RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03209
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20081227

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Welder, medically separated for “bilateral plantar fasciitis,” rated 10% and 10%, respectively, with a combined disability rating of 20%.  

CI CONTENTION:  The CI’S condition was rated higher by the VA and the overall rating by the VA was higher.  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 based on 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 – 20080919	VARD - 20090327   	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Plantar Fasciitis	5399-5310	20%	Chronic Right Foot Strain due to Plantar Fasciitis and Pes Planus	5276-5284	0%	20081010	
			Chronic Left Foot Strain due to Plantar Fasciitis and Pes Planus	5276-5284	0%		
GERD	Not Unfitting 	GERD	7399-7346	0%		
Neck Pain		Cervical Spine Strain	5237	10%		
Back Pain		Lumbosacral Spine Strain	5237	10%		
Allergic Rhinitis		Allergic Rhinitis	6522	0%		
Adjustment Disorder		Adjustment Disorder	9440	NSC		
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  50%	

ANALYSIS SUMMARY:  

Bilateral Plantar Fasciitis Condition.  The first record in evidence for the plantar fasciitis condition is a podiatry examination on 29 June 2005.  Orthotics were dispensed, but pes planus (flat feet) was not noted.  He was subsequently noted to have a stress fracture of both heels on a re-evaluation 6 weeks later.  He was issued a permanent L2 profile, on 24 February 2006, which restricted running.  The record is then silent, other than a visit in March 2007, until April 2008 when he reported ongoing pain which impaired duty.  He was issued a permanent L3 profile and entered into the MEB process.  X-rays showed a normal left foot and borderline pes planus on the right.  At the MEB examination on 21 May 2008, the CI reported a 3 year history of bilateral foot pain aggravated by prolonged walking or standing.  The examiner noted bilateral, asymptomatic pes planus on examination.  The gait was normal.  The narrative summary (NARSUM) was dated 4 August 2008.  The CI reported the use of custom orthotics.  His bilateral foot pain was aggravated by activity and impaired duty and the plantar fascia were painful at the insertion into the heel bone.  The gait was normal, but the plantar fascia were tender at the insertion into the heel bones.  Bilateral weight bearing X-rays were noted to be normal (the report cited above noted borderline right pes planus).  The commander noted on the 17 September 2008 assessment that the CI was performing his duties well and did not impair mission accomplishment.  At the VA Compensation and Pension (C&P) examination, performed on 10 November 2008, 2 months before separation, the CI reported ongoing pain and the use of orthotics.  Tenderness was present over the plantar fascia.  On examination, the gait and posture were normal; the plantar fascia were tender to touch.  

The Board directed its attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral plantar fasciitis condition at 20% (10% each with the bilateral factor applied), coded 5399-5310 (moderate Group X muscle dysfunction which includes the plantar fascia).  The VA rated the feet at 0% each, coded 5276-5284 (flatfoot-other foot injuries).  While the CI had plantar fascia tenderness, he was noted to have a normal gait on multiple examinations.  The Board found no route to a rating higher than the 10% rating adjudicated by the PEB for each foot.  After due deliberation in consideration of the preponderance of the evidence, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the bilateral plantar fasciitis condition.  

Contended PEB Conditions:  Gastroesophageal Reflux Disease (GERD), Back Pain, Neck Pain, Allergic Rhinitis, and Adjustment Disorder.  The Board’s main charge is to assess the fairness of the PEB’s determination that the contended conditions were not unfitting.  The Board’s threshold for countering fitness determinations requires a preponderance of evidence, but remains adherent to the DoDI 6040.44 “fair and equitable” standard.  None of the conditions was profiled or implicated in the commander’s statement.  In fact, the commander noted that the CI did his normal duties well and without mission impact.  None were judged to fail retention standards.  All were reviewed and considered by the Board.  There was no performance based evidence from the record that any of these conditions significantly interfered with satisfactory duty performance.  After due deliberation in consideration of the preponderance of the evidence, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the any of the contended conditions and so no additional disability ratings are recommended.  

BOARD FINDINGS:  In the matter of the bilateral plantar fasciitis condition and IAW VASRD §4.71a and §4.73, the Board unanimously recommends no change in the PEB adjudication.  In the matter of the contended GERD, back pain, neck pain, allergic rhinitis, and adjustment disorder conditions, the Board unanimously recommends no change from the PEB determinations as not unfitting.  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 20141010, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

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 XXXXXXXXXXXXXXXXXXXXX AR20160011315 (PD201403209)

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