Flatfoot (pes planus)

Medical records and physical examination findings are the core of evidence for flatfoot ratings. For a pronounced rating, an examiner would need to document marked pronation, extreme plantar tenderness, and severe Achilles tendon spasm on manipulation, along with a record showing that orthopedic shoes or appliances have not improved the condition. For a severe rating, records should show objective findings of marked deformity, pain that worsens with activity and on examination, swelling that appears with use, and the presence of callosities.

For a moderate rating, examination notes should document that your weight-bearing line falls over or medial to the great toe, inward bowing of the Achilles tendon, and pain during manipulation and activity. For any level above mild, your own statements describing how foot pain affects standing, walking, and daily tasks at home or work can help show functional impact. Imaging such as X-rays may support findings of deformity. Records showing failed or ongoing use of orthotics are relevant, particularly at the pronounced level.