RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01974
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20080130

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Basic Trainee, medically separated for “chronic right foot pain,” with a disability rating of 10%.

CI CONTENTION:  The CI made contention for his right foot pain.  The CI’s 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 panel 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 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 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 - 20090223	VARD - 20080610	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Foot Pain	5284	10%	Right Foot Navicular Fracture	5299-5284	0%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Chronic Right Foot Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right foot pain condition began in the first week of Basic Training September 2007 when he jumped down from a balance beam while doing an obstacle course.  On 21 September 2007 the CI underwent a surgical repair of the fracture with external fixation.  Following surgery further treatment did not result in improvement sufficient to allow unrestricted duty.  The MEB forwarded “right foot navicular fracture” for PEB adjudication.  The MEB NARSUM examination on 21 November 2007, 2 months prior to separation, noted complaints of continued 3/10 pain with walking.  The examiner noted that the CI was still using a removable cast to walk.  Physical examination of the right foot revealed a well healed incisional scar on the dorsum of the right foot.  No signs of infection.  The CI did exhibit some pain and stiffness with both dorsiflexion and plantar flexion.  There was normal power of inversion and eversion at the ankle.  There was no significant swelling about the foot or the ankle.  The service member did however continue to walk with a slight limp with minor pain with weight bearing.  At a physical therapy examination dated 3 December 2007, 2 months prior to separation, the CI reported no specific complaints.  Physical exam showed the following feet ranges of motion findings.  Right foot; Dorsiflexion: 1 degree (20 normal); Plantarflexion: 40 degrees (45 normal).  Left foot; Dorsiflexion: 1 degree (20 normal); Plantarflexion: 50 degrees (45 normal).  There was no VA Compensation and Pension (C&P) evaluation proximate to separation in evidence.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right foot condition 10%, coded 5284 (foot injuries, other), citing fracture requiring surgery with intermittent 3/10 pain.  The VA rated the right foot condition 0% analogously coded 5284, based on the STR, citing a non-compensable evaluation assigned in the absence of moderate symptoms.  All panel members agreed the foot injury was no more than moderate, therefore supporting the 10% rating adjudicated by the PEB (5284).  A higher rating of 20% was not indicated in the absence of moderately severe symptoms coded 5284.  All panel members agreed there was a limitation of motion no more than moderate supporting the 10% rating (5271).  However, the panel agreed that the foot injury, and the decreased foot dorsiflexion were diagnoses related to the foot pain and were not separate conditions which could be separately rated IAW §4.14 (avoidance of pyramiding; more than one rating based on the same impairment is prohibited).  A higher rating of 20% was not indicated in the absence of marked limited ROM of the ankle coded 5271.  There was no ankle ankylosis to support a rating coded 5270.  The panel considered alternative VASRD ankle and analogous codes, but all were less applicable and not advantageous to rating.  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 chronic 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 20150630, w/attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170010011, 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,