A plantar fasciitis nexus letter for your VA claim, from your foot and service records

What the clinician looks for in your foot records

Heel pain is common; a plantar fasciitis claim needs it documented as a diagnosis with a history. For the $500 fee, the clinician reviews your records for the diagnosis, the treatment record, and the in-service demands on your feet.

• A diagnosis of plantar fasciitis, in one foot or both, with exam findings such as tenderness where the fascia meets the heel and pain with the first steps in the morning.
• Imaging when it was done, such as an X-ray showing a heel spur, or an ultrasound or MRI showing a thickened fascia.
• The treatments tried and how they worked: stretching, physical therapy, orthotics or inserts, night splints, injections, or surgery. VA's rating criteria for plantar fasciitis look at whether treatment has relieved it.
• In-service foot complaints: sick call visits for heel or arch pain, profiles that limited running or marching, and podiatry referrals.
• Duties that pounded the feet, such as long runs and ruck marches in boots, or long shifts standing on flight lines, decks or concrete floors.
• Other service-connected foot, ankle, knee or back conditions, and any record of flat feet.

Common service-connection routes for plantar fasciitis

Direct service connection under 38 CFR 3.303 is the most common route: heel pain treated in service, during training or heavy duty, and a diagnosis now that a clinician can trace back to it.

Secondary service connection under 38 CFR 3.310 may fit in two physical patterns a clinician may consider: plantar fasciitis following service-connected flat feet, which change how the arch carries load, and plantar fasciitis following a service-connected knee, ankle or back condition that altered your gait for a long period. Both need records that show the first condition and the change in how you walk.

If your heel pain started well after service and nothing in the records points back, the screen says so before you spend anything.

Is there a DBQ for plantar fasciitis?

Yes. VA's public Foot Conditions Including Flatfoot (Pes Planus) DBQ includes plantar fasciitis. Commander Health completes it for a flat $200, or with the nexus letter for $550. The licensed clinician completes and signs it only when your records show which feet are affected, the treatments tried, and whether they helped.

The same form covers flat feet and other foot conditions, so if your records show more than one, upload them all. VA may still order its own exam, and VA decides the rating.

What it is not

• Physical conditions only: Commander Health does not write PTSD or other mental health opinions, or secondary opinions that run through a mental health condition.
• Not an exam or an appointment. There are no calls or video visits; the clinician works from your records, and any follow-up comes by email.
• Not a filing service. Commander Health does not file claims and is not a VSO, a law firm, or a VA-accredited representative. Free help filing a claim is available from a VA-accredited Veterans Service Organization.
• Not a guarantee. Clinical review never guarantees an outcome. A clinician signs only if your records support the opinion, and VA decides the claim.

Frequently asked questions

My heel pain started in basic training. Does that help?

Yes, if it was recorded. Sick call notes, profiles and podiatry visits from training are the in-service evidence a clinician looks for, and later records showing it kept up connect them to today.

Is plantar fasciitis the same claim as flat feet?

They are different diagnoses, and records often show both. If VA already connected flat feet, a clinician may consider plantar fasciitis secondary to them under 38 CFR 3.310.

Do records of orthotics and injections matter?

Yes. They show a treated, ongoing condition, and VA's rating criteria for plantar fasciitis look at whether treatment has relieved it.