Top 10 VA Secondary Conditions to Flat Feet for Disability Benefits

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Flat feet, also known as pes planus, is a condition where the arch of the foot collapses, causing the entire sole to make contact with the ground.

While flat feet itself can cause significant pain and functional limitations, it often leads to a range of secondary conditions that can qualify veterans for additional service connected VA disability compensation.

In this blog post, VA disability expert Brian Reese explains what flat feet is, how to establish secondary service connection for related conditions, and the top 10 secondary conditions linked to flat feet for VA disability benefits.

Pro Tip: The VA rates flat feet under 38 CFR § 4.71a, using Diagnostic Code (DC) 5276, from 0% to 50% with breaks at 10%, 20%, and 30%, depending on unilateral (one foot) vs bilateral (both feet), the severity of symptoms, whether there is any relief from built-up shoes, arch supports, or orthotic devices, and negative impacts to your work, life, and social functioning.

Summary of Key Points

• Flat Feet Overview: Flat feet (pes planus) is a condition where the arch of the foot collapses, often caused or worsened by the physical demands of military service, such as prolonged standing, heavy loads, and repetitive impacts from marching or running.

• VA Ratings for Flat Feet: The VA rates flat feet under 38 CFR § 4.71a, Diagnostic Code 5276, with ratings ranging from 0% to 50% based on symptom severity, unilateral (one foot) or bilateral (both feet), and how the condition affects work, life, and social functioning. Relief from orthotics or built-up shoes is also considered.

• Secondary Conditions to Flat Feet: Flat feet often lead to secondary conditions such as plantar fasciitis, knee pain, hip pain, lower back pain, and ankle instability. These secondary conditions may also qualify veterans for additional VA disability compensation.

• Establishing Secondary Service Connection: Veterans must provide a current diagnosis of the secondary condition, evidence that flat feet is already service-connected, and a nexus letter from a medical professional linking the secondary condition to flat feet to successfully establish secondary service connection.

What is Flat Feet (Pes Planus) for VA Disability?

Flat feet, also known as pes planus, is a common condition among veterans, often caused or worsened by the physical demands of military service.

Activities such as prolonged standing, carrying heavy loads, and repetitive impact from running or marching can contribute to the development or aggravation of this condition.

While some veterans may experience mild discomfort initially, the condition often worsens over time, leading to debilitating symptoms that can significantly impact daily life and work.

Early Symptoms of Flat Feet in Veterans

Veterans with flat feet may experience the following early symptoms:

• Foot pain after walking or standing for long periods: Discomfort typically starts in the arch or heel and intensifies with physical activity.

• Ankle pain due to overpronation: Flat feet cause the ankles to roll inward excessively, straining ligaments and tendons and resulting in persistent soreness.

• Shin splints: Overpronation places additional stress on the lower leg muscles, leading to pain along the inner edge of the shin, particularly after high-impact activities.

Progressive Symptoms of Flat Feet in Veterans

As flat feet progress, the condition can lead to more severe and chronic complications, including:

• Gait disorders and abnormalities: The collapse of the foot’s arch disrupts natural alignment, causing veterans to adopt an uneven or altered walking pattern. This misalignment can lead to further strain on the legs, hips, and lower back, reducing mobility and efficiency in movement.

• Deformities such as bunions or hammertoes: Prolonged misalignment places excessive pressure on the toes, resulting in painful deformities that can worsen over time and may require surgical correction.

• Chronic pain, even at rest: Advanced flat feet can cause persistent pain in the feet, ankles, knees, hips, or back. This discomfort may occur even during rest or sleep, significantly affecting a veteran’s quality of life.

Establishing Service Connection for Secondary Conditions to Flat Feet

Under 38 CFR § 3.310, secondary service connection can be granted for disabilities that are proximately due to, caused, or aggravated by an existing service-connected condition.

To establish secondary service connection to pes planus for VA disability benefits, three key elements are necessary:

• Current Diagnosis of the Secondary Condition: You must have a current diagnosis of the secondary condition in a medical record (e.g., plantar fasciitis, knee condition, hip pain, back condition). Documentation from VA or private healthcare providers is crucial.

• Service-Connected Primary Condition (Flat Feet): Your flat feet must already be recognized as service-connected by the VA and rated between 0% and 50%.

• Medical Nexus Evidence: A detailed explanation of the connection between flat feet and the secondary condition is essential. A qualified private medical professional should provide a nexus letter for a secondary claim, explaining that the secondary condition is “at least as likely as not” caused or aggravated by your flat feet.

Remember this fellow veterans: MEDICAL EVIDENCE WINS VA DISABILITY CLAIMS!

A nexus letter for your secondary condition to pes planus is often the linchpin between a VA claim approval and a denial.

10 Most Common Secondary Claims to Flat Feet for VA Disability Benefits

Plantar Fasciitis Secondary to Flat Feet

Flat feet place additional strain on the plantar fascia, the thick ligament connecting the heel to the toes. Over time, this stress can lead to inflammation, microtears, and chronic pain in the heel and arch of the foot, resulting in plantar fasciitis. Veterans with flat feet often experience sharp, stabbing pain in the heel, particularly after prolonged periods of rest or first thing in the morning. This condition can make walking or standing for long periods unbearable, impacting both work and daily life. The ongoing discomfort and functional limitations caused by plantar fasciitis are a direct result of the abnormal foot mechanics associated with flat feet.

Knee Pain Secondary to Flat Feet

The abnormal alignment caused by flat feet forces the knees to bear extra strain, leading to chronic knee pain and joint deterioration over time. Veterans with flat feet often experience overpronation, where the foot rolls inward excessively, disrupting the alignment of the entire leg. This misalignment puts stress on the knees, causing conditions like patellofemoral pain syndrome or arthritis. Veterans may notice swelling, stiffness, or grinding sensations in the knees, particularly after walking or standing for extended periods. The pain can make physical activities like climbing stairs or squatting difficult, significantly reducing mobility and overall quality of life.

Hip Pain Secondary to Flat Feet

Flat feet alter the natural alignment of the legs, causing compensatory movements in the hips to maintain balance and stability. This misalignment increases stress on the hip joints, leading to conditions like trochanteric bursitis or arthritis. Veterans with flat feet may experience chronic hip pain that radiates to the lower back or thighs, particularly during physical activity. The pain often worsens with prolonged walking, standing, or carrying heavy loads. Over time, this strain can reduce range of motion and flexibility in the hips, making daily tasks like climbing stairs or bending over increasingly difficult.

Lower Back Pain Secondary to Flat Feet

Flat feet can disrupt the natural curvature of the spine, shifting the body’s center of gravity and placing additional strain on the lower back. This misalignment causes the muscles and joints in the lumbar region to work harder, leading to chronic back pain, stiffness, or even degenerative conditions like herniated discs. Veterans with flat feet may notice persistent lower back pain that worsens with standing, walking, or physical exertion. This discomfort can limit physical activity, make sitting or sleeping challenging, and negatively impact overall quality of life.

Ankle Instability Secondary to Flat Feet

The lack of arch support in flat feet weakens the ligaments and tendons surrounding the ankle, making it prone to instability and repeated injuries. Veterans with flat feet often experience frequent ankle sprains, pain, or a feeling that the ankle might “give out” during movement. Over time, this instability can develop into posterior tibial tendon dysfunction (PTTD), a progressive condition that further weakens the ankle and affects mobility. Veterans may find it difficult to walk on uneven surfaces or perform physical tasks that require balance, increasing their risk of falls and further injuries.

Bunions Secondary to Flat Feet

Flat feet can cause the big toe joint to shift outward due to uneven weight distribution, leading to the formation of bunions. This bony protrusion at the base of the big toe causes pain, swelling, and redness, especially when wearing tight or ill-fitting footwear. Veterans with flat feet often find that bunions make walking or standing uncomfortable, limiting their ability to perform daily tasks or engage in physical activities. Left untreated, bunions can worsen over time, further restricting mobility and requiring surgical intervention.

Achilles Tendonitis Secondary to Flat Feet

Flat feet cause the foot to roll inward excessively, placing additional stress on the Achilles tendon at the back of the heel. Over time, this can lead to Achilles tendonitis, characterized by pain, stiffness, and inflammation in the tendon. Veterans with flat feet may experience pain that worsens during physical activities like running, jumping, or climbing stairs. The condition can also cause swelling or tenderness at the back of the ankle, making it difficult to wear certain types of footwear or maintain an active lifestyle.

Shin Splints Secondary to Flat Feet

Flat feet disrupt the alignment of the lower legs, increasing stress on the tibia (shin bone) and surrounding muscles. This repetitive strain can lead to shin splints, also known as medial tibial stress syndrome. Veterans with flat feet may experience pain along the inner edge of the shin, particularly during or after physical activity. The pain can be sharp or throbbing, making it difficult to run, march, or even walk long distances. Without proper treatment, shin splints can lead to more severe conditions like stress fractures.

Sciatica Secondary to Flat Feet

The altered posture and gait caused by flat feet can lead to nerve compression or irritation in the lower back, contributing to sciatica. Veterans with sciatica often experience sharp, shooting pain that radiates from the lower back down the buttocks and legs. This pain can be accompanied by numbness, tingling, or muscle weakness in the affected leg. The chronic discomfort caused by sciatica can limit mobility, make sitting or standing for long periods unbearable, and significantly impact daily life.

Depression or Anxiety Secondary to Flat Feet

The chronic pain and physical limitations caused by flat feet and their associated conditions can take a toll on a veteran’s mental health. Veterans may develop depression or anxiety due to their reduced ability to work, engage in social activities, or maintain an active lifestyle. The frustration of dealing with persistent pain and mobility issues can lead to feelings of hopelessness, irritability, or withdrawal. Addressing both the physical and mental health aspects of flat feet is essential for improving a veteran’s overall quality of life.

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