RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXX	CASE:  PD-2013-01914
BRANCH OF SERVICE:  NAVY	BOARD DATE:  20150120
SEPARATION DATE:  20041105

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a Reserve OC/E-5 (Officer Candidate) medically separated for “delayed union left fifth metatarsal fracture.”  The condition could not be adequately rehabilitated to meet the physical requirements of his Rating or satisfy physical fitness standards.  He was placed on limited duty and referred for a Medical Evaluation Board (MEB).  The left foot condition, characterized as “delayed union left 5th metatarsal fracture” was forwarded to the Physical Evaluation Board (PEB) IAW SECNAVINST 1850.4E.  No other conditions were submitted by the MEB.  The informal PEB adjudicated “delayed union left fifth metatarsal fracture” as unfitting, rated 10%.  The CI made no appeals and was medically separated.

CI CONTENTION:  “I was awarded 10% disability from the Navy for a foot injury which was not expected to ever heal.  The VA has given me 0%.  The foot still has issues and I agree with the Navy’s award.  VA should follow suit.”

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e.(2).  It is limited to those conditions determined by the PEB to be unfitting for continued military service and when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting.  Any conditions outside the Board’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the Board for Correction of Military/Naval Records.  Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) / VASRD standards to the unfitting medical condition at the time of separation.  The Board has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions.  That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws.  The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation.

RATING COMPARISON:

Service IPEB – Dated 20040923	VA - based on Service Treatment Records (STR)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Delayed Union Left Fifth Metatarsal Fracture	5283	10%	Delayed Union Left Fifth Metatarsal Fracture	5284	0%	STR	
Other x 0  (Not in Scope)	Other x 0 	
Combined:  10%	Combined:  0%	
Derived from VA Rating Decision (VARD) dated 20060609 (most proximate to date of separation [DOS]).

ANALYSIS SUMMARY:

Delayed Union Left Fifth Metatarsal Fracture.  The CI injured his left foot in July 2003 playing sports while completing his Bachelor’s degree in an active duty status.  X-rays at the time demonstrated a fracture of the 5th metatarsal bone of the left foot (the long bone on the outside aspect of the mid-foot).  The CI reinjured the foot playing sports in January 2004 and X-rays demonstrated the persistence of the fracture.  According to STRs he experienced intermittent foot pain after January 2004.  Following graduation, the CI reported to Officer Candidate School in July 2004 and experienced left foot pain with running and prolonged standing.  X-rays demonstrated evidence of incomplete healing (new bone formation but with a persistent fracture line of 4 millimeters in length) consistent with non-union of the left 5th metatarsal bone.  At the time of the MEB orthopedic narrative summary (NARSUM) examination on 24 August 2004, the left foot was normal in appearance without evidence of deformity.  There was tenderness to palpation of the left 5th metatarsal.  The gait was normal.  There was no VA Compensation and Pension examination proximate to separation.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the delayed union left 5th metatarsal fracture 10%.  The VA rated the condition 0% citing absence of post-separation medical treatment, examinations or evidence of moderate symptoms to support a 10% rating.  The Board noted there was partial non-union of the left fifth metatarsal fracture without deformity (malunion).  The CI was unable to tolerate the vigorous physical training and running required for military training but at the time of the MEB NARSUM examination, the gait was normal indicating mild impairment.  All Board members agreed the evidence did not support a rating higher than the 10% (moderate) adjudicated by the PEB.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the delayed union left 5th metatarsal fracture condition.

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.  The Board did not surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD were exercised.  In the matter of the delayed union left 5th metatarsal fracture condition and IAW VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication.  There were no other conditions within the Board’s scope of review for consideration.

RECOMMENDATION:  The Board, therefore, recommends that there be no re-characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20131003, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

		

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS
Subj:	PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATION 
Ref:	(a) DoDI 6040.44
(b) CORB ltr dtd XX Jun 15

In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their forwarding memorandums, approve the recommendations of the PDBR that the following individual's records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy' s Physical Evaluation Board:

-	XXXXXXXXXXXXXXXXXXXX, former USN
-	XXXXXXXXXXXXXXXXXXXX, former USN
-	XXXXXXXXXXXXXXXXXXXX , former USN
-	XXXXXXXXXXXXXXXXXXXX, former USN