RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-02854
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20080618

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E6, Chemical Operations Specialist, medically separated for “bilateral plantar fasciitis…” rated 20%.  

CI CONTENTION:  The CI requests that all conditions be considered.  Her 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 based upon a 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 - 20080418	VARD - 20080829	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Plantar Fasciitis… with Bilateral Pes Planus 	5399-5310	20%	Bilateral Plantar Fasciitis…	5299-5276	NSC	DNR	
			Bilateral Pes Planus	5276	NSC		
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Bilateral Plantar Fasciitis with subsumed Pes Planus.  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI was diagnosed with bilateral flat feet and symptomatic plantar fasciitis in 2007.  Record documentation indicated that the CI underwent surgical intervention of both feet in April and August 2007, respectively.  Further treatment to include orthotics did not result in improvement sufficient to allow unrestricted duty.  The MEB forwarded “bilateral pes planus, bilateral plantar fasciitis status post right subtalar arthrodesis and status post left tarsi arthrodesis, otherwise the x-rays were normal” for PEB adjudication.
The MEB NARSUM examination on 2 September 2008, 5 months prior to separation, noted complaints of a constant dull, achy, throbbing pain to the insteps and heels of both feet which was aggravated with prolonged standing.  The CI further endorsed the inability to run, jump, march, or wear body armor, secondary to pain.  Her physical examination revealed “moderate” bilateral flat feet with tenderness about both heels and insteps.  

The foot-focused VA Compensation and Pension (C&P) examination was conducted nearly 2 years after separation and therefore, its findings were not probative in deciding a final rating impairment.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB separately rated each foot at 10% under the analogous (Group X) muscle code of 5310, citing repetitive micro-trauma of training.  The VA considered all conditions as “Not Service Connected (NSC)” due to “failure to report” for a scheduled appointment near the time of separation.  The Board members first agreed that the PEB’s decision to separately code the foot conditions analogous to 5310 was not inconsistent with VASRD standards; however, all members further agreed that a more appropriate diagnostic identification of the CI’s bilateral foot condition was that of periostitis and therefore, recommends a bundled re-coding of 5099-5022 at an unchanged rating of 20%.  Therefore, the Board concluded that there was insufficient cause to recommend a change in the PEB’s level of impairment rating.  

BOARD FINDINGS:  In the matter of the bilateral foot condition and IAW VASRD §4.71a, the Board unanimously recommends no change in the PEB's rating impairment 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 20140610, 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 
AR20160016975 (PD201402854)

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