The U.S. Department of Veterans Affairs recognizes plantar fasciitis as a common condition among veterans, often resulting from overuse, prolonged standing, and physical strain experienced during military service. The strain on the feet can lead to chronic complications, affecting the veteran’s mobility and daily activities. In this blog, we will discuss what causes plantar fasciitis in veterans, the VA disability rating system for compensation, and tips for successfully filing or strengthening a disability claim.
What Is Plantar Fasciitis?
Plantar fasciitis is more than just an occasional foot pain. It’s a degenerative and often chronic condition affecting the plantar fascia, the fibrous ligament connecting your heel bone to your toes. This ligament plays a key role in supporting your foot arch and enabling normal walking movements. When inflamed, the plantar fascia causes stabbing or burning pain in the heel or arch, especially when taking the first steps in the morning or after periods of inactivity.
Risk Factors Among Veterans
The study titled “The Incidence of Plantar Fasciitis in the United States Military” found that the overall unadjusted incidence rate was 10.5 per 1,000 person-years, with higher prevalence observed among women, Black service members, Army and Marine personnel, and those over 40 years old.
For veterans, the risk of developing plantar fasciitis, sometimes known as ‘runner’s heel’, is higher than the general population. Years of military service often mean:
- Repetitive overuse from training or deployment activities
- Wearing unsupportive boots for long periods
- Marching on uneven or challenging terrain
- Pre-existing structural foot abnormalities, such as pes planus (flat feet)
- Adjustments in posture caused by pain in the knees, hips, or back
These repetitive, high-impact activities can overstress the plantar fascia, eventually leading to inflammation and severe pain. Veterans may experience symptoms such as:
- Sharp heel pain
- Swelling around the heel
- Pain worsening with activity or after rest
- Tightness in the Achilles tendon
This chronic discomfort can affect mobility, sleep, and mental health, ultimately interfering with daily activities or employment. For these reasons, many veterans seek full compensation through a VA disability claim, aiming to secure the benefits they earned through service.
VA Rating Criteria for Plantar Fasciitis
Since February 2021, the VA has rated plantar fasciitis as a separate and often debilitating condition under Diagnostic Code 5269 (38 CFR § 4.71a) of the Schedule for Rating Disabilities.
Here’s a breakdown of the VA disability rating for plantar fasciitis:
- 10% Rating: Assigned for unilateral or bilateral plantar fasciitis that responds to treatment (e.g., orthotics, physical therapy).
- 20% Rating: Given if only one foot is affected and unresponsive to both surgical and non-surgical treatments.
- 30% Rating: Awarded when both feet are affected and symptoms persist despite all treatment efforts. This is the highest VA rating assigned for this condition.
A 40% rating is reserved for cases involving complete loss of use of the foot due to plantar fasciitis, under Diagnostic Code 5167.
Importantly, veterans recommended for surgery but who cannot undergo it may be eligible for a 20% or 30% rating, depending on whether one or both feet are impacted. This allows for VA compensation in scenarios where pain relief is impossible due to medical limitations.
Ratings reflect not just pain levels but also the impact on daily functionality and mobility. Veterans experiencing secondary conditions such as back, hip, or knee issues due to altered walking mechanics may qualify for additional compensation through a secondary service connection.
How to Establish Service Connection for Plantar Fasciitis Claims
To receive VA compensation, veterans must prove that the condition is caused or aggravated by their active duty. There are three main ways veterans consider when attempting to build a successful VA claim and secure the highest possible rating for plantar fasciitis.
Direct Service Connection
A direct service connection is often one of the most common claim types. It applies if you began experiencing heel or foot pain during service duties like having to spend hours standing, marching, or carrying heavy loads. To establish this connection, you need evidence for three components:
- A current diagnosis of plantar fasciitis
- Evidence of an in-service event or injury that could have caused the condition (e.g., physical training, poor footwear, or long deployments on hard terrain)
- A nexus, or medical opinion, linking your current diagnosis to the in-service event or illness. The nexus opinion, written by a qualified healthcare professional, must validate the link by stating that the disability is “at least as likely as not” caused by military service.
Secondary Service Connection
Many veterans are diagnosed with plantar fasciitis secondary to flat feet (pes planus) or another service-connected condition. For example, having flat feet can alter gait and place extra stress on the plantar fascia, which may result in ongoing inflammation. Secondary claims require:
- A primary service-connected condition (e.g., pes planus)
- A medical opinion showing the secondary condition is “at least as likely as not” caused or aggravated by the primary disability.
Service Connection by Aggravation
If you had plantar fasciitis or foot pain before entering service, you may still qualify if your condition worsened during your military service. This is called aggravation. As a disabled veteran, you must prove that the military duties permanently worsened your foot pain beyond its natural progression. Medical records before and after your deployment and expert nexus statements are key to proving this claim.
Establishing the right service connection is the foundation for receiving fair VA compensation.
TDIU and Plantar Fasciitis
Even though the highest plantar fasciitis VA rating is 40%, many veterans find themselves unable to work due to their condition, especially if it affects both feet or contributes to other mobility-limiting conditions. That’s where TDIU (Total Disability based on Individual Unemployability) comes in.
TDIU provides veterans with compensation at the 100% disability rate when their service-connected disabilities prevent them from maintaining substantially gainful employment, even if their combined disability rating is less than 100%.
Eligibility for TDIU requires meeting one of the following conditions:
- One service-connected disability rated at 60% or higher
- Two or more service-connected disabilities, with at least one rated at 40% or more and a combined rating of 70% or higher
Your TDIU application must also include proof that your condition affects your ability to work, for example, employer statements or vocational assessments.
Veterans struggling with related conditions should consider exploring TDIU as a path to full compensation.
Difference Between Flat Feet and Plantar Fasciitis
Flat feet (pes planus) and plantar fasciitis are common among veterans and often confused due to common symptoms like heel and arch pain. However, they are distinct conditions with their own causes and treatments.
Flat feet, or pes planus, is a structural condition where arches of the foot either collapse or were never present, causing the sole to nearly touch the ground. Symptoms of flat feet include:
- Foot fatigue
- Ankle instability
- Pain in the arches, knees, or lower back
- Difficulty standing on tiptoe
Plantar fasciitis is an inflammatory condition that occurs when the plantar fascia, a ligament that runs from your heel to the ball of your foot, becomes inflamed due to overuse or stress. It results in:
- Stabbing pain near the heel, particularly in the morning
- Swelling and tenderness at the foot base
- Tightness in the Achilles tendon
- Difficulty walking or bearing weight after inactivity
Many veterans experience plantar fasciitis secondary to flat feet due to altered walking mechanics. If both conditions exist, veterans should include detailed documentation and report specific symptoms for each condition to ensure the VA reviews both issues.
VA Secondary Conditions for Plantar Fasciitis
Many veterans don’t realize that service-connected plantar fasciitis can lead to or exacerbate other conditions, particularly those that affect gait, weight distribution, or foot mechanics. Some common secondary claims are:
- Flat feet (pes planus): One of the most common secondary conditions is flat feet, which alters foot alignment and increases strain on the plantar fascia.
- Obesity: Excess body weight puts additional stress on the foot’s arch.
- Achilles tendonitis: Tight calf muscles can limit ankle mobility and increase tension on the plantar fascia.
- Arthritis: Rheumatoid or reactive arthritis may inflame foot tissues, indirectly irritating plantar fascia.
- Lower limb injuries: Foot injuries and ankle or knee conditions alter how weight is distributed when walking, often developing plantar fasciitis.
- Lower Back Pain (Sciatica): Nerve dysfunction or altered gait from back pain can increase pressure on the plantar fascia, causing heel pain.
- Tarsal Tunnel Syndrome: A condition involving compression of the posterior tibial nerve near the ankle, often linked with abnormal foot mechanics.
- Metatarsalgia: Pain and inflammation in the ball of the foot caused by an imbalance in pressure distribution.
- Hallux Valgus: Hallux valgus (bunion), a foot deformity characterized by a bony bump at the base of the big toe, can result from altered gait or foot mechanics.
- Stress Fractures: Small, painful cracks in the bones of the foot may result from overuse or uneven weight-bearing.
- Depression or Anxiety: Chronic pain from foot disabilities may lead to mental health issues, especially if it restricts employment, daily activities, or social interactions.
These secondary conditions may also be compensable by the VA, and claiming them can in some cases support your case for disability benefits and increase your overall rating.
Evidence for Plantar Fasciitis Secondary to Flat Feet (Pes Planus)
This is one of the most common combinations we see. Many veterans already service-connected for pes planus later develop plantar fasciitis as a result of their altered foot mechanics. Flat feet collapse the foot arch, increasing strain on the plantar fascia and making inflammation more likely. To support this, a study found that individuals with flat feet had thicker plantar fascia compared to those with normal arches.
In these cases, veterans often file for a secondary service connection. This involves showing:
- A current plantar fasciitis diagnosis
- A service-connected diagnosis of pes planus
- A medical nexus linking the two conditions
If both conditions cause different symptoms and require different treatments, veterans may receive separate ratings for each. Claiming these together can lead to a higher combined disability rating in some cases and may even qualify a veteran for TDIU benefits.
We always recommend that veterans work with a VA-accredited representative or attorney to ensure that their combined ratings reflect the full extent of their impairments.
VA’s Steps to File a Plantar Fasciitis VA Claim
Filing a successful VA disability claim requires the following essential steps, including those listed on VA.gov:
Complete VA Form 21-526EZ
This form is used to initiate your claim. You can complete VA Form 21-526EZ online via VA.gov, submit it by mail, or file it in person at a VA regional office.
Gather Compelling Evidence
To receive benefits, consider including comprehensive documentation like:
- Medical documentation showing a current diagnosis
- Photos of orthotic use or medical devices
- Service treatment records and deployment records
- A nexus letter from a qualified doctor linking your condition to service or another VA-rated disability
- Lay statements
- Job performance records if the service-connected condition affected your duties
Attend the C&P Examination
You may also be scheduled for a Compensation & Pension (C&P) exam, where a VA-contracted medical professional assesses your plantar fasciitis symptoms. Failing to attend this can negatively affect your claim’s outcome and may even result in a denied claim.
Track Your Claim Status
After submission, monitor the progress of your claim through the VA website, or by contacting your local VA office or Veterans Service Officer (VSO).
Review and Appeal If Necessary
Once the VA issues a decision, review your rating. If denied or underrated, consider submitting a supplemental claim, requesting a higher-level review, or filing an appeal if applicable.
Seeking guidance from VA-accredited representatives or attorneys specializing in building claims can make a huge difference.
What to Expect at Your VA C&P Exam for Plantar Fasciitis
The Compensation and Pension (C&P exam) is one of the important steps in your VA claim. It serves to help establish whether your condition is connected to your military service and how severely it impacts your daily life and ability to work. Conducted by a VA-contracted physician, or other allied health care practitioner, this evaluation helps the VA assign an appropriate disability rating.
What Happens During the Exam?
- Medical History Review: The examiner will review your records, including service treatment documents, diagnosis notes, and past C&P reports if applicable.
- Physical Examination: During the physical assessment, you will be asked to walk, stand, and describe your pain. The examiner will check for tenderness in the heel, swelling, abnormal gait, range of motion, and your ability to bear weight.
- Symptom Discussion: This is your opportunity to explain how plantar fasciitis affects your daily life. Expect questions about when pain occurs, the nature and frequency of flare-ups, the use of orthotics or assistive devices, and the overall impact on your mobility and employment.
Tips to Succeed:
Be specific and detailed about your symptoms, don’t just say “It hurts”. Talk about sharpness, duration, and what triggers plantar fasciitis pain if applicable.. Bring supporting materials like pain journals, medical statements, or imaging reports to strengthen your case.
Considerations For How to Improve Your Plantar Fasciitis VA Rating
Many veterans find that their initial rating doesn’t reflect the severity of their condition or that their symptoms worsen over time. In that case, here are practical steps to consider for increasing your VA rating for plantar fasciitis.
1. Submit a Request for Re-Evaluation
If your symptoms have intensified, you may request an increase by submitting a new claim for increased compensation. Review VA Form 21-526EZ.
2. Get a Medical Nexus Letter
Consider obtaining a well-written nexus letter from a qualified medical professional such as a podiatrist, orthopedic surgeon, or primary care physician. These nexus letter providers review your service records, military medical records, and other documents based on which they draft an unbiased opinion that your condition has worsened due to military service and continues to limit your ability to work or function. This can be crucial if your original claim lacked strong medical backing. Remember that these types of reports are never required but can be helpful in some cases.
For veterans seeking trusted medical opinions and expert support, Prestige Veteran Medical Consulting offers detailed nexus letters to help support your claim with confidence. Our experienced medical professionals understand how to use the proper language and medical rationale that the VA looks for.
3. Provide Symptom Documentation
Keep a pain journal detailing your daily limitations. Record how far you can walk, how long you can stand, whether you use orthotics or walking aids, and how the foot pain disrupts your sleep or job duties. This evidence of personal documentation may strengthen your case.
4. Attend All VA Appointments
Do not skip a scheduled C&P exam unless your accredited legal professional advises you to. Be honest, consistent, and specific about how the foot pain affects your life. VA examiners will note your range of motion, pain levels, and mobility to determine the final rating for plantar fasciitis.
5. Consider Filing for Secondary Service Connections
If plantar fasciitis has altered your gait and led to back, hip, or knee issues, you may be eligible to file for a secondary service connection. These secondary conditions can increase your overall combined VA disability rating.
A thorough and well-documented case is the key to receiving a more accurate and fair rating, ultimately improving your VA disability benefits.
Appealing a Denied VA Claim
Usually, if the VA denies plantar fasciitis claims it may be due to insufficient documentation or weak medical records. Fortunately, according to the appeals modernization act you can appeal in one of three ways:
- File a Supplemental Claim with new and relevant evidence, such as a detailed medical nexus letter, updated medical exams or imaging, or lay evidence.
- Request a Higher-Level Review to have your initial claim re-evaluated by a senior VA reviewer.
- File an appeal to the Board of Veterans’ Appeals (BVA) with the help of a veterans law attorney to structure your case.
Many appeals for VA disability for foot conditions are won on the second attempt once proper evidence is submitted.
Case Study: VA Claim for Chronic Plantar Fasciitis
A 32-year-old Army mechanic developed chronic plantar fasciitis after years of working on hard surfaces in combat boots. Initially denied VA compensation, her case was later supported by additional evidence, like:
- Consistent treatment notes from military and VA healthcare professionals
- Orthopedic evaluations confirming chronic inflammation and heel spurs
- Buddy statements describing visible pain in her affected foot during field operations
- Physical therapy records documenting limited mobility
She also developed Achilles tendinitis and an altered gait, which led to knee strain, further reinforcing her case. The Veterans Affairs ultimately awarded a 30% disability rating, noting her ongoing pain wasn’t relieved by orthotics and severely impacted her ability to walk. The supporting evidence, along with documentation of related complications, played a key role in securing fair compensation for her long-term mobility issues.
Special Monthly Compensation for Foot Disabilities
When plantar fasciitis affects both feet, it can seriously hinder walking, driving, or working. In severe cases, veterans may qualify for Special Monthly Compensation (SMC) if there is a loss of use of one or both feet. Unlike standard disability ratings, SMC isn’t based on percentages, it offers higher pay for extraordinary impairments like immobility or the use of assistive devices.
The VA evaluates each case individually, considering functional loss and its impact on daily life. Proper documentation, including medical records and mobility assessments, is essential to support SMC benefits claims.
Veterans unsure of their eligibility for SMC benefits should consider taking guidance from a VA-accredited representative.
Final Thoughts
Plantar fasciitis can disrupt nearly every aspect of a veteran’s daily life, from mobility and work to mental health and overall quality of life. While the claims process can seem overwhelming, understanding your condition, gathering strong evidence, and knowing how to navigate the plantar fasciitis VA rating system are powerful tools. Whether you are filing a new claim or seeking a rating increase, take your time. Be consistent and don’t hesitate to seek expert help for the appeal process. You have earned these VA benefits, hence, now it’s time to claim them.
FAQs
What is the VA disability rating for plantar fasciitis?
The VA rates plantar fasciitis at 10%, 20%, or 30% based on severity and treatment response, with up to 40% if there’s a complete loss of foot use.
Is plantar fasciitis bilateral?
Yes, plantar fasciitis can impact both feet, and when the bilateral condition is unresponsive to treatment, it may increase a veteran’s eligibility for a 30% VA disability rating.
Is plantar fasciitis considered a handicap?
Yes, it can be considered a disability if it significantly impairs mobility, daily function, or employability.
How can I prove my VA disability claim for plantar fasciitis?
You can prove by submitting evidence of a current diagnosis, service-related event or injury, and a medical nexus linking the plantar fasciitis to your military service.
What are the secondary conditions linked to plantar fasciitis?
Secondary conditions may include pes planus, Achilles tendonitis, arthritis, lower back pain, tarsal tunnel syndrome, metatarsalgia, stress fractures, and mental health issues like depression.
Can I have pes planus and plantar fasciitis at the same time?
Yes, pes planus (flat feet) and plantar fasciitis commonly occur together and may be rated separately by the VA if properly documented.
Also read: Pes Planus and Veterans Disability
At Prestige Veteran Medical Consulting, a veteran-owned company, we specialize in Independent Medical Opinions (IMOs) known as Nexus letters.
Our purpose is to empower YOU, the veteran, to take charge of your medical evidence and provide you with valuable educational tools and research to guide you on your journey.
Understanding the unique challenges veterans face, our commitment lies in delivering exceptional service and support.
Leveraging an extensive network of licensed independent medical professionals, all well-versed in the medical professional aspects of the VA claims process, we review the necessary medical evidence to incorporate in our reports related to your VA Disability Claim.
Prestige Veteran Medical Consulting is not a law firm, accredited claims agent, or affiliated with the Veterans Administration or Veterans Services Organizations. However, we are happy to discuss your case with your accredited VA legal professional.
