RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01788
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20021105

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 right foot pain due to scar on plantar surface over the metatarsal joints,” with a disability rating of 10%.  

CI CONTENTION:  She still has pain in her knees, back, and feet.  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 - 20021001	VARD - 20030613	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Foot Pain…	5279	10%	Residuals, R Foot Abscess, w/…Pain	5284-8520	10%	20030529	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

Chronic Right Foot Pain Due to Scar on Plantar Surface over the Metatarsal Joints.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s chronic right foot pain began in November 2001 after development of a surgical scar from draining an abscess.  At the MEB examination (recorded on DD Forms 2807 and 2808) dated 30 July 2002, 4 months prior to separation, the CI reported a painful scar on his right foot.  Physical exam showed a well healed, slightly hard scar at the plantar 2nd-4th right metatarsal bones (the long bones behind the ball of the foot).  The MEB NARSUM examination on 16 August 2002, 3 months prior to separation, noted complaints of throbbing pain rated 4/10 in severity 18 hours per day with occasional stabbing pain with any weight bearing, but especially with walking, running and road marches.  Physical examination showed a well healed scar on the underside of the foot at the metatarsal joint (the ball of the foot) at the 4th toe with tenderness to slight touch.  There was a normal arch and no other abnormalities.  A diagnosis of chronic right foot pain due to scar was rendered.  

At the 29 May 2003 VA Compensation and Pension (C&P) evaluation, performed 6 months after separation, the CI reported intermittent bouts of sharp burning pain on the right foot scar site.  The pain occurred most days, especially in the evening or after he had been on his feet for some time.  It was alleviated by rest and over the counter pain medications as needed.  The CI worked in construction and occasionally had exacerbation of pain if he stepped on a rock or uneven surface.  He could walk over a mile without worsening the pain.  He occasionally played softball and continued to decline a second surgery.  Physical examination showed a well-healed surgical scar on the bottom of the right foot, near the first and second metatarsal bones.  There was no associated abnormality but there was trace tenderness on the bottom of the foot.  Walking was normal.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the chronic right foot pain condition 10%, coded 5279 (Metatarsalgia, anterior.)  The VA rated the residuals right foot abscess with neurogenic pain due to scarring at 10% coded 5284-8520 (mild incomplete paralysis of the sciatic nerve due to foot injuries), based on the C&P examination 6 months after separation, citing pain, numbness and mild incomplete paralysis below the knee.   There was no evidence of flatfoot (5276), claw foot (5278), malunion (5283), or moderately severe impairment (5284.)  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 right foot pain condition. 

BOARD FINDINGS:  In the matter of the chronic right foot pain condition and IAW VASRD §4.71a, the panel unanimously 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 20150626, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170009075, 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,					      
						      					
Enclosure