Plantar Fasciopathy
Running, marching, prolonged standing, and load carriage driving plantar fasciitis in the military population.
38 CFR diagnostic code 5269
Peer-reviewed evidence (4)
The verified studies behind a Plantar Fasciopathy claim — each links to its real PubMed or DOI record. These are sources our nexus drafts can draw from; none are invented.
- Scher DL, Belmont PJ Jr, Bear R, Mountcastle SB, Orr JD, Owens BD. The incidence of plantar fasciitis in the United States military. J Bone Joint Surg Am. 2009;91(12):2867-72. PMID:19952249. doi:10.2106/JBJS.I.00257.
- Xu J, Saliba S, Fraser J. Burden and risk factors for plantar fasciopathy in the military population from 2006 to 2015: a retrospective cohort study. BMJ Mil Health. 2026;172(3):236-241. PMID:39904534. doi:10.1136/military-2024-002869.
- Roy TC. Diagnoses and mechanisms of musculoskeletal injuries in an infantry brigade combat team deployed to Afghanistan evaluated by the brigade physical therapist. Mil Med. 2011;176(8):903-8. PMID:21882780. doi:10.7205/milmed-d-11-00006.
- Purcell RL, Schroeder IG, Keeling LE, Formby PM, Eckel TT, Shawen SB. Clinical Outcomes After Extracorporeal Shock Wave Therapy for Chronic Plantar Fasciitis in a Predominantly Active Duty Population. J Foot Ankle Surg. 2018;57(4):654-657. PMID:29622498. doi:10.1053/j.jfas.2017.11.030.
Controlling law
The CFR sections and cases the theories relevant to this condition rest on — the legal standard raters evaluate against, never a prediction about any claim.
Direct (§ 3.303)
Regulation
38 C.F.R. § 3.303
Direct service connection — a current disability linked to service. (Continuity of symptomatology under § 3.303(b) is limited by case law to the § 3.309(a) chronic diseases — Walker.)
Case law
Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004)
The three-element test: current disability, in-service event, and a nexus between them.
Holton v. Shinseki, 557 F.3d 1363 (Fed. Cir. 2009)
Federal Circuit restatement of the same three direct-service-connection elements.
Caluza v. Brown, 7 Vet. App. 498 (1995)
The evidentiary framework a rater weighs each element against.
Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013)
Continuity of symptomatology (§ 3.303(b)) is available ONLY for a chronic disease listed in § 3.309(a); any other condition must use the medical-nexus pathway.
Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009)
A categorical 'a medical opinion is always required for nexus' is legal error — competent lay evidence can suffice.
Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Layno v. Brown, 6 Vet. App. 465 (1994)
A veteran is competent to report symptoms they personally observe (Layno), and lay evidence can even establish a simple diagnosis in the right case (Jandreau).
McLendon v. Nicholson, 20 Vet. App. 79 (2006)
A LOW threshold — evidence that merely indicates a nexus MAY exist obligates VA to provide a C&P exam.
38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990)
When the evidence is in relative equipoise, the tie goes to the veteran — the preponderance must be AGAINST the claim to deny it.
Aggravation (§ 3.306)
Regulation
38 C.F.R. § 3.306 (38 U.S.C. § 1153)
DIRECT aggravation: a pre-existing condition NOTED AT ENTRY that increased in disability during service — unless the increase is due to the natural progress of the disease. An in-service increase raises a PRESUMPTION of aggravation VA must rebut.
38 C.F.R. § 3.310(b)
SECONDARY aggravation (a distinct branch): a non-service-connected condition worsened by an already service-connected condition — see Allen.
Case law
Wagner v. Principi, 370 F.3d 1089 (Fed. Cir. 2004)
If the condition was NOT noted at entry, the veteran is presumed sound; VA must rebut BOTH pre-existence and lack of aggravation by clear and unmistakable EVIDENCE (not the CUE error doctrine). If VA fails, the claim proceeds as ordinary DIRECT service connection — not as an aggravation claim.
Horn v. Shinseki, 25 Vet. App. 231 (2012)
That rebuttal burden never shifts back to the veteran — VA must rely on affirmative evidence of no aggravation.
Hunt v. Derwinski, 1 Vet. App. 292 (1991); Davis v. Principi, 276 F.3d 1341 (Fed. Cir. 2002)
Temporary flare-ups are not aggravation — the UNDERLYING condition (not just symptoms) must have worsened.
Allen v. Brown, 7 Vet. App. 439 (1995)
Compensation is for the measurable degree of worsening over the established baseline.
38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990)
When the evidence is in relative equipoise, the tie goes to the veteran — the preponderance must be AGAINST the claim to deny it.
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