The Department of Veterans Affairs pays disability for hallux valgus — one of the foot conditions that is presumptively service-connected. While a good percentage of hallux valgus is hereditary, it is also caused by wearing tight shoes, being flatfooted, or wearing heels. It is also degenerative and worsens over the years.
The condition is often not painful when it starts, but as time goes on, it can become very painful. Patients could also develop related disabilities, including gout and rheumatoid arthritis. If the Veterans Administration finds that hallux valgus (including bilateral) is service-connected, veterans could collect disability for the condition.
VA Disability Ratings for Hallux Valgus
Some servicemembers could develop hallux valgus as a result of their time in the service. Hallux valgus – bunions – is the misalignment of toes, particularly the great toe, usually caused by splayfoot. In splayfoot, the front part of the foot’s arch drops, causing the ends of your toes to stay flat on the ground in an outward position. Wearing shoes that cause a lot of pressure on the front of your foot causes the tendon to become strained, which in turn causes the big toe to rotate out of its joint.
After some time, the big toe moves towards the foot and crowds the rest of the toes. It also strains the join, causing hallux valgus or bunions. Hallux valgus can be unilateral or bilateral.
Related disabilities might include:
- Metatarsus primus varus: The medial deviation of the first metatarsal
- Bunion: Medial metatarsal head is uncovered, and patients might have medial exostosis
- Pes planus: Having flat feet – the arch in the foot is low or flat
- Rheumatoid arthritis
- Gout
Service Connection for Hallux Valgus and Bunions
Veterans can receive disability for hallux valgus related to active military service. The injury does not have to be new. The United States Code allows for aggravation of an existing injury. To receive a service-connected disability award for hallux valgus, the veteran must:
- Have a current diagnosis of hallux valgus.
- Have been involved in an incident or occurrence that caused or aggravated hallux valgus.
- Have a medical nexus letter from a doctor that connects hallux valgus to the incident or occurrence that allegedly caused or exacerbated hallux valgus.
According to a study by Naohiro Shibuya, DPM, MS and several other doctors, military boots caused foot problems, including hallux valgus. Prior to 1965, military boots had thick soles and were rigid so that the soldiers would have a rigid gait. The boot was supposed to help the lower leg muscles stabilize the foot, but after years, doctors found that the boot instead caused pain after activity and training because it forced abnormal pressure on the muscles.
In 1965, the military screened prospective soldiers for foot problems prior to enlistment. It also ensured that the soldiers had boots that fit properly and educate the soldiers on foot hygiene. However, a 1976 study by Bensel found that the two types of military boots did not protect the soldier’s feet from injuries. The study also found that soldiers were more likely to suffer from stress fractures, heel contusions, retrocalcaneal bursitis. Even with yet another change in boots, the problems did not significantly decrease.
Further study showed that no military boots had the cushioning required for stressful foot activity, including running and marching. Thus, hallux valgus is one of the presumptive diseases on the list for service-connected disabilities, and the veteran is entitled to disability benefits and disability compensation.
Secondary Service Connection for Hallux Valgus
The Department of Veterans Affairs also pays a veteran for secondary service connection. Hallux valgus could lead to other injuries. The secondary issues must also be listed in the CFR for service-connected disabilities. The servicemember receives additional compensation for secondary service-connected injuries.
For example, hallux valgus could lead to gout, which is listed. Thus a servicemember who suffered hallux valgus during and after active duty and developed gout would receive the disability rating for hallux valgus plus an additional rating for gout.
Hallux valgus could also cause rheumatoid arthritis. The CFR also lists rheumatic diseases as being service-connected. Thus, a servicemember with rheumatoid arthritis in his or her feet and toes could also receive compensation for the condition.
Service Connection by Aggravation
In some cases, the military accepts a person with a minor case of hallux valgus. The servicemember might have calluses or flatfeet, but no foot pain or major deformity. During the servicemember’s time in the service, the activities cause the affliction to worsen. If the VA’s doctors find that the work the servicemember did during his or her time in the military exacerbated the problem, the veteran could receive compensation for service-connected aggravation of hallux valgus.
However, the veteran must prove that the aggravation of hallux valgus is a permanent increase in severity. A doctor can tell if the veteran’s service caused the increase in severity and if the increase in severity is permanent.
Compensation & Pension Exams for Hallux Valgus and Bunions
Once the Department of Veterans Affairs receives a claim for hallux valgus, it will set up an appointment for the veteran to attend a Compensation and Pension hearing for disability compensation. At the C&P exam which is a medical exam, the VA’s doctors will examine the veteran’s hallux valgus.
Prior to the VA examination, the veteran should obtain any supporting medical records regarding his or her condition. During the exam, the doctor will examine the veteran’s foot and will ask questions about the affliction, including when it started, if it is a preexisting condition, how much the severity of the issue increased during the service, and how the issue is currently affecting the veteran. The doctor might also take an x-ray of the foot.
After the hearing, the examining doctors add their findings to the veteran’s disability claim. Once received, the disability board reviews the information to determine whether the veteran is eligible for disability for hallux valgus.
Should the disability board deny the veteran’s disability claim, the veteran can appeal the decision. The veteran has three ways to appeal and can try a second method if the first method does not render favorable results: File a supplemental claim, request a higher-level review, or file a board appeal.
Regardless of which method the veteran chooses, he or she should provide additional medical records showing that the veteran was in active duty caused or aggravated the disability. A second opinion from a VA doctor or an outside doctor helps, but make sure the doctor writes it up as caused by the veteran’s service.
How Does the VA Rate Hallux Valgus (Bunions)?
The VA rates hallux valgus (diagnostic code 5280) as 10 percent disability for:
- Operated with resection of metatarsal head
- Severe, if equivalent to amputation of great toe
- Moderate tarsal or metatarsal bones, malunion of, or nonunion of
The rating criteria is the severity of the condition, including limitation of motion and whether hallux valgus caused additional conditions, including metatarsalgia, rheumatoid arthritis, gout, hallux rigidus, and other foot conditions that affect use of the foot.
Schedule for Rating Disabilities
For a 10 percent rating, a veteran who files a VA claim receives $144.14 as of Dec. 20, 2020. For a 20 percent rating, the veteran receives $284.93. The veteran does not receive increased compensation for family members or special monthly compensation at the 10- and 20-percent ratings for VA disability benefits.
If a veteran is rated at 30 percent and:
- Has a spouse and one dependent parent (no kids): $535.35
- Has a spouse and two dependent parents (no kids): $577.35
- Has one dependent parent (no spouse or kids): $483.35
- Has two dependent parents (no spouse or kids): $525.35
- One dependant child (no spouse or dependent parents): $476.35
- One dependent child and spouse (no dependent parents): $532.35
- One child, spouse, and one dependent parent: $574.35
- One child, spouse, and two dependent parents: $616.35
- One child, no spouse, one dependent parent: $518.35
- One child, two parents, no spouse: $560.35
At the 30 percent rating, for each minor child, add a $26 entitlement. If the child is 18 or over and in a qualifying school program, add $84. For a spouse receiving Aid and Attendance, add $48.
TDIU for Hallux Valgus
The possibility of receiving total disability based on individual unemployability for hallux valgus foot injuries is zero as doctors can repair the problem with surgery or amputate the toe. Because a missing toe does not prevent someone from walking or working, it is not total impairment, nor does the veteran suffer from loss of use of the entire foot. If the impairment becomes too painful, the claimant can seek medical remedies for hallux valgus, claw foot, plantar fasciitis, and other foot problems.
Starting Your Foot Injury VA DisabilityClaim
If a servicemember has hallux valgus or other foot injuries, he or she should see doctors and obtain a diagnosis, even before leaving active duty. Creating a paper trail helps when it is time to file a disability claim. If the servicemember is already out of the service and is now a veteran, he or she should obtain a diagnosis from his regular doctor. Once the servicemember receives a diagnosis and is no longer on active duty, she can file a disability claim. Always be sure to provide as much information about the diagnosis and other medical conditions as possible. The more information and proof you have, the higher the chance that you will receive disability the first time you submit your claim. Veterans should check on their claims frequently, as the veterans claims service does take some time to get through the system, including those for foot deformity, functional loss and other foot issues.