RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXX		CASE: PD-2016-00045 BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20070803

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Automated Logistical Specialist, medically separated for “bilateral pes planus” with a disability rating of 10%.

CI CONTENTION: The CI made no specific contention. 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 - 20070628		VARD - 20080207	
Condition	Code	Rating		Condition	Code	Rating	Exam	
Bilateral Pes Planus	5299-5276	10%		Bilateral Pes Planus with Plantar Fasciitis	5278-5276	10%	20071130	
COMBINED RATING: 10%		COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Bilateral Pes Planus. According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s bilateral pes planus condition began in March 2006 with no specific trauma. There was no indication for surgery and the CI failed conservative therapy.

During the 22 January 2007 MEB examination (recorded on DD Forms 2807-1 and 2808), 6 months prior to separation, the CI reported bilateral foot pain with use of orthotics. Physical examination showed symptomatic pes planus of both feet, with the left at moderate and the right at mild.  The soles of both feet were tender.  The 4 April 2007 MEB NARSUM examination, 4 months prior to separation, noted complaints of bilateral foot pain. The CI reported pain “after

ten minutes of standing and becoming severe shortly thereafter and reporting toe numbness that starts after about 20 minutes of standing.” She was able to walk for 20-30 minutes before symptoms became unbearable. X-rays showed mild hammer toes of all digits except for the great toe on both feet. Physical examination showed flat feet and cited the MEB examination above.

At the 30 November 2007 VA Compensation and Pension (C&P) evaluation, 4 months after separation, the CI reported constant mild pain of both feet without relief with orthotics. Physical examination showed a normal gait with normal range of motion of all toes without decrease on repetition. There was no evidence of edema or instability. There was “mild pain on manipulation or mild tenderness” on the mid-third plantar aspect of both feet; with no evidence of callus formation of the feet and no unusual shoe pattern wear. There was flat feet bilaterally with the Achilles tendon being mid-line. The examiner diagnosed “bilateral pes planus or flat feet with plantar fasciitis both feet mildly active at the time of the examination.”

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the bilateral pes planus condition 10%, coded analogously as 5299-5276 (acquired flatfoot), citing mild tenderness. The VA also rated the bilateral pes planus condition 10%, dual coded as 5278-5276 (acquired claw foot [pes cavus]-flatfoot), and acquired flatfoot), based on the C&P examination 4 months after separation, citing pain on manipulation and use of [the CI’s] feet.

The panel adjudged there was no documented clawing or limitation of dorsiflexion of either great toe, or marked tenderness under the metatarsal heads for any higher rating under code 5278; no severe pes planus symptoms, marked deformity, or characteristic callosities for any higher rating under code 5276; and no moderate muscle disability for either foot for any higher rating analogous to 5310 (group X muscle function). 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 bilateral pes planus condition.

BOARD FINDINGS: In the matter of the bilateral pes planus condition and IAW VASRD §4.71a, 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 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 20160125, w/atchs Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans Affairs Treatment Record

AR20170013205, 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,