Inside the exam room
1. You will be asked which toes are affected and about treatment or surgery. Name the side, affected toes, shoe problems, and surgery dates.
2. The examiner will check toe position, tenderness, and any relevant surgery findings. Explain trouble pushing off, walking, or wearing shoes.
3. You will be asked how the toe problem affects standing and walking. Explain your limits, whether treatment helps, and what you can still do.
How VA rates toe conditions
Identify the affected toes and the diagnosis. Explain problems with walking, shoes, bending the toes, or pushing off, and list any toe surgery. VA rates a big toe angled toward the other toes (hallux valgus) under 38 CFR § 4.71a, DC 5280, severe stiffness of the big toe (hallux rigidus) under DC 5281, hammer toe under DC 5282, and a broken ankle or foot bone (tarsal/metatarsal) that healed out of alignment (malunion) or a broken bone that has not joined back together (nonunion) under DC 5283.
What each rating percentage means
Match the whole description with your exam and records. A single symptom or illustration does not decide your rating.
| Rating | What the rule requires |
|---|---|
| 10% | DC 5280: a severely angled big toe on one foot (hallux valgus) that is as disabling as losing the big toe, or surgery removing part of the bone at its base (metatarsal-head resection) |
| 10% | DC 5281: severe stiffness of the big toe on one foot (hallux rigidus); do not combine with claw-foot ratings |
| 0/10% | DC 5282: single hammer toes are 0%; all toes on one foot without claw foot are 10% |
| 10/20/30% | DC 5283: a broken ankle or foot bone (tarsal/metatarsal) that healed out of alignment (malunion) or has not joined back together (nonunion), classified as moderate, moderately severe, or severe |
Check these details in your records
The examiner uses a condition form called a Disability Benefits Questionnaire (DBQ). Compare these items with your own records and explain what actually happens in daily life.
- A severely angled big toe on one foot (hallux valgus) that is as disabling as losing the big toe10%DC 5280
- A big toe angled toward the other toes (hallux valgus), treated with surgery that removed part of the bone at its base (metatarsal-head resection)10%DC 5280
- Severe stiffness of the big toe on one foot (hallux rigidus)10%DC 5281; rated as a severely angled big toe (hallux valgus)
- Hammer toe of all toes on one foot without claw foot10%DC 5282
- A broken ankle or foot bone (tarsal or metatarsal) that healed out of alignment (malunion) or has not joined back together (nonunion), with a moderate effect on use of the foot10%DC 5283
- A broken ankle or foot bone (tarsal or metatarsal) that healed out of alignment (malunion) or has not joined back together (nonunion), with a severe effect on use of the foot30%DC 5283
What may happen in the exam room
- The examiner checks the position and shape of your toes, bunions, and thickened skin
- They press gently to check where it is tender
- They watch you walk and push off with your toes
- They check surgery scars and changes you need to make to your shoes
What the measurements tell you
- Which toe and which foot are affected
- Severity of deformity and loss of ability to use the affected body part
- Whether all toes are involved
- Effect on push-off, balance, and shoe fit
Questions the examiner may cover
- Which toes are painful or fixed?
- Have you had metatarsal-head surgery?
- What shoes can you tolerate?
- How do toe symptoms change walking, balance, or standing?
Questions to expect
Which toe, side and diagnosis are involved?
Explain: Describe push-off, shoe pressure, walking limits and surgery, with operative records if available.
Rating connection: Hallux valgus, hallux rigidus and hammer toes have different rules, including specific surgery or extent requirements.
What changes with repeated walking?
Explain: Describe distance, pain and adjustments, and identify any clinician-recorded fixation or bone injury.
Rating connection: The examiner identifies the structure and diagnosis; symptoms alone do not choose the code.
Your answer outline
The [specific toe or toes] on my [side] foot are affected. During [shoe use or activity], [what happens]. After [amount of walking or time], I [adjustment]. [What helps and what still causes difficulty].
Mark approximate dates and counts as estimates.
My notes: ________________________
Service connection records
1. How is this connected to your service?
For a direct claim, identify your current disability, what happened in service, and evidence linking them. Being on active duty or orders alone does not prove that link.
- Write the 5 Ws and how: who was there; what happened; when; where; why you were there; how the problem began. Add duty status, treatment, witnesses, and records. Mark uncertain dates as estimates.
- Guard or Reserve: find your orders, dates, duty type, and any line-of-duty records. Active duty, training, and drills have different rules.
- Secondary condition: it may start after service. Identify the service-connected condition and evidence that it caused or worsened this problem. A medical opinion may help explain the link.
- Started before service? Record what changed during service. Presumptive condition? Check the required diagnosis and service history; qualifying claims do not require separate proof of a link.
- Already service connected and seeking an increase? Focus on what has worsened and the records showing it.
If you do not know the cause, say so. Do not guess a medical connection.
Explain what changes in daily life
Describe both what you can do and what becomes difficult. Include how often it happens and how long it lasts.
- Identify the specific toe and side.
- Describe shoe pressure, push-off pain, and balance limits.
- Explain whether symptoms worsen after repeated walking or during flares.
Common mistakes to avoid
- Folding toe deformities into an ankle claim
- Not identifying the affected toe and side
- Failing to mention prior surgery
Records to get ready before the exam
- Foot Conditions DBQ
- Foot specialist or bone and joint treatment notes
- Weight-bearing imaging
- Surgical reports
- Photos showing deformity or shoe accommodation
Preparation notes
- Bring the shoes or inserts you normally use.
- Describe function on a bad day without forcing movement.
Pain, repeated use, and worse periods
Loss of ability to use the affected body part: Describe painful use, repeated walking, flare-ups, and reduced push-off under 38 CFR §§ 4.40, 4.45, and 4.59.
Official rating rule and code numbers
Use this source to check the full rule and its medical terms: 38 CFR 4.71a, DCs 5280-5283. Source review recorded 2026-09-04.
Could one health problem have caused another?
A condition VA has already linked to your service may cause another health problem or make it worse. VA calls this secondary service connection. Having both conditions does not prove the link. Your records need to show a current diagnosis and explain how the first condition or its treatment affected the second.
- Start with your records. Find the current diagnosis, the condition VA already linked to service, and evidence from someone qualified to explain the connection.
- Ask about cause and worsening. Did the first condition or its treatment cause the new disability, or make an existing disability worse? These are different questions. The rules call them causation under 38 CFR § 3.310(a) and aggravation under § 3.310(b). If both are raised by your records, the medical opinion should address both; answering only the cause question may not be enough (El-Amin).
- If treatment may be involved, collect the dates. List the medicine or surgery prescribed for the condition VA linked to service, the side effect, and the new diagnosis. Bring pharmacy records and dates when treatment started or stopped. A provider must explain the connection in your case; taking a medicine alone does not prove it.
- If weight gain may be involved, ask how it fits. Weight gain or obesity can be a step between the first condition and another diagnosed disability under VAOPGCPREC 1-2017. Obesity itself does not receive a VA disability rating.
- You do not need absolute certainty. VA uses the “at least as likely as not” standard and the reasonable-doubt rule under 38 CFR § 3.102. Ask a VA-accredited representative how the evidence applies to your claim.
- The same symptom cannot be counted twice. This is the rule against pyramiding in 38 CFR § 4.14. Mental-health diagnoses generally share one § 4.130 rating when they affect the same work and social abilities. Trouble sleeping may be a symptom rather than a separate disability.
- Check whether VA already assumes a link to service. Some conditions qualify based on where or when you served. These are called presumptive conditions. Examples can include chronic rhinitis, chronic sinusitis, hypertension after qualifying herbicide exposure, and type 2 diabetes. Sleep apnea (OSA) is not a PACT Act presumptive. Check eligibility before seeking a medical opinion about the link.
- An exam form and a medical opinion do different jobs. A Disability Benefits Questionnaire (DBQ) records the diagnosis and how severe it is. It may not explain why it is linked to service, often called a nexus. A VA-accredited veterans service organization (VSO) can help you file at no charge.
If another prescribed treatment may have caused a problem, ask your health care provider to record what happened and explain the connection in your case.
Sources: 38 CFR § 3.310 · 38 CFR § 4.14 · VA-accredited representatives
Other health problems to ask about
Use these notes to ask your provider about problems you already have. Your records must explain the connection. VA decides whether the condition is linked to service.
If your toe injury or its treatment left a scar, show where it is and whether it hurts or the skin keeps breaking open. Bring the injury or surgery records. A scar has its own rules; the same effects cannot be counted twice.
Sources: VA foot and toe exam form · VA scar rating rules
Choose the related health problems you want to discuss. Your preparation packet will include the notes you select and the full condition guides available for them.