VA Plantar Fasciitis Ratings: Orthotics in 2026

Heel pain can make every morning step difficult, but the VA does not assign a percentage based on pain alone. The current VA plantar fasciitis ratings depend mainly on whether one or both feet are affected and whether treatment has failed.

Orthotics often appear in the medical record, yet they don’t create a separate rating level by themselves. The most useful evidence connects your diagnosis, treatment history, and daily limitations to the rating criteria under Diagnostic Code 5269.

VA plantar fasciitis ratings under Diagnostic Code 5269

As of August 2026, VA rates plantar fasciitis under Diagnostic Code 5269 in 38 C.F.R. § 4.71a. The VA added plantar fasciitis as its own listed condition effective February 7, 2021. The 2021 Federal Register rule explains that change to the musculoskeletal rating schedule.

The current schedular ratings are:

VA rating	Criteria under DC 5269
10%	Unilateral or bilateral plantar fasciitis that does not meet the higher criteria
20%	Unilateral plantar fasciitis with no relief from both non-surgical and surgical treatment
30%	Bilateral plantar fasciitis with no relief from both non-surgical and surgical treatment
40%	Actual loss of use of the foot under the note to the diagnostic code

The 10% level applies when plantar fasciitis is service connected but the evidence does not establish the requirements for 20% or 30%. That rating can apply to one foot or both feet.

The 20% level requires one affected foot and no relief from both non-surgical and surgical treatment. The 30% level requires the same treatment history in both feet. The difference between those ratings is bilateral involvement.

The regulation also addresses surgery that has been recommended but cannot be performed because the veteran isn’t a surgical candidate. In that situation, VA evaluates the condition under the 20% or 30% criteria, depending on whether the condition affects one foot or both.

This language matters because a veteran doesn’t have to undergo surgery when a physician has determined that surgery is medically inappropriate. At the same time, a general statement that surgery was discussed may not establish the full treatment requirement. The record should show what the provider recommended and why the veteran could not receive it.

The maximum ordinary schedular rating under DC 5269 is 30%. The 40% provision applies when the evidence establishes actual loss of use of the foot. Loss of use is a serious functional finding. Severe pain alone doesn’t automatically meet that standard.

The VA plantar fasciitis rating guidelines provide a Florida-focused explanation of the difference between the 10% and 30% levels. The central issue remains the same: prove the diagnosis, identify the affected foot or feet, and document the response to treatment.

How orthotics affect VA plantar fasciitis evidence

Orthotics can help prove the severity and persistence of plantar fasciitis, but the rating schedule doesn’t create a separate percentage for custom inserts, shoe supports, or arch supports.

A prescription for orthotics may show that a medical provider found ordinary footwear insufficient. It can also establish when treatment began and whether the provider expected the device to reduce symptoms. Those details become more useful when later records document continued heel pain despite consistent use.

The strongest orthotics evidence usually answers several practical questions:

• Who prescribed or recommended the orthotics?
• Were they custom-made or purchased over the counter?
• Did the veteran use them as directed?
• How long were they used?
• Did they reduce pain, improve walking, or fail to help?
• Did symptoms return when the veteran stood, walked, or worked for extended periods?

A medical record that says “orthotics provided” gives the VA less information than a follow-up note describing the result. For example, a podiatry record may state that custom orthotics were fitted, worn for several months, and failed to relieve bilateral heel pain. That record helps establish treatment history and ongoing symptoms.

Still, the evidence should not overstate what the regulation says. Some summaries describe the 10% rating as pain that remains despite orthotics. The actual DC 5269 language says 10% applies “otherwise, unilateral or bilateral.” It does not create an independent orthotics test.

Orthotics may also point to another foot diagnosis. Flat feet, plantar fasciitis, tendon disorders, arthritis, and ankle problems can produce overlapping symptoms. The medical record should identify which condition causes each limitation when possible.

For example, arch collapse may support a pes planus claim, while heel pain along the plantar fascia may support plantar fasciitis. The VA must avoid compensating the same manifestation twice, but separate symptoms and diagnoses may matter when the evidence distinguishes them. Veterans dealing with overlapping foot conditions can review this VA flat feet ratings guide for the separate pes planus criteria.

A prescription alone won’t prove a higher percentage. The value of orthotics evidence comes from the complete treatment story, including use, medical follow-up, and the symptoms that remained.

Treatment history and the 20% or 30% standard

The phrase “no relief from both non-surgical and surgical treatment” is the most important part of the higher plantar fasciitis ratings. The VA must consider the treatment history as a whole.

Non-surgical treatment can include measures such as orthotics, supportive footwear, stretching, physical therapy, activity changes, medication, injections, or other care recommended by a treating provider. The record doesn’t need to contain every possible conservative treatment. DC 5269 doesn’t establish a fixed checklist of procedures that every veteran must try.

Instead, the evidence should show what treatment was medically recommended, what the veteran tried, and what happened afterward. A treatment plan without a documented response leaves an important gap.

A useful timeline might include:

1. The date plantar fasciitis was diagnosed.
2. The foot or feet affected at each visit.
3. The treatment recommended by the provider.
4. The veteran’s response after a reasonable period.
5. Any change in walking, standing, work duties, or daily activities.
6. The provider’s recommendation about further treatment or surgery.

Treatment response can also change over time. A veteran may receive temporary improvement after an injection but experience recurring pain later. Another person may benefit from orthotics in one foot while the other remains painful. The VA should consider the full period under review rather than relying on one isolated visit.

When surgery was recommended

Surgery requires careful documentation because the regulation distinguishes surgical treatment from a surgical recommendation. If surgery occurred, the file should identify the procedure, the date, the recovery period, and the result. Continued pain after surgery may support the argument that treatment did not provide relief, but the record should establish that fact through medical evidence and credible reports.

If surgery was recommended but the veteran wasn’t a surgical candidate, the VA can evaluate the disability under the higher criteria for the affected foot or feet. The reason matters. A physician’s statement that medical risks, another condition, or a specific clinical factor prevents surgery is more useful than a vague note that the veteran declined it.

A veteran who chooses not to pursue a recommended procedure for personal reasons may face a different evidentiary issue. The file should explain the circumstances rather than leave the VA to assume that surgery was medically unavailable.

The phrase “no relief” also requires more than a single complaint of pain. Records should describe persistent symptoms despite treatment, such as pain with the first steps of the day, pain after standing, difficulty walking on hard surfaces, or the need to stop activities.

Orthotics can document treatment, but the higher rating depends on the treatment outcome, the number of affected feet, and the complete medical record.

Service connection is separate from the percentage

A rating percentage answers how disabling the condition is after service connection has been established. It doesn’t answer whether the condition is connected to military service.

For direct service connection, a veteran generally needs evidence of a current diagnosis, an in-service disease, injury, or symptoms, and a medical connection between the current condition and service. Service treatment records may show foot pain, treatment for heel symptoms, a diagnosis, or physical demands that affected the feet.

The absence of a formal plantar fasciitis diagnosis during service does not automatically end the claim. The file may contain repeated complaints of heel pain or foot problems described under different terms. A medical professional may need to explain whether those earlier symptoms are consistent with the current diagnosis.

Plantar fasciitis can also be claimed as secondary to another service-connected condition when medical evidence supports that relationship. A veteran may argue that service-connected pes planus caused or aggravated plantar fasciitis. The same issue can arise when altered gait from a service-connected leg, knee, or ankle condition affects the foot.

A secondary claim still requires more than timing. The fact that plantar fasciitis appeared after another disability doesn’t prove causation or aggravation by itself. A medical opinion should address the relationship and explain the reasoning.

Aggravation has its own focus. The evidence should show that a service-connected disability made the plantar fasciitis worse beyond its natural progression. Treatment records before and after the change can help establish that increase.

The VA also must identify the correct diagnosis. A veteran may have plantar fasciitis and pes planus at the same time, but similar pain descriptions can create confusion. Medical records should separate heel pain, arch pain, ankle symptoms, numbness, swelling, and gait problems when possible.

The date of service connection can affect the effective date of compensation. A denial may involve the nexus issue, the severity percentage, the effective date, or more than one issue. The correct appeal strategy depends on what the VA decided and what new evidence is available.

Evidence that supports a stronger plantar fasciitis claim

A strong file usually contains more than a diagnosis and a general statement that the feet hurt. It shows how the condition behaves over time and how treatment changed, or failed to change, the veteran’s function.

Medical records should identify the affected foot or feet. A claim for 30% requires bilateral plantar fasciitis, so records that consistently discuss only one foot may create a problem. If both feet hurt, tell the provider and make sure the examination records both sides.

Treatment records should also describe severity in concrete terms. Useful details may include pain while standing, limited walking distance, difficulty climbing stairs, changes in gait, inability to tolerate certain shoes, and symptoms after work or household tasks.

Personal statements can fill gaps in the medical timeline. A veteran can describe when pain began, how often it occurs, whether orthotics helped, and what activities became difficult. Family members, coworkers, or supervisors may describe observable changes, such as frequent sitting, slower walking, or difficulty completing physical duties.

Those statements don’t replace a medical diagnosis. They provide firsthand evidence about symptoms and function, especially when treatment was received at different facilities or there are long gaps between appointments.

A complete claim file may include:

• Service treatment records and separation examinations.
• VA podiatry, primary care, orthopedic, and physical therapy records.
• Private medical records and imaging when relevant.
• Orthotics prescriptions, fitting notes, and follow-up appointments.
• Medication, injection, and other treatment records.
• Surgical recommendations or medical statements explaining why surgery isn’t appropriate.
• A personal statement describing daily and work-related limitations.
• Statements from people who regularly observe the veteran’s symptoms.
• Prior VA decisions and examination reports.

A Compensation and Pension examination can have a major effect on the outcome. Describe symptoms accurately, including better and worse days. Explain how long you can stand or walk, what happens when you use orthotics, and whether pain affects both feet.

Avoid minimizing the condition because the examination occurs on a better day. Also avoid presenting symptoms more severely than they are. The examiner and adjudicator will compare the account with treatment records, work history, and prior statements.

The examiner should have access to the relevant medical history, but you should still bring a clear understanding of your treatment timeline. If an examination leaves out bilateral symptoms, orthotics use, or the surgical recommendation, that omission may matter during an appeal.

Common mistakes in VA plantar fasciitis ratings

Many disputes over VA plantar fasciitis ratings come from incomplete records rather than a total absence of medical evidence.

First, veterans sometimes assume that custom orthotics automatically support 20% or 30%. They don’t. Orthotics show treatment, but the higher ratings require evidence of no relief from both non-surgical and surgical treatment, with bilateral involvement required for 30%.

Second, records may describe “foot pain” without identifying the side. A claim can become difficult to evaluate when one visit mentions the right heel, another mentions the left arch, and neither clearly states whether plantar fasciitis affects both feet.

Third, a surgery discussion may be mistaken for failed surgical treatment. The file should distinguish among surgery that occurred, surgery that was recommended but medically unavailable, and surgery that was discussed without a final recommendation.

Fourth, veterans may focus on pain while leaving out function. The VA needs evidence about standing, walking, work tasks, footwear, and daily activities. Pain is important, but concrete limitations make the effect easier to evaluate.

Fifth, overlapping foot conditions can create inconsistent claims. A veteran may describe arch pain as plantar fasciitis in one statement and as flat-foot pain in another. A medical provider should explain the source of symptoms instead of forcing the veteran to make a medical conclusion.

Finally, a claim may overlook the service-connection issue. Treatment evidence can support the percentage, but it may not establish that the condition began in service or resulted from another service-connected disability.

Reviewing your file before an appeal

Start by reading the VA decision closely. Identify whether the VA denied service connection, granted the wrong percentage, used the wrong effective date, or failed to address a reasonably raised theory.

Next, compare the evidence with the DC 5269 requirements. Confirm whether the records show unilateral or bilateral plantar fasciitis. Then identify each non-surgical treatment, the result, and any medical statement concerning surgery.

Look for missing information in examination reports. A report may mention plantar fasciitis but omit the left foot, orthotics response, standing limits, or the reason surgery isn’t appropriate. Those omissions can support a challenge when the missing facts could affect the rating.

Finally, match the appeal option to the problem. A supplemental claim may need new and relevant medical or lay evidence. A Higher-Level Review examines the existing record and can address an error without adding new evidence. The best option depends on the decision, the evidence already submitted, and the reason for the denial.

A VA-accredited attorney or representative can review the medical and procedural records together. That review is particularly useful when plantar fasciitis overlaps with flat feet, ankle problems, or an altered gait.

Conclusion

The current VA plantar fasciitis ratings turn on a short list of facts: the affected foot or feet, the response to non-surgical treatment, the evidence concerning surgery, and the condition’s effect on function. Orthotics can strengthen the treatment history, but they don’t create an automatic higher percentage.

A 10% rating may apply when the condition doesn’t meet the higher standard. A 20% rating requires unilateral plantar fasciitis with no relief from both types of treatment, while 30% requires the same level of treatment failure in both feet. Clear medical records and a complete timeline give the VA a reliable basis to evaluate the claim.