RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01264
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20070427

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Tank Systems Mechanic, medically separated for “reflex sympathetic dystrophy [RSD], right foot …” with a disability rating of 10%.

CI CONTENTION:  “Review all conditions.”  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 – 20070314	VARD – NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
RSD, R. Foot S/P Bunionectomy	5280-8799-8720	10%	No VA Exam in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Right Foot RSD ….  According to the service treatment record and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right foot condition began in May 2006.  The CI had a right foot proximal crescentic osteotomy on 14 August 2006.  A follow-up radiograph performed on 2 October 2006 showed “some interval callus formation of proximal first metatarsal osteotomy” and the Kirschner wire was removed.  

The CI was noted to have complained of “occasional pain in the foot with prolonged footwear” at an orthopedic examination on 25 October 2006.  The CI was no longer wearing a CAM walker.
At an orthopedic appointment in January 2007, the CI complained of continued pain with stiffness at the metatarsal phalangeal joint, especially with prolonged activity.  He also stated that there was dysesthesia (an unpleasant abnormal sensation) in the dorsum of the foot surrounding the incisions.  The CI admitted that the stiffness had improved with therapy.  

The 9 February 2007 MEB NARSUM examination, 2 months prior to separation, noted improved foot stiffness, but persistent foot pain.  Physical examination showed mottled skin (a pattern of irregular marks, spots, streaks, blotches or patches of different shades or colors) consistent with his history of reflex sympathetic dystrophy, pain at extremes of range of motion. 
 
There was no VA Compensation and Pension examination in evidence proximate to separation.    

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right foot condition 10%, coded 5280, 8799-8720 codes (hallux valgus unilateral, operated with resection of metatarsal head, neuralgia), citing mild incomplete paralysis.  The highest rating under 5280 is 10% as adjudicated by the PEB.  There was no evidence of foot drop for a 20% rating analogous to 8720.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the right foot condition.  

BOARD FINDINGS:  In the matter of the right foot condition and IAW VASRD §4.124a, 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 20150615, w/atchs
Exhibit B.  Service Treatment Record

AR20170008432, XXXXXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXXXX:

	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,					      
						      					
Enclosure