RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01259
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060728

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Patriot Operator/Maintainer, medically separated for “left foot metatarsalgia,” with a disability rating of 10%.

CI CONTENTION:  The CI made no specific contention.  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 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 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 - 20060620	VARD 	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Foot Metatarsalgia	5279	10%	No VA Examination in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  N/A	

ANALYSIS SUMMARY:  

Left Foot Metatarsalgia.  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s condition began in January 2004 after some activity, with no history of trauma.  The CI was prescribed anti-inflammatory medication taken as needed and surgery was not indicated.  The MEB forwarded metatarsalgia for PEB adjudication.  

The MEB NARSUM examination on 25 May 2006, 2 months prior to separation, noted complaints of inability to do any vigorous activity outside of walking, and any activity causing him to bear weight on his foot caused discomfort.  Physical examination revealed tenderness to palpation of the first and second metatarsals, normal muscle strength in lower extremities, and normal sensory exam.  Radiographs of the left foot showed no significant bony or joint abnormalities, and no evidence of fracture, dislocation, arthritic or inflammatory change.  Physical therapy range of motion (ROM) measurements for the MEB demonstrated 15 degrees of dorsiflexion (normal 20) and 60 degrees of plantar flexion (normal 45) without pain limiting motion.  

A VA Compensation and Pension (C&P) evaluation was not performed.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the left foot condition 10%, coded 5279 (Metatarsalgia, anterior (Morton’s disease), unilateral, or bilateral), citing tenderness and inability to do rushes, or stand for prolonged periods.  The 5279 code allows a maximum of 10% rating for the condition of metatarsalgia.  The Board considered the 5283 code (tarsal, or metatarsal bones, malunion of, or nonunion of), and the 5284 (foot injuries, other); however, there was no justification for rating the condition under either code since radiographic evidence of bony or joint abnormalities was absent, and documented foot injury was not in evidence.  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 left foot condition. 

BOARD FINDINGS:  In the matter of the left foot metatarsalgia condition and IAW VASRD §4.72, the Board 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 20150614, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB						

MEMORANDUM FOR Commander

08 MAR 2017

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
XXXXXXXXXXXXXXXXXX, AR20170001270 (PD201501259)

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