RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01124
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20080930

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a National Guard E1, Basic Trainee, medically for “bilateral foot injuries due to calcaneal stress fractures” with a disability rating of 20%.

CI CONTENTION:  “I still have many issues with my feet/weak, it’s hard to stand all day at work.”  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 - 20080819	VARD - 20081229	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Foot Injuries due to Calcaneal Stress Fractures	5284	20%	Bilateral Calcaneal Stress Fractures	5299-5279	NSC	STR	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Bilateral Calcaneal (Heel) Stress Fractures.  According to service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s bilateral foot condition began in March 2008 after marching and running during basic training.  X-rays were reported to reveal stress fractures of both heels.  Despite home-based physical therapy and reduced activities, her treatment did not result in improvement sufficient to allow unrestricted duty.  The MEB forwarded “bilateral calcaneal stress fractures” for PEB adjudication. 
 
At the 4 August 2008 MEB NARSUM examination, a month prior to separation, the CI endorsed intermittent daily pain in both feet made worse by prolonged standing, walking, or with any impact activities such as running.  Her physical examination revealed normal ankle range of motion and a normal gait.  Tenderness was present when pressure was applied to either heel.  

There was no VA Compensation and Pension examination within the case file for the CI “failed to report” for a scheduled examination proximate to separation.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral foot condition at 10% each foot for a combined rating of 20% coded as 5284 (foot injuries, other), citing risk of further injury with continuation of rigors of military activities.  The VA rated the same condition as “not service connected” and analogously coded as 5299-5279 (metatarsalgia, anterior) based on the STR.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was no route to a higher rating than the PEB’s current combined 20% and therefore, does not recommend a change in the PEB’s adjudication for the bilateral foot condition.  

BOARD FINDINGS:  In the matter of the bilateral foot condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  The panel, therefore, recommends that there be no modification or re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150609, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170010609, XXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXX
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,