RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01388
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050207

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Infantryman, medically separated for “chronic pain, right foot…,” with a disability rating of 10%.

CI CONTENTION:  The CI requested a review of all conditions.  His 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 - 20041220	VARD - 20050307	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Pain, Right Foot	5099-5003	10%	Chronic Right Foot Pain	5284	NSC	20041214	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  N/A	

ANALYSIS SUMMARY:  

Chronic Right Foot Pain.  According to service treatment record and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right foot condition began in June 2004 after jumping off a vehicle.  The MEB forwarded “chronic right foot pain” for PEB adjudication.  The MEB NARSUM examination on 20 October 2004 (4 months prior to separation) noted complaints of right foot pain that was worse with weight bearing.  Physical examination showed tenderness on top of the foot at the midpoint and an otherwise normal evaluation.  At the 14 December 2004 VA Compensation and Pension evaluation (performed 2 months before separation) the CI reported right foot pain, stiffness and swelling that was worse with walking more than 1/4 mile or standing longer than 20 minutes.  Physical examination showed a normal evaluation.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the right foot condition 10%, analogously coded 5099-5003 (degenerative arthritis), citing the US Army Physical Disability Agency pain policy.  The VA did not service connect the right foot condition because there was no specific diagnosis for reported symptoms.  The CI was evaluated with multiple sets of plain film X-rays and a bone scan all of which were interpreted as normal.  The CI was treated with anti-inflammatory medications, physical therapy and rest including 30 days of convalescent leave, which did not improve his complaint of foot pain.  There was no evidence by X-ray findings of degenerative arthritis of the foot; however, Board members agreed that a 10% rating was justified with application of VASRD §4.59 (painful motion and functional loss) analogously coded 5099-5003.  There was no evidence of severe or moderately sever injury of the foot to justify a higher rating under the 5284 (foot injuries, other) code.  

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 chronic right foot pain condition.  

BOARD FINDINGS:  In the matter of the right foot condition 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 20150618, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB						

MEMORANDUM FOR Commander

09 MAR 2017

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
XXXXXXXXXXXXXXXXXX, AR20170002472 (PD201501388)

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