RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00872
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20090327

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E2, Basic Trainee, medically separated for “foot injuries, other, due to bilateral calcaneal stress fractures,” rated 10% for each foot, with a combined disability rating of 20%.  

CI CONTENTION:  The CI requests the Board consider 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 - 20090312	VARD - 20090914	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Foot Injuries, other, due to Bilateral Calcaneal Stress Fractures	5284	10%	Calcaneal Stress Fracture, Left Foot	5284	0%	STR	
	5284	10%	Calcaneal Stress Fracture, Right Foot	5284	0%	STR	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Bilateral Calcaneal Stress Fractures.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s bilateral foot injuries began in October 2008.  She initially was thought to have pain in the Achilles tendons.  She subsequently developed bilateral heel bone (calcaneus) pain 1 week later which did not respond to medication.  A bone scan on 30 October 2008 showed bilateral stress fractures.  
She was removed from basic training and placed on convalescent leave without resolution of her pain.  X-rays on 6 January 2009 showed increased sclerosis compared to prior X-rays done on 25 October 2008.  A physical therapy evaluation that day noted that she had a painful gait and tenderness of both heels.  She was entered into the MEB process as she could not complete training and complete resolution could take up to a year.  The MEB NARSUM examination on 16 January 2009, 2 months prior to separation, noted complaints of bilateral heel pain aggravated by activity.  On examination, she limped and favored the right foot.  Tenderness was present over both heels.  The CI did not present for the VA Compensation and Pension (C&P) evaluation scheduled for 29 July 2009.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral foot injury conditions 20% (10% each with the bilateral factor applied), coded 5284 (foot injuries at the moderate level), citing moderate pain.  The VA rated the foot injury conditions 0% coded 5284 (foot injuries), based on STRs.  The Board considered the evidence and found no route to a rating higher than the 10% adjudicated by the PEB for each foot.  It noted that the chronic bilateral heel pain and calcaneal stress fractures were not severable for rating purposes.  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 foot injuries condition.  

BOARD FINDINGS:  In the matter of the foot injury 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 20150604, 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 
XXXXXXXXXXXXXXXXXX, AR20170001047 (PD201500872)

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