The Foot and Lower Leg Muscles
Reminder: The VA will give a Military Disability Rating for each service-connected condition a service member has, but the DoD will only rate service-connected conditions that make a service member Unfit for Duty.
All muscle conditions are either rated on the Slight to Severe Scale detailed on another page (the links in the rating discussions will take you straight to the scale), or on the limited motion of the joint the muscle condition affects, whichever gives a higher rating. So, if there is a muscle injury near the ankle, it can either be rated on the muscle injury itself (the Slight to Severe Scale) or on the limited motion of the ankle. If the muscle injury is the cause of the limited motion, then only one can be rated. If, however, there is a muscle injury that does not affect a joint, and that joint has limited motion because of another condition, then both can be rated. If the muscle condition is rated as limited motion, then the final code will look like this: 5301-5271. The first four-digit code defines the condition as a muscle injury, and the second code tells how it is rated (limited motion of the ankle).
Code 5310: This group controls the movements of the ball of the foot and toes. The plantar muscles allow the toes to point forward, like a ballet dancer. The dorsal muscles allow the toes to flex upward and toward the shin of the leg.
Plantar muscles/tendons: flexor digitorum brevis, abductor hallucis, abductor digiti minimi, quadratus plantae, lumbricals, flexor hallucis brevis, adductor hallucis, flexor digiti minimi brevis, dorsal and plantar interossei, plantar aponeurosis, long plantar ligament, calcaneonavicular ligament, tibialis posterior, peroneus longus, and long flexors of the big toe and pinky toe.
The ratings for the plantar muscles are only based on the Slight to Severe Scale: slight = 0%, moderate = 10%, moderately severe = 20%, and severe = 30%.
Dorsal muscles/tendons: extensor hallucis brevis, extensor digitorum brevis, long extensors of toes, peronei muscles.
The ratings for the dorsal muscles are only based on the Slight to Severe Scale: slight = 0%, moderate = 10%, moderately severe = 10%, and severe = 20%.
Code 5311: This group controls the plantar flexion of the entire foot. These muscles allow the foot to push downward and help move the body forward when walking.
Muscles/tendons: triceps surae, tibialis posterior, peroneus longus, peroneus brevis, flexor hallucis longus, and flexor digitorum longus.
Code 5312: This group controls the dorsiflexion of the entire foot. These muscles allow the entire foot to flex upward and toward the shin.
Muscles/tendons: tibialis anterior, extensor digitorum longus, extensor hallucis longus, and peroneus tertius.
Principles that Apply
The Amputation Rule: Any ratings for the foot cannot be combined to be more than 40% for the entire foot and 30% for toes only. Likewise, any ratings for the lower leg (below the knee and including the foot) cannot be combined to be more than 40%.
Special Monthly Compensation: If your condition makes it impossible to push off with the foot or balance on the foot, you may qualify for the VA’s Special Monthly Compensation.
Combined Ratings for Muscle Injuries: A nerve rating in the foot cannot be combined with a muscle rating in the foot unless each condition affects completely different functions (i.e. the nerve condition affects the plantar flexion and the muscle condition affects the dorsiflexion). If more than one muscle group is injured in the foot, then they must be combined as described in this principle.
Painful Motion: If pain is present with motion, then the minimum rating must be given.
Pyramiding: A single condition can only be rated once! However, if a nerve condition or other condition exists that is additional to the foot or leg condition (not simply caused by it), then it can also be rated.
Probative Value: If two exams record the condition differently, the exam with the most thorough data and performed by the most qualified physician in that specialty will be the exam the rating is based on.
A Tie Goes to the Veteran: If there are two equally strong exams with conflicting information, or if the condition can be equally rated under two different codes, then the one that gives the highest rating will be assigned. Every conflict should be resolved in favor of the higher rating.
Accurate Measurements: It is essential that the necessary information to rate your condition is recorded by the physician in your exam. With the information on this page, you should know what needs to be measured and recorded. Make sure this happens correctly to ensure that you receive a proper rating.
Hospital or Convalescent Ratings: Some conditions require periods of hospitalization or constant medical care (at-home nurse, etc.). Any condition that requires this is rated 100% during this intensive treatment. Once it ends, then the 100% rating will continue for a certain period. This period is 3 months unless another length (6 months, 1 year, etc.) is directly specified in the condition ratings. Some patients may need more time to recover than others, so the physician or Rating Authorities can lengthen this time period if they see fit.