Claw Foot (Pes Cavus)

DC 5278Musculoskeletal38 CFR 4.71a, DC 5278

A foot condition where the arch of the foot is abnormally high, causing pain, instability, and difficulty with walking. The VA rates pes cavus based on specific physical findings including toe position, ankle motion, plantar fascia tightness, calluses, and deformity severity.

How the VA rates this condition

The VA rates this condition based on objective clinical measurements and test results. The examiner will use standardized tests or lab values to determine the severity of your condition rather than relying primarily on subjective symptom reports.

Diagnostic code

DC 5278

Rating range

0% – 50%

Rating levels

Rating criteria are defined in 38 CFR 4.71a, DC 5278. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

You have the most severe form of claw foot in both feet: marked contraction of the plantar fascia with dropped forefoot, all toes are hammer toes, very painful calluses, and marked varus deformity. This is the maximum rating for bilateral pes cavus.

What the VA looks for

Marked contraction of plantar fascia with dropped forefoot
All toes hammer toes
Very painful callosities (calluses)
Marked varus deformity (foot turning inward)
Bilateral involvement with severe functional limitation

Common Pitfalls

⚠Not having the examiner document every specific finding — the rating criteria for pes cavus are very detailed. Make sure the examiner checks for toe dorsiflexion, ankle dorsiflexion limitation, plantar fascia tightness, metatarsal tenderness, calluses, and varus deformity.
⚠Not claiming both feet — if both feet are affected, the bilateral rating levels are higher. Make sure both feet are examined and documented.
⚠Not describing pain from calluses — the severity of callus pain is a specific rating criterion. Tell the examiner exactly how painful they are and how they affect your ability to walk.
⚠Not connecting pes cavus to military service — ill-fitting boots, prolonged marching, and high-impact training can worsen or cause this condition. Document these activities in your claim.
⚠Not filing for secondary conditions — pes cavus changes how you walk and can lead to knee, hip, and back problems. Consider filing for these as secondary to your foot condition.

Related DBQ Forms

DBQ Foot Conditions (Including Flatfoot)

View evidence checklist →See secondary conditions →

Related Conditions

Conditions commonly associated with Claw Foot (Pes Cavus) or rated under the same body system.

Lumbar Strain (Low Back Pain)

DC 5237·Musculoskeletal

Cervical Strain (Neck Pain)

DC 5237·Musculoskeletal

Knee Limitation of Flexion

DC 5260·Musculoskeletal

Knee Limitation of Extension

DC 5261·Musculoskeletal

Knee Instability (Subluxation)

DC 5257·Musculoskeletal

Plantar Fasciitis (Foot Pain)

DC 5276·Musculoskeletal

Degenerative Arthritis (Osteoarthritis)

DC 5003·Musculoskeletal

Fibromyalgia

DC 5025·Musculoskeletal

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

Claw Foot (Pes Cavus)

How the VA rates this condition

Diagnostic code

DC 5278

Rating range

0% – 50%

Rating levels

Rating Levels

What the VA looks for

Marked contraction of plantar fascia with dropped forefoot
All toes hammer toes
Very painful callosities (calluses)
Marked varus deformity (foot turning inward)
Bilateral involvement with severe functional limitation

Common Pitfalls

⚠Not having the examiner document every specific finding — the rating criteria for pes cavus are very detailed. Make sure the examiner checks for toe dorsiflexion, ankle dorsiflexion limitation, plantar fascia tightness, metatarsal tenderness, calluses, and varus deformity.

⚠Not claiming both feet — if both feet are affected, the bilateral rating levels are higher. Make sure both feet are examined and documented.

⚠Not describing pain from calluses — the severity of callus pain is a specific rating criterion. Tell the examiner exactly how painful they are and how they affect your ability to walk.

⚠Not connecting pes cavus to military service — ill-fitting boots, prolonged marching, and high-impact training can worsen or cause this condition. Document these activities in your claim.

⚠Not filing for secondary conditions — pes cavus changes how you walk and can lead to knee, hip, and back problems. Consider filing for these as secondary to your foot condition.