RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-00245
BRANCH OF SERVICE:  NAVY  	 separation DATE:  20040919
SEPARATION DATE:  20040919

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-4 (Engineman) medically separated for a right foot condition by the Informal Physical Evaluation Board (PEB), rated 10%.  

CI CONTENTION:  “I believe my healing chielectomy right foot should have been granted at 20%, not 10%.”  

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  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) 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 PEB 20040519	VARD 20050803  	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Healing Chielectomy Surgery to Right First Ray	5281	10%	Osteoarthritis, First Metatarsal Phalangeal Joint Status Post Chielectomy Due to Hallux Llmitus, Right Foot	5010-5276	20%	20050613	
COMBINED RATING:  10%	COMBINED RATING FOR ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:  

Right Foot.  In September 2002, this CI had cheilectomy surgery on his right foot.  After surgery, he continued to experience significant problems with his right foot.  He was treated with physical therapy (PT), medications, custom orthotics, and two periods of limited duty (LIMDU).  In spite of all treatment efforts, his symptoms persisted and a Medical Evaluation Board (MEB) was initiated.  The MEB physical examination (PE) was on 2 March 2004.  The CI’s gait was normal.  PE of the right foot showed some swelling and tenderness at the base of the big toe.  
In May 2004, an Informal PEB found the CI unfit for Naval duty.  He was medically separated on 19 September 2004.  Nine months later, on 13 June 2005, he had a VA Compensation and Pension (C&P) exam.  He reported pain and stiffness in the right foot.  On PE, his gait and posture were normal.  No cane or other assistive device was required for ambulation.  PE of the right foot showed painful motion and tenderness, but no tenderness to palpation (TTP) of the plantar surface.  Gross examination of the muscles was normal.

The Board directed attention to its rating recommendation based on the evidence.  The Navy PEB used VASRD diagnostic code 5281 (Hallux rigidus, unilateral) and assigned a disability rating of 10%.  The VA coded the right foot condition as 5010-5276 (Traumatic arthritis, with flatfoot), and rated it 20%.  The Board deliberated at length with regard to the most appropriate diagnostic code and rating to use for this case.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board found insufficient cause to recommend a change in the PEB adjudication of the unfitting right foot condition.  

BOARD FINDINGS:  In the matter of the right foot 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.  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 20130923, 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) RECOMMENDATIONS
 
Ref:   (a) DoDI 6040.44
       (b) CORB ltr dtd 16 Feb 16

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

					XXXXXXXXXXXXXXXXXXXX	     				  	Assistant General Counsel
					(Manpower & Reserve Affairs)