Musculoskeletal System§ 4.71aUpdated
Rating criteria

VA Diagnostic Code 5278Claw foot (pes cavus), acquired

Rated from 0% to 50% under § 4.71a. Here is what the VA requires at each level.

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What each rating requires

The VA assigns the highest level your evidence actually supports. Read up the stack until your records stop matching.

  1. 50%

    Marked contraction of plantar fascia with dropped forefoot, all toes hammer toes, very painful callosities, marked varus deformity: Bilateral

  2. 30%

    Marked contraction of plantar fascia with dropped forefoot, all toes hammer toes, very painful callosities, marked varus deformity: Unilateral

  3. 30%

    All toes tending to dorsiflexion, limitation of dorsiflexion at ankle to right angle, shortened plantar fascia, and marked tenderness under metatarsal heads: Bilateral

  4. 20%

    All toes tending to dorsiflexion, limitation of dorsiflexion at ankle to right angle, shortened plantar fascia, and marked tenderness under metatarsal heads: Unilateral

  5. 10%

    Great toe dorsiflexed, some limitation of dorsiflexion at ankle, definite tenderness under metatarsal heads: Bilateral

  6. 10%

    Great toe dorsiflexed, some limitation of dorsiflexion at ankle, definite tenderness under metatarsal heads: Unilateral

  7. 0%

    Slight

Claw Foot (Pes Cavus), Acquired — VA Disability Rating

Diagnostic Code 5278 · 38 CFR § 4.71a · Musculoskeletal System

Understanding This Condition

Claw foot, medically known as pes cavus, is a condition of the foot that appears under the VA's musculoskeletal rating schedule. The "acquired" designation refers to the version of this condition addressed under Diagnostic Code 5278.

The VA rates claw foot based on the severity of specific foot deformities and whether the condition affects one foot (unilateral) or both feet (bilateral). More pronounced deformities and involvement of both feet generally correspond to higher rating levels.

Available Rating Levels

The VA assigns a disability rating for acquired claw foot according to the following criteria:

50%

  • Bilateral: Marked contraction of plantar fascia with dropped forefoot, all toes hammer toes, very painful callosities, marked varus deformity

30%

  • Unilateral: Marked contraction of plantar fascia with dropped forefoot, all toes hammer toes, very painful callosities, marked varus deformity
  • Bilateral: All toes tending to dorsiflexion, limitation of dorsiflexion at ankle to right angle, shortened plantar fascia, and marked tenderness under metatarsal heads

20%

  • Unilateral: All toes tending to dorsiflexion, limitation of dorsiflexion at ankle to right angle, shortened plantar fascia, and marked tenderness under metatarsal heads

10%

  • Bilateral: Great toe dorsiflexed, some limitation of dorsiflexion at ankle, definite tenderness under metatarsal heads
  • Unilateral: Great toe dorsiflexed, some limitation of dorsiflexion at ankle, definite tenderness under metatarsal heads

0%

  • Slight

What the VA Looks For

When rating acquired claw foot, the VA evaluates the specific characteristics of the foot deformity described in the rating criteria, including:

  • Contraction of the plantar fascia and whether it is shortened or markedly contracted
  • Position of the toes — such as toes tending to dorsiflexion, the great toe being dorsiflexed, or all toes presenting as hammer toes
  • A dropped forefoot and the presence of marked varus deformity
  • Limitation of dorsiflexion at the ankle, ranging from some limitation up to limitation to a right angle
  • Tenderness under the metatarsal heads, described as definite or marked
  • Callosities, particularly very painful ones
  • Whether the condition is unilateral (one foot) or bilateral (both feet)

The combination of these findings, along with whether one or both feet are involved, determines which rating level applies.

These criteria are a rendering of § 4.71a, diagnostic code 5278. The official version is the one that governs your rating.

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What next

How to claim this

Knowing the criteria is the first half. Getting your file to show them is the second.

  1. Find your level in the stack

    Read each rung against what your medical records already say. The level your records document today is the one the VA can support today.

  2. Name the gap

    Look at the rung above yours and write down exactly what it asks for that your file does not show yet — a diagnosis, a measurement, a prescribed brace, a doctor’s opinion linking it to service.

  3. Claim it by code

    File under diagnostic code 5278 and attach the evidence for the level you are asking for. Other Musculoskeletal System codes may cover your secondary conditions.

Find out which rating your evidence supports.

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