What the criteria ask for at each level

DC 5271 / 5276 / 5269 - 38 CFR §4.71a

Rating	What the record has to show
10–20% (ankle, DC 5271)	Moderate limitation 10%; marked limitation (<5° dorsiflexion or <10° plantar flexion) 20%.
10–50% (flat feet, DC 5276)	Up to 50% for pronounced bilateral pes planus: marked pronation, extreme tenderness, not improved by orthopedic shoes.
10–30% (plantar fasciitis, DC 5269)	10% standard; 20% unilateral with no relief from treatment; 30% bilateral with no relief from treatment.

What the C&P exam actually measures

This is a measurement exam. The examiner uses a goniometer on the joint, and §4.59 sets out how that measuring is supposed to be done.

Range of motion in degrees, tested for pain on both active and passive motion, and in weight-bearing and nonweight-bearing, as §4.59 requires.
Where pain begins in the arc of motion, which is not the same as where motion stops.
Gait, and any observable pronation or tenderness.
What treatment has been tried and whether any of it gave relief - the plantar fasciitis levels are written around exactly that.

Ankle limitation, flat feet and plantar fasciitis are three separate codes covering the same foot. Which one a record is read under changes what the criteria ask for.

Two records, read against the criteria

Two plantar fasciitis records under DC 5269.

Outcome	What the record held	How the criteria read it
Read at 30%	Both feet affected. Podiatry notes across three years listing orthotics, night splints, injections and physical therapy, each followed by a note that symptoms continued.	The 30% level is bilateral plantar fasciitis with no relief from treatment. The record establishes both halves - that it is bilateral, and that treatment was tried and did not relieve it.
Read at 10%	Both feet affected. Orthotics prescribed once, four years ago. No follow-up recorded after that.	Nothing states whether the treatment helped, so the "no relief" the higher levels ask about is not established. The 10% level is what the record supports.

The schedule's own words

Ratings turn on specific terms, and a record that describes the same reality in different language often reads as a lower rating. These are the words this code measures:

marked pronation
extreme tenderness
not improved by orthopedic shoes or appliances
no relief from both non-surgical and surgical treatment

Evidence that moves this rating

Podiatry records documenting failed treatments
Imaging and gait observations

What your statement has to cover

Doctors chart symptoms; they rarely chart consequences. That part is yours, and it is usually what separates a documented rating from a reported one.

State which treatments you've tried (inserts, orthopedic shoes, injections, surgery) and that they did NOT relieve symptoms - "no relief despite treatment" drives the higher levels.
Both feet affected = say so explicitly (bilateral ratings + bilateral factor).

Where records for this condition fall short

Where foot and ankle records commonly come up short:

Range of motion measured only one way
§4.59 asks for testing on active and passive motion, weight-bearing and nonweight-bearing. A single measurement is not the full picture the regulation describes.
Failed treatments never recorded as failed
The plantar fasciitis levels turn on relief. A file listing four treatments with no outcome for any of them reads as four treatments, not as four that did not work.
Measured on a good day, at rest
Plantar fasciitis is usually worst on the first steps of the morning and after standing. A mid-afternoon measurement at a seated appointment can miss the condition’s actual range.
One foot claimed when both are affected
Bilateral is a separate, higher level under DC 5269, and it is also relevant to the bilateral factor in the combined-rating math.

What plantar fasciitis and foot can lead to 7 documented pathways

A secondary claim runs through a condition the VA already accepts, so the argument about your service is already won. What is left is the medical link - and a nexus opinion has to name the mechanism, not just the pair.

Can lead to	The mechanism a nexus has to state
Erectile dysfunction / FSAD	Long-term NSAID and pain-medication use causes erectile dysfunction as a side effect.
Degenerative arthritis	Altered gait places abnormal load on joint mechanics, causing arthritis.
GERD (acid reflux)	Long-term NSAID / pain-medication use for this condition damages the stomach lining and relaxes the esophageal sphincter - a well-established medication-side-effect pathway.
Knee condition	Gait imbalance travels up the kinetic chain, stressing the knees.
Hip condition (bursitis, arthritis, limited motion)	Gait imbalances force abnormal movements up the kinetic chain, causing hip bursitis or osteoarthritis.
Lower back condition (lumbar spine)	"Ankle-spine syndrome" - compensatory posture strains the lumbar spine.
Depression	Chronic pain, lost mobility, and isolation degrade mental health.

Before you spend money on this claim

VA ratings do not add. Each new rating applies only to the part of you the VA still counts as unimpaired, then rounds to the nearest ten - so from 70%, a new 10% condition leaves you at exactly 70% and changes your payment by nothing.

That does not make the claim worthless; it can still matter for TDIU, for SMC, or later when something else is added. But it is worth knowing before you pay for a nexus letter rather than after. Check what one more condition does at your rating - it takes a minute.

Who is behind this: Lima Charlie is written by John G., a U.S. Army veteran who went through the VA claims process himself - VSO route, then claim sharks, then finally doing it alone with the regulations open - and built this so no veteran leaves money on the table for want of knowing how the system works.
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