RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-02387
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20070124

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-3 (Trainee) medically separated for plantar fasciitis of the left foot.  The condition could not be adequately rehabilitated to meet the physical requirements of the Military Occupational Specialty (MOS) he was in training for.  He was issued a permanent L3 profile and referred for a Medical Evaluation Board (MEB).  The condition characterized as “plantar fasciitis, left foot” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  No other condition was submitted by the MEB.  The Informal PEB adjudicated “plantar fasciitis, left foot” as unfitting, rated 0%.  The CI made no appeals and was medically separated.  

CI CONTENTION:  The CI requested that the Board review all of his conditions.  The complete submission is at Exhibit A.

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) 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:  

IPEB - Dated 20070108	VA* - Based on Service Treatment Records (STR)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Plantar Fasciitis, Left Foot	5399-5310	0%	Left Foot Plantar Fasciitis	5099-5020	0%	STR	
Other MEB/PEB Conditions x 0 (Not In Scope)	Other x 5 	
RATING:  0%	RATING:  0%	
*Derived from VA Rating Decision (VARD) dated 20071002 (most proximate to date of separation [DOS]).  

ANALYSIS SUMMARY:  

Plantar Fasciitis, Left Foot Condition.  Treatment records evidence reports of the onset of left foot pain with exercise in April 2006.  On 21 June 2006 the CI presented to the emergency department with reports of left ankle pain.  An orthopedic evaluation dated 26 June 2006 documented examination findings of tenderness to palpation on the inside and front of the ankle.  A provisional diagnosis of left ankle fracture was rendered and the CI was placed in a short leg cast.  At the orthopedic evaluation performed 27 July 2006 the examiner noted X-ray results consistent with an old injury at the attachment of the deltoid ligament to the inner ankle.  The CI underwent a course of physical therapy with reports of left foot cramps. An orthopedic treatment note dated 16 November 2006 noted reports of continued left foot muscle cramps.  The cramps were worse in the morning and improved during the day.  The examiner noted magnetic resonance imaging results of chronic edema at the plantar aponeurosis (inflammation of the tissue at the bottom of the foot) of the calcaneal insertion.  A diagnosis of planter fasciitis was rendered and the examiner opined that there was no requirement for surgical intervention.  The narrative summary (NARSUM) physical findings were pain with motion of the foot and toe walking and tenderness to palpation at the inner arch and Achilles insertion.  Physical therapy ankle range of motion performed 1 month prior to separation noted dorsiflexion to 15 degrees (normal 20 degrees), 70-80 degrees of plantar flexion (normal 45 degrees, and painful motion.  There was no record a VA Compensation and Pension (C&P) examination within the available evidence.  

The Board directed attention to its rating recommendation based on the above evidence.  Both the PEB and VA rated the ankle condition at 0%.  The PEB coded the ankle condition 5399-5310 (Muscle Injury Group X) with cited application of the Table of Analogous and rated as slight.  The VA coded the condition 5099-5020 (analogous to Synovitis).  The Board considered whether the evidence supported a higher than 0% rating.  Multiple treatment notes and the NARSUM examination documented subjective reports of pain with use and objective findings of painful motion, tenderness to palpation, and pain with toe walking.  Board member agreed that the evidence met criteria for a 10% rating IAW VASRD§ 4.40 (Functional Loss) and §4.59 (Painful motion).  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 10% for the left foot plantar fasciitis 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 left foot plantar fasciitis condition, the Board unanimously recommends a disability rating of 10%, coded 5399-5010 IAW VASRD §4.71a, § 4.40, and §4.59.  There were no other conditions within the Board’s scope of review for consideration.  

RECOMMENDATION:  The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of his prior medical separation:  

CONDITION	VASRD CODE	RATING	
Left Foot Plantar Fasciitis 	5399-5310	10%	
RATING	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140516, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB

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 XXXXXXXXXXXXXXXXXX, AR20160004391 (PD201402387)

1. 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, accept the Board's recommendation to modify the individual's disability rating to 10% without re-characterization of the individual's separation. This decision is final.

2. I direct that all the Department of the Army records of the individual concerned be corrected accordingly no later than 120 days from the date of this memorandum.

3. I request that a copy of the corrections and any related correspondence be provided to the individual concerned, counsel (if any), any Members of Congress who have shown interest, and to the Army Review Boards Agency with a copy of this memorandum without enclosures.

BY ORDER OF THE SECRETARY OF THE ARMY:

CF:
( ) DoD PDBR
( ) DVA