RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00852
BRANCH OF SERVICE:  Navy	SEPARATION DATE:  20060801

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a Reserve O3, Medical Services Corps and Industrial Hygiene Officer, medically separated “pes cavus bilateral feet” with a disability rating of 10%.  

CI CONTENTION:  “Review all conditions.”  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 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 - 20060608	VA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Pes Cavus Bilateral Feet	5278	10%	No VA Disability Claim Filed	
Calcaneal Heel Spurs, Bilateral	Cat II		
Plantar Fasciitis, Bilateral			
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  N/A	

ANALYSIS SUMMARY:  

Bilateral Feet (Pes Cavus, Calcaneal Heel Spurs, Plantar Fasciitis).  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s bilateral pes cavus, calcaneal heel spurs and plantar fasciitis conditions began in 2004 after prolonged standing in boots and constantly going up and down ladders on and off ships.  The MEB forwarded “plantar fascial fibromatosis, calcaneal spur and cavus deformity of foot” for PEB adjudication.  A podiatry examination on 17 October 2005, 10 months prior to separation, noted complaints of worsening chronic bilateral plantar fasciitis, right greater than left, pain.  The Ci stated that the pain increases with activity in the morning and at night.  The physical examination showed tenderness to palpation and tightness to bilateral plantar fasciae, right greater than left. The MEB NARSUM examination on 15 May 2006, 3 months prior to separation, noted complaints of bilateral heel pain, right greater than left, when standing for prolonged periods of time wearing boots on steel decks and constantly going up and down ladders on and off ships.  The physical examination showed pain on palpation of bilateral plantar fascial areas and over the medial, distal and plantar aspects of the heels bilaterally.  There was not any limitation of motion, decreased strength, inversion or eversion of the feet and joints of the feet.  Radiographs of both feet showed a plantar calcaneal heel spur.  There was no VA Compensation and Pension examination for this Board to review.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral pes cavus condition 10%, coded 5278 (claw foot (pes cavus), acquired). The VA did not rate this bilateral foot condition because the CI did not file a VA disability claim. The Board’s initially charge was to decide whether the Category II conditions, plantar fasciitis bilateral feet and calcaneal heel spurs bilateral feet, were appropriately subsumed under the unfitting condition, pes cavus bilateral feet, adjudicated by the PEB.  The primary functional impairment resulted from bilateral foot pain.  It would be speculative to segregate the foot pain attributable to pes cavus from that of plantar fasciitis and calcaneal heel spurs.  The Board agreed that the Category II conditions contributed to the primary unfitting condition and were appropriately subsumed under the unfitting condition.  

The Board then considered the rating of the bilateral pes cavus condition.  There was no evidence of dorsiflexion of all toes, limitation of dorsiflexion at ankle to right angle, shortening of the plantar fascia or marked tenderness under metatarsal heads for a 30% rating.  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 bilateral pes cavus condition.  

BOARD FINDINGS:  In the matter of the bilateral pes cavus, plantar fasciitis, and calcaneal heel spur conditions 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 20150603, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
               BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
 
Ref:   (a) DoDI 6040.44
       (b) CORB ltr dtd 13 Dec 16

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their forwarding memorandums, approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy’s Physical Evaluation Board:

		- XXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXX, former USMC 
		- XXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN 

						  XXXXXXXXXXXXXXXXXX	     				  			  		  Assistant General Counsel
						  (Manpower & Reserve Affairs)