RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00597
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20090424

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an Army Reserve E2, Chemical, Biological, Radiological and Nuclear Specialist, medically separated for “left calcaneal stress fracture” with a disability rating of 20%.

CI CONTENTION:  The CI made no specific contention.  The 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 - 20090402	No VA Rating Decision in evidence	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Calcaneal Stress Fracture	5284	20%		
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Left Calcaneal Stress Fracture.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI presented with a 2-day history of left heel pain on 17 January 2009 in the second week of basic training.  She endorsed a sedentary life-style prior to accession.  Her heels were both tender to palpation.  X-rays were normal and she was placed on quarters for 48 hours.  Her pain persisted and repeat X-rays on 2 February 2009 showed a stress fracture of the left heel (calcaneus).  She was evaluated in podiatry on 20 February 2009 and requested MEB.  She was noted to limp and to have tenderness over the heel.  The NARSUM was done the same day by the podiatrist.  The CI reported that she did not believe that she would be able to complete training.  The examination revealed a normal to high arch and pain with standing.  
The range of motion of the ankle and forefoot was normal.  Tenderness was present over both heels.  She had pain while standing and shifted her weight.  There was not a VA Compensation and Pension (C&P) evaluation in evidence.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the left calcaneal stress fracture condition 20%%, coded 5284 (other foot injuries), at the moderately severe (but recorded as moderate) level of impairment since the CI was walking with crutches.  The Board considered if a severe level of impairment was present to support a higher 30% rating.  The CI was using crutches at the time of the NARSUM; this, however, is normal treatment to place the patient in a partial or non-weight bearing capacity for a time.  She was able to bear weight on the left albeit with pain.  The Board determined that this is more consistent with a moderately severe level of impairment than severe.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the condition.  

BOARD FINDINGS:  In the matter of the left calcaneal stress fracture 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 20150605, with attachments
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 XXXXXXXXXXXXXXXXXXXXX, AR20170000275 (PD201500597)

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