RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-01497
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20090601

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Laundry and Bath Specialist, medically separated for “bilateral foot pain,” with a disability rating of 20%.

CI CONTENTION:  The CI contends for his unfitting foot condition. The CI’s complete submission is at Exhibit A.    

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  It is limited to those conditions determined by the Physical Evaluation Board (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 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 - 20090219	VARD -  20100923	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Foot Pain	5284	20%	Left Foot Condition with Pain, S/P Stress Fracture	5284	0%	20100209	
			Residuals, Stress Fracture Right Foot	5284	0%	20100209	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:  

Bilateral Foot Pain.  According to service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s bilateral foot condition developed in 2006 while at basic training.  Although absent the radiologic source document, historical clinical encounter notes indicated stress fractures in the second metatarsal of both feet in April 2006.  Further diagnostic imaging performed in October 2007 did not reveal any stress fractures, edema to either foot, or impaired ligaments/tendons.  Despite temporary immobilization and podiatric orthotics, his painful symptoms could not be adequately rehabilitated to meet the physical requirements of the CI’s military specialty and the CI was referred for MEB.  At the MEB examination (21 January 2009), 4 months prior to separation, the CI reported that he could not stand for long periods of time, or run and march without significant pain.  His physical examination (PE) revealed the presence of bilateral flat feet and gait was normal.  At the VA Compensation and Pension (C&P) examination (9 February 2010), 8 months after separation, the CI reported constant 7 of 10 aching bilateral foot pain aggravated by physical activity; however, he additionally reported that he does not experience any overall functional impairment from either foot condition.  His foot-focused PE was detailed and normal.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB assigned a combined 20% rating (10% for each foot) under the 5284 code (foot injuries, other), citing painful walking and standing.  The VA also used the 5284 code, but assigned a 0% rating based on the VA C&P examination 8 months after separation, citing no functional limitation of standing and walking, and no pathology to render a diagnosis.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was no route to a higher rating than the PEBs current combined 20% and therefore, does not recommend a change in the PEB’s adjudication for the bilateral foot condition.  

BOARD FINDINGS:  In the matter of the bilateral 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 20140327, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB						

13 SEP 2016

MEMORANDUM FOR Commander, US Army Physical Disability Agency 
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for XXXXXXXXXXXXXXXXXXXX, AR20160010973 (PD201401497)

I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD PDBR) recommendation and record of proceedings pertaining to the subject individual.  Under the authority of Title 10, United States Code, section 1554a, I accept the Board’s recommendation and hereby deny the individual’s application.  
This decision is final.  The individual concerned, counsel (if any), and any Members of Congress who have shown interest in this application have been notified of this decision by mail.

 BY ORDER OF THE SECRETARY OF THE ARMY:
 						         
Enclosure

CF: 
(  ) DoD PDBR
(  ) DVA