[Code of Federal Regulations]
[Title 38, Volume 1]
[Revised as of July 1, 2008]
From the U.S. Government Printing Office via GPO Access
[CITE: 38CFR4.57]

[Page 377]
 
            TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF
 
                CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS
 
PART 4_SCHEDULE FOR RATING DISABILITIES--Table of Contents
 
                      Subpart B_Disability Ratings
 
Sec. 4.57  Static foot deformities.

    It is essential to make an initial distinction between bilateral 
flatfoot as a congenital or as an acquired condition. The congenital 
condition, with depression of the arch, but no evidence of abnormal 
callosities, areas of pressure, strain or demonstrable tenderness, is a 
congenital abnormality which is not compensable or pensionable. In the 
acquired condition, it is to be remembered that depression of the 
longitudinal arch, or the degree of depression, is not the essential 
feature. The attention should be given to anatomical changes, as 
compared to normal, in the relationship of the foot and leg, 
particularly to the inward rotation of the superior portion of the os 
calcis, medial deviation of the insertion of the Achilles tendon, the 
medial tilting of the upper border of the astragalus. This is an 
unfavorable mechanical relationship of the parts. A plumb line dropped 
from the middle of the patella falls inside of the normal point. The 
forepart of the foot is abducted, and the foot everted. The plantar 
surface of the foot is painful and shows demonstrable tenderness, and 
manipulation of the foot produces spasm of the Achilles tendon, peroneal 
spasm due to adhesion about the peroneal sheaths, and other evidence of 
pain and limited motion. The symptoms should be apparent without regard 
to exercise. In severe cases there is gaping of bones on the inner 
border of the foot, and rigid valgus position with loss of the power of 
inversion and adduction. Exercise with undeveloped or unbalanced 
musculature, producing chronic irritation, can be an aggravating factor. 
In the absence of trauma or other definite evidence of aggravation, 
service connection is not in order for pes cavus which is a typically 
congenital or juvenile disease.