VA Disability for Bilateral Pes Planus with Plantar Fasciitis

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As the nature of military service involves an intense level of physicality, specifically with regard to walking or running, many veterans experience foot conditions as the result of their service.  Pes planus and plantar fasciitis are two very common foot conditions that affect veterans.

What is “Bilateral Pes Planus”?

Pes Planus, often referred to as flat feet, is a common foot deformity in which the arch of the foot is flattened to the point where it touches, or nearly touches, the ground.  If a veteran has bilateral pes planus, then the condition affects both feet.

Symptoms of Pes Planus

While many people might have flat feet and not experience any serious symptoms or pain, others with more severe symptoms may experience:

• Aches or pains in arches or heels of feet
• Foot swelling
• Feet easily tiring out
• Difficulty performing certain foot movements (ex: standing on your toes)
• Leg and back pain

Causes of Pes Planus in Veterans

• Torn or stretched tendons
• Inflammation or damage to the posterior tibial tendon that runs from the lower leg to the ankle, and to the middle arch of the foot
• Dislocated or broken bones in the legs or feet
• Co-existing health conditions (ex: rheumatoid arthritis)
• Nerve damage, such as from peripheral neuropathy
• Persistent high-impact physical training

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What is Plantar Fasciitis?

Plantar fasciitis is a condition in which the plantar fascia, a thick band that runs across the bottom of the foot and connects the heel bone to the toes, becomes inflamed.

Symptoms of Plantar Fasciitis

• Shooting or stabbing pain in the bottom of foot
• Pain that worsens with standing
• Pain that can be worst in the morning
• Swelling in the heel
• Tightened Achilles tendon

Causes of Plantar Fasciitis

• Having flat feet (pes planus)
• Working or exercising on hard surfaces
• Exercising without stretching
• Persistent use of ill-fitting shoes
• Prolonged exercise

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How are Pes Planus and Plantar Fasciitis Connected?

Having pes planus, or flat feet, can be an aggravating factor for plantar fasciitis.  Specifically, having flat feet can place more pressure on the veteran’s heels.  This can strain the tissues on the bottom of the feet and worsen plantar fasciitis.

Additionally, people who work in professions that require long periods of time on their feet or who participate in certain forms of exercise, such as running, face an increased risk of developing pes planus or plantar fasciitis.  As servicemembers often have to run for long distances during training, sometimes wearing boots, this can cause them to develop pes planus, and in turn, plantar fasciitis.

Service Connection for Bilateral Pes Planus with Plantar Fasciitis

To file a claim for bilateral pes planus with plantar fasciitis, veterans will need to fill out and submit VA Form 21-526, Application for Disability Compensation and Related Compensation Benefits.  Once the form is filled out, veterans can submit the form to VA online, in person, or by mail.  They may also have a legal representative submit on their behalf.

In addition to this form, veterans will need to submit:

• A current diagnosis of bilateral pes planus; and
• Evidence of an in-service event, or stressor, which caused the pes planus; and
• A nexus linking the veteran’s pes planus to the veteran’s in-service event or stressor.

In order to establish bilateral pes planus with plantar fasciitis, veterans will also need to submit:

• A current diagnosis of plantar fasciitis; and
• Medical evidence demonstrating the link between pes planus and plantar

Filing a Claim for Secondary Service Connection for Bilateral Pes Planus with Plantar Fasciitis

In order to establish plantar fasciitis as secondary to bilateral pes planus, veterans may need to file a claim for secondary service connection.  Filing a claim for secondary service connection involves the same process as filing any claim for service connection.  Specifically, veterans will fill out and submit VA Form 21-526 – an original claim for service connection.  On this form, veterans will want to ensure that they are filing for plantar fasciitis as secondary to pes planus.

How Does VA Rate Bilateral Pes Planus with Plantar Fasciitis?

Ratings For Pes Planus

VA rates veterans with flatfoot under 38 C.F.R § 4.71a, diagnostic code 5276.  Veterans can be rated between 0 percent and 50 percent on a scale of mild (least severe) to pronounced (most severe).  The rating schedule is as follows:

• Pronounced: If veteran experiences marked pronation, inward displacement of the Achilles tendon on manipulation with spasms, and severe tenderness of the plantar surfaces of the feet, they may receive the highest rating for flat feet.  To be considered pronounced, the condition cannot be helped by shoe supports and both feet must be affected.
  • Veterans with pronounced bilateral flat feet are rated at 50 percent.
  • Veterans with pronounced unilateral flat foot are rated at 30 percent.
• Severe: Veterans with medical evidence showing clear deformity of their foot, pain and/or swelling on use or manipulation, and characteristic callosities, may receive one of the following ratings:
• • Veterans with severe bilateral flat feet are rated at 30 percent.
  • Veterans with severe unilateral flat foot are rated at 20 percent.
• Moderate:  If a veteran’s weight-bearing line is over the big toe rather than spread across the entire foot, there is inward bowing of the Achilles tendon, and pain on manipulation or use of the foot, they may be rated at 10 percent for both unilateral or bilateral.
• Mild: Veterans with flat feet who use arch supports to successfully relieve their symptoms are considered to have a mild, non-compensable condition and are rated at 0 percent.

Ratings For Plantar Fasciitis

• 40% – Veterans who lose the use of a foot because of plantar fasciitis can be awarded a 40 percent rating under diagnostic code 5167.
• 30% – Veterans can receive the 30 percent rating for plantar fasciitis that affects both feet and is not responsive to treatment.
• 20% – Veterans can receive the 20 percent rating for plantar fasciitis that affects one foot and is not responsive to treatment.  This means that there is no relief from non-surgical or surgical treatment.
• 10% – Veterans can receive the 10 percent rating for plantar fasciitis affecting one or both feet that is responsive to treatment.

Ratings For Bilateral Pes Planus with Plantar Fasciitis

If a veteran has bilateral pes planus with plantar fasciitis, and if those two conditions cause distinct symptoms necessitating distinct treatments, then veterans may be eligible for a rating for their pronounced bilateral pes planus and, separately, a rating for their plantar fasciitis, since it affects both feet.

TDIU Benefits for Bilateral Pes Planus with Plantar Fasciitis

Total disability based on individual unemployability (TDIU) is a monthly benefit that compensates veterans at the 100 percent rate, regardless of their actual combined rating, if their condition(s) prevents them from working.

There are generally two ways that a veteran can qualify for TDIU:

For schedular TDIU, veterans must meet the criteria listed under 38 CFR § 4.16a.  The criteria stipulate that veterans must have one condition rated at 60 percent minimum OR two conditions that can be combined to reach 70 percent, where one condition is at a minimum of 40 percent.

Veterans who do not meet these criteria but are still unable to work due to their disabilities may qualify for extraschedular TDIU under 38 CFR § 4.16b.

Ratings for bilateral pes planus with plantar fasciitis can help contribute to a veteran’s eligibility for TDIU.

Get Help with Benefits for Bilateral Pes Planus

If you need accredited representation to guide you through your appeal for VA disability benefits for bilateral pes planus, Chisholm Chisholm & Kilpatrick may be able to help.  Our experienced team has helped many veterans win the benefits they deserve.  Call today for a free case evaluation.