RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01882
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20090601

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E2, Explosive Ordnance Disposal Specialist, medically separated for “bilateral flat feet…” with a disability rating of 10%.

CI CONTENTION:  Review of all conditions requested.  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 - 20090403	VARD -  N/A	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Flat Feet, Bilateral	5299-5276	10%	No VA Exam in Evidence	
New Onset Hyperlipidemia	Not Unfitting		
Exogenous Overweight	Not Compensable		
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  N/A	

ANALYSIS SUMMARY:  

Bilateral Flat Feet.  According to the service treatment record and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI was noted to have asymptomatic, moderate pes planus (flat feet) on the accession physical.  The first record in evidence for the bilateral flat foot condition was a podiatry evaluation dated 5 March 2008, 15 months prior to accession.  It was noted that the CI had a normal gait.  Excessive pronation (rolling the foot inwards) was noted, but the medial longitudinal arch was not decreased.  This was thought to be a congenital condition and the CI was issued custom shoe inserts (orthotics).  X-rays on 20 November 2008 showed bilateral pes planus.  The CI was seen in podiatry the same day and reported bilateral foot pain with standing or activity; it was relieved by rest.  On examination, the gait and stance were normal.  The feet were normal to examination other than excessive pronation bilaterally.  The CI was then seen in orthopedics on 11 December 2008.  Bilateral pes planus refractory to treatment was noted.  

At the 19 December 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, the CI reported severe bilateral foot pain.  On examination, his arches were decreased (flat feet).  Severe bilateral pes planus was also documented.  The 9 February 2009 MEB NARSUM orthopedic addendum, 4 months prior to separation, noted a 1-year history of bilateral foot pain which began in training with the wear of military footwear.  He was able to walk about 1 mile.  He was noted to have pes planus (bilaterally) with a slight pronation when viewed from behind.  Pain with manipulation was not recorded.  In the 5 March 2009 MEB NARSUM, 3 months prior to separation, the author indicated that this NARSUM was obtained solely from a health record review and referred the reader to the 9 February 2009 orthopedic NARSUM detailed above.  It documented stable ankles with full range of motion.  There were no skin changes or callouses over either foot.  Sensation was normal.  There was no VA examination in evidence proximate to separation.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral food condition 10%, coded analogously to 5276 (flatfoot, acquired), citing “moderate pain on use of the feet, bilateral.”  Criteria for a higher rating such as callosities, swelling, and pain on manipulation were not present.  Slight pronation was noted by the orthopedist, but this was not at the level of a marked deformity.  The gait was noted to be normal which is not consistent with a severe level of impairment.  A higher 30% rating is not supported by the evidence.  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 bilateral flat feet condition.  

Contended PEB Conditions:  Hyperlipidemia and Exogenous Overweight.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended conditions were not unfitting.  The panel notes that hyperlipidemia is an abnormal laboratory finding and not a ratable condition.  The panel also notes that IAW DoDI 1332.38, enclosure 5, obesity is a condition not constituting a physical disability.  Therefore neither one of the contended conditions is ratable.  In addition, neither was profiled nor implicated by the commander as impairing duty.  Both were found to meet retention standards.  There was no performance-based evidence from the record that any of the conditions significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded that there was insufficient cause to recommend a change in the PEB fitness determination for any of the contended conditions and so no additional disability ratings are recommended.  

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.  In the matter of the contended hyperlipidemia and overweight conditions, the panel unanimously recommends no change from the PEB determinations as not unfitting and not compensable.  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 20150612, w/atchs
Exhibit B.  Service Treatment Record

AR20170007435, XXXXXXXXXXXXXXXXXX 

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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