RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX.	CASE:  PD-2015-00914
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20070919

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an Reserve E3, Healthcare Specialist, medically separated for “metatarsalgia, bilateral…” with a disability rating of 10%.

CI CONTENTION:  The CI contends for her feet condition and a condition not identified by either the MEB or PEB (legs), and that the conditions continue to worsen and negatively impact her quality of life.  The complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned 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 or non-compensable.  Any conditions outside the panel’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 panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determination 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(s) at the time of separation.  The panel 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 panel 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 - 20070814	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Metatarsalgia, Bilateral…	5279	10%	No VA Examination in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Bilateral Metatarsalgia (Foot Pain).  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s bilateral metatarsalgia (foot pain) condition began in January 2006 without specific injury, while she was in basic training.  Radiographs in January 2007 showed normal bilateral feet, and bone scan performed in March 2007 suggested the possibility of mild plantar fasciitis.  Despite orthotics and physical therapy treatment of her condition did not result in improvement sufficient to allow unrestricted duty. The MEB forwarded “metatarsalgia.  Bilateral, manifested by chronic forefoot pain and inability to wear military boots” for PEB adjudication.  

The MEB NARSUM examination on 31 May 2007, 4 months prior to separation, noted complaints of pain in both feet at all times, but most severe at the end of the work day.  She had pain with running and walking, and standing aggravate her pain.  Wearing her shoes and military boots was painful.  Physical examination showed normal gait, non-tender arches and plantar fascia, and normal feet.  The CI was able to walk on her heels and toes, and perform single leg forefoot rise.  Toe mobility and strength was normal, and sensations were intact.  Painful motion was not recorded.  The examiner recorded the diagnosis of metatarsalgia, bilateral.  At the MEB examination (recorded on DD Forms 2807 and 2808) dated July 2007, 10 weeks prior to separation, the CI reported pain in that both feet, right greater than left since basic training.  She rated her pain at 3-8/10 and reported increase in pain with standing, running and with wearing military footwear.  Physical examination recorded no tenderness to palpation and decrease arches.  

There was no VA examination in evidence within the 12-month allowable window for adjudication.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral metatarsalgia condition 10%, coded 5279 (metatarsalgia, anterior (Morton’s disease), unilateral, or bilateral).  There was no foot deformity, weight bearing issues, or weakness to support a rating under the respective codes, 5276 (flatfoot), 5278 (claw foot), or 5277 (weak foot), and no abnormalities or injuries of the toes to rate under any of the respective codes (5280, 5281, 5282, 5283, 5284).  Therefore, there was no VASRD §4.71a route to a rating higher than the 10% adjudicated by the PEB under any applicable code.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB adjudication for the bilateral metatarsalgia condition.  

BOARD FINDINGS:  In the matter of the bilateral metatarsalgia condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  There were no other conditions within the panel’s scope of review for consideration.  The panel, 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 20150606, w/atchs
Exhibit B.  Service Treatment Record

AR20170007155, XXXXXXXXXXXXXXXXXX. 

Dear XXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.

Sincerely,