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5278
§ 4.71a Schedule of ratings—musculoskeletal system.

Claw foot (pes cavus)

The foot has an abnormally high arch, causing the toes to curl downward.

What the rating means

VA rates acquired claw foot under diagnostic code 5278. The rating depends on how severely the foot is affected and whether one or both feet are involved. There are four possible levels.

The highest level, 50% for both feet or 30% for one foot, applies when you have marked contraction of the plantar fascia with a dropped forefoot, all toes forming hammer toes, very painful callosities, and marked varus deformity. The next level, 30% for both feet or 20% for one foot, applies when all toes tend toward dorsiflexion, dorsiflexion at the ankle is limited to a right angle, the plantar fascia is shortened, and there is marked tenderness under the metatarsal heads. The third level, 10% whether one or both feet are affected, applies when the great toe is dorsiflexed, there is some limitation of dorsiflexion at the ankle, and there is definite tenderness under the metatarsal heads. A slight degree of claw foot rates 0%.

Evidence that helps

Medical records and physical examination findings are central to establishing the level of your condition. For the highest rating, an examiner would need to document marked contraction of the plantar fascia, a dropped forefoot, hammer toe deformity of all toes, very painful callosities, and marked varus deformity of the foot. For the middle rating, records should show that all toes tend toward dorsiflexion, that dorsiflexion at the ankle is limited to a right angle, that the plantar fascia is shortened, and that there is marked tenderness under the metatarsal heads. For the 10% level, findings of great toe dorsiflexion, some limitation of ankle dorsiflexion, and definite tenderness under the metatarsal heads would be relevant.

In all cases, imaging such as X-rays may help show structural changes. Statements from you or people who know you describing how foot pain or deformity affects walking, standing, and daily activities can also reflect the severity of your symptoms.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.