Posterior Tibial Tendon Dysfunction (PTTD)

DC 5024Musculoskeletal38 CFR 4.71a, DC 5024

Damage or degeneration of the posterior tibial tendon, which supports the arch of the foot. When this tendon fails, the arch collapses and the foot flattens, causing pain along the inner ankle and foot. The VA rates PTTD based on tenosynovitis with limitation of motion or as acquired flatfoot.

How the VA rates this condition

The VA rates this condition based on how much it affects your ability to work and carry out daily activities. The examiner will focus on the functional limitations your condition causes, not just the diagnosis itself.

Diagnostic code

DC 5024

Rating range

10% – 30%

Rating levels

Rating criteria are defined in 38 CFR 4.71a, DC 5024. 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 posterior tibial tendon dysfunction with severe acquired flatfoot. You have marked deformity with pronounced arch collapse, significant pain, swelling, and callosities. Orthotics do not adequately relieve your symptoms. This rating applies for severe bilateral involvement.

What the VA looks for

Marked foot deformity with pronation and abduction
Pain on manipulation and use accentuated
Swelling on use documented
Characteristic callosities present
Failure of conservative treatment including orthotics

Common Pitfalls

⚠Not getting an MRI of the posterior tibial tendon — this shows the extent of tendon degeneration, tearing, or rupture and is essential for documenting the severity of your condition.
⚠Not documenting the progressive nature of PTTD — this condition worsens over time, and serial examinations showing progressive arch collapse support a higher rating.
⚠Not claiming the condition as acquired flatfoot if applicable — severe PTTD leads to acquired flatfoot (pes planus), which has its own diagnostic code (5276) and may provide a higher rating.
⚠Not reporting bilateral symptoms if both feet are affected — bilateral involvement receives a higher rating than unilateral, and many veterans develop PTTD in both feet.

Related DBQ Forms

DBQ Foot Conditions (Other)
DBQ Flatfoot (Pes Planus)

View evidence checklist →See secondary conditions →

Condition Rating Guides

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Posterior Tibial Tendon Dysfunction (PTTD)

How the VA rates this condition

Diagnostic code

DC 5024

Rating range

10% – 30%

Rating levels

Rating Levels

What the VA looks for

Marked foot deformity with pronation and abduction
Pain on manipulation and use accentuated
Swelling on use documented
Characteristic callosities present
Failure of conservative treatment including orthotics

Common Pitfalls

⚠Not getting an MRI of the posterior tibial tendon — this shows the extent of tendon degeneration, tearing, or rupture and is essential for documenting the severity of your condition.

⚠Not documenting the progressive nature of PTTD — this condition worsens over time, and serial examinations showing progressive arch collapse support a higher rating.

⚠Not claiming the condition as acquired flatfoot if applicable — severe PTTD leads to acquired flatfoot (pes planus), which has its own diagnostic code (5276) and may provide a higher rating.

⚠Not reporting bilateral symptoms if both feet are affected — bilateral involvement receives a higher rating than unilateral, and many veterans develop PTTD in both feet.