RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00595
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040105

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Infantryman, medically separated for “plantar fasciitis, left foot” with a disability rating of 0%.    

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 - 20031105	VARD - 20091009	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Plantar Fasciitis, Left Foot	5399-5310	0%	Plantar Fasciitis, Left Foot, Post First Metatarsal Osteotomy	5280-5279	10%	STR	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Plantar Fasciitis, Left Foot.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI began service on 18 May 2001 and was evaluated in podiatry on 8 February 2002 for left foot pain from a bunion refractory to a change in shoe size, duty limitations, and heat.  The CI had greater than a 3-year history in the operative report dated 25 March 2002 for the left sided bunionectomy.  He was rehabilitated after surgery and treatment included a short leg cast and the use of crutches for non-weight bearing for 4 weeks.  However, he remained symptomatic and had revision surgery on 3 February 2003.    

The MEB NARSUM examination was dated 23 July 2003, 5 months prior to separation.  The CI reported ongoing difficulty with prolonged walking and prolonged wear of military footwear. There was no crepitus and no limitation in motion.  He could single heel rise without significant discomfort.  X-rays showed that the repair was well healed.  Tenderness of the plantar fascia developed after the second operation.  This was consistent with chronic plantar fasciitis for which the CI had been treated with orthotics, night splints, a walker, and injections, but without benefit.  Mild discomfort was noted with palpation on examination.  The gait was not recorded.  

At the MEB examination (recorded on DD Forms 2807-1 and 2808) dated 9 September 2003, 4 months prior to separation, the CI reported complications from the two operations but did not elaborate.  The examiner noted that the range of motion was reduced, but did not quantify this.  The plantar arch was also tender to palpation.  There was not a VA Compensation and Pension evaluation in evidence proximate to separation.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the plantar fasciitis left foot condition 0%, coded 5399-5310 (muscle injuries, group X; this includes the plantar fascia), rated as slight.  The VA rated the plantar fasciitis left foot, status post first metatarsal osteotomy 10%, analogously coded 5280-5279 (metatarsalgia, unilateral, or bilateral) based on the STR.  The panel considered the evidence.  The CI was treated for plantar fasciitis with multiple modalities.  Tenderness was present.  The CI was limited in how far he could walk or the prolonged use of military footwear.  The panel determined that this was more consistent with a moderate level of impairment than slight.  A 10% rating is supported under by the code 5310.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the left foot plantar fasciitis condition, coded 5310.  

BOARD FINDINGS:  In the matter of the plantar fasciitis condition, the panel unanimously recommends a disability rating of 10%, coded 5310, IAW VASRD §4.73.  There are no other conditions within the panel’s scope of review for consideration.  

The panel recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Plantar Fasciitis, Left Foot	5399-5310	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160912, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170015817, XXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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. 

	A copy of this decision has also been provided to the Department of Veterans Affairs.

Sincerely,	
Enclosure