment for plantar fasciitis? Did it alleviate your symptoms?

• Were you recommended for surgical treatment for plantar fasciitis but found not to be a suitable candidate?

• Describe any functional loss of the foot/feet due to plantar fasciitis.

SECTIONS V to XI – OTHER FOOT CONDITIONS

• Are there any other diagnosed foot conditions such as Morton’s neuroma, metatarsalgia, or hammer toe?

SECTION XII – SURGICAL PROCEDURES

• Have you had any surgical procedures on your feet? Please specify the type, side affected, and date of surgery.

• Are there any residual signs or symptoms from the surgery?

SECTION XIII – PAIN

• Do you experience pain during physical exams of your feet?

• Does this pain contribute to functional loss?

SECTION XIV – FUNCTIONAL LOSS

• What factors contribute to the functional loss or impairment of your feet?

• During flare-ups or after repeated use over time, how does your functional ability change?

SECTION XVIII – DIAGNOSTIC TESTING

• Have any imaging studies or other diagnostic tests been performed for your plantar fasciitis? If so, what were the findings?

• How do the test results relate to the diagnosis of plantar fasciitis?

SECTION XIX – FUNCTIONAL IMPACT

• Does plantar fasciitis impact your ability to work? If yes, explain.

Examples of Work, Life, and Functional Impacts of Plantar Fasciitis

Plantar fasciitis is a common foot condition that can have significant impacts on various aspects of a veteran’s life, including work, daily activities, and overall function.

Here are some examples of how plantar fasciitis can affect these areas:

Work Impacts

• Reduced Mobility: Jobs that require standing or walking for prolonged periods, like nursing, retail, or construction, can become particularly challenging. Veterans may experience pain that limits their ability to perform their duties effectively.

• Increased Absenteeism: The discomfort and pain may lead to increased absenteeism as veterans may require time off to recover or attend medical appointments.

• Decreased Productivity: Pain and discomfort can distract and prevent veterans from focusing fully on their tasks, potentially decreasing productivity.

Life Impacts

• Daily Activities: Routine activities such as walking, climbing stairs, or even getting out of bed can become painful and challenging, affecting a veteran’s quality of life.

• Exercise Limitations: Physical activities and exercises that involve foot impact, like running or jumping, may need to be avoided or modified, which can impact overall health and fitness.

• Sleep Disturbances: The pain, especially when it flares up at night, can disrupt sleep, leading to fatigue and affecting mood and well-being.

Functional Impacts

• Mobility Impairment: Chronic pain can lead to a decrease in foot mobility and flexibility, impacting the way a veteran walks as well as their overall balance.

• Alterations in Gait: To avoid pain, veterans might alter their walking pattern, which can lead to secondary issues such as hip, knee, or back problems due to an uneven gait.

• Chronic Pain Cycle: If not properly managed, plantar fasciitis can become a chronic issue, leading to a persistent cycle of pain and inflammation that can further impair function.

Tips to Help You Prepare for Your VA C&P Exam for Plantar Fasciitis

Here’s a list of tips to help you prepare for your C&P exam for plantar fasciitis:

• Gather Records and Documents: Collect all relevant medical records, including diagnoses, treatment histories, medication lists, and any pertinent correspondence about your plantar fasciitis. These documents are essential evidence to support your claim during the examination. Review them thoroughly and bring hard copies to the C&P exam for reference.

• Maintain a Symptoms Diary: Keep a detailed record of your plantar fasciitis symptoms, noting the frequency, severity, and duration of pain and discomfort. Record any factors that exacerbate or alleviate your symptoms, such as specific activities or wearing particular footwear. This diary will play a crucial role in illustrating the impact of plantar fasciitis on your daily life and functionality during the examination.

• Take Pictures: It’s a good idea to take pictures of your heels, especially during periods of flare-ups. For example, you might have visible signs of cracking, yellow calluses, redness, and swelling. In addition to showing the C&P examiner, we also recommend you upload these photos with your VA claim for plantar fasciitis.

• List Functional Impacts: Document specific ways in which plantar fasciitis affects your daily functioning. For example, plantar fasciitis can cause significant pain and discomfort, making it challenging to stand or walk for prolonged periods. It might also limit your ability to engage in routine physical activities or exercise, impacting your overall mobility and quality of life. Additionally, the ongoing pain can lead to modifications in your walking pattern, which may affect other parts of your body.

• Review the DBQ for Foot Conditions: Familiarize yourself with the Disability Benefits Questionnaire (DBQ) for foot conditions before your exam. Focus on sections relevant to plantar fasciitis and be prepared to discuss the onset, progression, and current status of your condition. Describe any treatments you have undergone and their effectiveness. The examiner will use this information to complete the DBQ for Plantar Fasciitis, which will then be reviewed by the VA Rater for further assessment of your claim.

DBQ for Plantar Fasciitis [Download]

The examiner will follow the sections and questions of the electronic DBQ for Foot Conditions, including flat feet and plantar fasciitis to evaluate the severity of disability caused by your heel pain.

We’ve made a copy available for review and download below:

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