RECORD OF PROCEEDINGS 
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXX		BRANCH OF SERVICE: NAVY
CASE NUMBER:  PD0900173		BOARD DATE: 20101014
SEPARATION DATE: 20071115
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SUMMARY OF CASE:  This covered individual (CI) was a Navy PO1/E-6 (Air Traffic Controller) medically separated in November 2007 after 18 years of service.  The medical basis for separation was Bilateral Lower Extremity Pain (feet and ankles).  The Navy Physical Evaluation Board (PEB) found him unfit for further military service, due to Bilateral Pes Planus, status post Bilateral Calcaneal Osteotomy.  Three other lower extremity conditions (listed in the table below) were found to be Category II (related to the Unfitting Bilateral Pes Planus Condition).  The CI was separated at 10% disability using the Veterans Affairs Schedule for Rating Disabilities (VASRD) and applicable Navy and DoD regulations.
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CI’s CONTENTION (20090218):  The CI states: “The board did not consider the fact that I was a member with eighteen (18) years, two (2) months, of service. My original paperwork showed fourteen (14) years, two (2) months of service. This was a mistake that I pointed out to my PEBLO (Physical Evaluation Board Liaison Officer) before my package was sent to Washington DC. He assured me that the change was going to be made before the package was sent. This did not happen. I was rated at 10% for the following conditions: Pes planus bilateral, Bilateral calcaneal osteotomy, Plantar fasciitis, Posterior tibialis tendon tenderness stage 1, Bilateral bunion deformity, Bilateral bunionectomy. Please review my Military medical record and my record from the Veterans Administration.”
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RATING COMPARISON:

Service PEB	VA (7 weeks after Separation)	
Unfitting Conditions	Code	Rating	Date	Condition	Code	Rating	Exam	Effective	
Pes Planus, bilateral 
   - Plantar Fasciitis (Cat. II)
   - Tendon Tenderness (Cat. II)
   - Bilateral Bunions (Cat. II)	5276	10%	20070907	Bilateral Pes Planus, with Plantar Fasciitis and Hallux Valgus 
(s/p multiple surgeries)	5299-5276	10%	20080104	20071116	
Low Back Pain (Cat. III)	Not Unfitting/Not Rated	Lumbar Strain 	5242	10%	20080104	20071116	
Obesity (Cat. IV)							
Hyperlipidemia (Cat. IV)							
		NOT IN DES	Tinnitus	6260	10%	20071227	20071116	
		NOT IN DES	Molectomy, Left Scalp	7800	0%	20080104	20071116	
		NOT IN DES	Condyloma accuminata	7819	0%	20080104	20071116	
TOTAL Combined:  10%	TOTAL Combined (Includes Non-DES Conditions):  30%    	
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ANALYSIS SUMMARY:

The CI’s contention concerning years of service was discussed by the Board.  The Board recognizes the CI’s length of service, but it is not relevant to the Board’s adjudication of CI’s medical conditions.  If the CI feels that administrative personnel errors may have been made with regard to his length of military service, he should address his concern to the Board for Correction of Naval Records (BCNR).

Bilateral Lower Extremity Condition – The CI received a waiver for asymptomatic, severe Pes Planus (flatfeet) when he joined the Navy in 1989.  The CI began to experience pain in his feet shortly after enlisting, and it has progressively been getting worse over time. The CI had bilateral bunionectomies (1999-2000) with minimal improvement of his foot symptoms.  He underwent a Medical Evaluation Board (MEB) for foot pain in July 2000. The MEB and Physical Evaluation Board (PEB) found him fit for duty, but recommended no shipboard work. The CI’s bilateral lower extremity symptoms continued to worsen.  In 2006 he underwent corrective surgery (bilateral calcaneal osteotomy) for his flatfeet.  The CI was seen, evaluated, and treated by numerous doctors without significant improvement.  His symptoms negatively impacted his ability to perform his military duties as an Air Traffic Controller.  In June 2007 he once again underwent MEB/PEB action.  The CI stated that his feet and ankles would become painful after standing more than five minutes, or walking a long distance.  He reported not being able to run, due to pain and swelling.  His 2007 MEB physical exam revealed tenderness of the feet, decreased arches, and decreased dorsiflexion at the first metatarso-phalangeal (MTP) joints.  Both heels everted with standing, and he was unable to stand on his toes.  X-rays of his feet showed post-surgical changes and mild pes planus, but no other significant abnormalities.  On 4 January 2008 (shortly after separation from service), the CI underwent a VA compensation and pension (C&P) exam.  That examination revealed normal gait and good alignment of the feet, with no painful motion, edema, disturbed circulation, weakness or atrophy of the musculature.  It was also noted that there was no significant deformity of either foot, such as inward rotation of the os calcis, medial tilting of the talus, marked pronation, or whole foot eversion.  The Board carefully examined all of the evidentiary information available.  Following thoughtful deliberation, the Board unanimously recommends a disability rating of 10% for the painful bilateral lower extremity condition.

Recurrent Low Back Pain – The Board then turned its attention to the issue of Low Back Pain.  The CI stated that he has had recurrent back pain since 1990, after he injured his back moving heavy boxes during Operation Desert Shield.  He reported that the low back pain occurs after standing a long time, and he feels it is due to his bilateral pes planus (flatfeet).  In 2001 he underwent an MEB for his chronic back pain.  The MEB found him fit for full duty, after completing an 8 month exercise program.  No back symptoms were reported at the time of the 2007 MEB evaluation, and the spine exam was normal.  The Board unanimously agrees that the Low Back Pain condition was not unfitting at the time of separation from service, and is not relevant for disability rating.

History of Other Conditions (documented in Disability Evaluation System (DES) package) – Obesity, Hyperlipidemia, and Hypertension were all discussed and considered by the Board.  There is no clearly documented evidence that any of these conditions caused a significant adverse effect on the performance of required military duties.  These other conditions are all judged by the Board to be not unfitting at the time of separation from service, and are not relevant for disability rating.  The Board therefore has no reasonable basis for recommending any additional unfitting conditions for separation rating.
  
History of Other Conditions (not documented in DES package) – Tinnitus, Scalp molectomy, and Condyloma accuminata (genital warts) were also considered by the Board.  There is no clearly documented evidence that these conditions were a matter of record in the DES package.  Therefore, these conditions are judged to be outside the scope of this Board. 
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BOARD FINDINGS:  IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication.  

In the matter of the painful bilateral lower extremity condition (Pes planus, Calcaneal osteotomy, Plantar fasciitis, Posterior tibialis tendon tenderness, Bunion deformity, and Bunionectomy), the Board unanimously recommends a rating of 10% (coded 5276), IAW VASRD §4.71a-29.       

In the matter of the Low back pain, Obesity, Hyperlipidemia, Hypertension, or any other medical conditions eligible for Board consideration; the Board unanimously agrees that it cannot recommend any findings of unfit for additional rating at separation.

Tinnitus, Scalp molectomy, and Condyloma accuminata, rated by the VA, were not in the Disability Evaluation System (DES) package and are therefore outside the scope of the Board. The CI retains the right to request his service Board for Correction of Naval Records (BCNR) to consider adding these conditions as unfitting.
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RECOMMENDATION:  The Board therefore recommends that there be no re-characterization of the CI’s disability and separation determination.

UNFITTING CONDITION	VASRD CODE	RATING	
Bilateral Pes Planus, status post surgical intervention, with residuals (moderate)	5276	10%	
COMBINED	10%	
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The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20090218, w/atchs.
Exhibit B.  Service Treatment Record.
Exhibit C.  Department of Veterans' Affairs Treatment Record.

 DEPARTMENT OF THE N VY 
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS
 720 KENNON STREET SE STE 309
 WASHINGTON NAVY YARD DC 20374-5023 
IN REPLY REFER TO 
1850 CORB:003 19 Nov 2010 
From:	 Director, Secretary of the Navy Co ncil of Review Boards 
To:	 
Subj :	 PHYSICAL DJ:SABI~:;I:';I:'X; :f30.AR.!) Of ~EV~i i":' C;I?DJ3R) 
Ref:	 (a) DoDI 6040.44 
(b) PDBR ltr of 28 Oct 10 
1.	Pursuant to reference (a), the PDBR r viewed your case and forwarded its recommendation (reference )) to the Department of the Navy for appropriate action. 
2.	On 18 November 2010, the Assistant Se retary of the Navy (Manpower & Reserve Affairs) took action n your case by accepting the recommendation of the PDBR that no ch nge be made to the characterization of separation or disabil ty rating assigned by the Department of" the Navy' s Physical Eva 1.lation Board. 
3.	The Secretary's decision represents f nal action in your case by the Department of the Navy and is not ubject to appeal or further review by the Board for Correctio 

Copy to: PDBR